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#WWBR Week of January 26, 2015

by John Moore lll | January 30, 2015

Setting Value-Based Payment Goals — HHS Efforts to Improve U.S. Health Care
Secretary Sylvia M. Burwell for NEJM
“Straight from the NEJM, Sec. Burwell’s outline of what CMS announced this week regarding accelerated move to VBR. Long on vision, short on details, this appears to be a politically motivated action to further embed ACA into healthcare making it that much harder to extract should the presidency change parties in 2016.” – John

CMS To Add More Flexibility to Meaningful Use in 2015
“CMS finally added a bit more flexibility and shortened the reporting periods but this strikes as being ‘too little, too late’ to really move the needle for eligible providers. While hospitals continue to do well with attesting to MU2, the most recent numbers of eligible providers who have successfully attested is still lagging badly. At this point, it doesn’t appear that even the modest ONC goal of having around ~45 percent of eligible providers successfully attest for MU2 appears unreachable.” – Matt

Telepsychiatry: the New Frontier in Mental Health
Kristine Crane for USNews
“Some small but steady progress is being made in the adoption of psychiatric telehealth consultations. This article offers up a high level synopsis of South Carolina’s pilot efforts (which save $1400 per episode of care and lead to higher follow up visit participation). While this article focuses mainly on the benefits for rural telehealth scenarios, we see telepsychiatry as a huge opportunity in more urban settings as well. Part of it has to do with the nature of the health conditions involved, and part of it with the broader shift towards on-demand, consumer-driven models of care. Either way – encouraging signs for this model.” – Naveen

Post-acute Care: Trends in Medicare’s Payments Across Sectors and Ways to Rationalize Payments
Carol Carter, Evan Christman, and Dana Kelly for MedPAC
“This presentation from Medpac outlines the trends that accompany the rising utilization of post-acute care (PAC) in the last decade and a half. Rationalizing the payment system for PAC will be difficult for a set of reasons. Whether patient are discharged to IRF or SNF has dramatic cost consequences even though a patient’s care needs may be identical either way. This outlines some of the options for site-neutral payments.” – Brian

Google, Biogen Seek Reasons for Advance of Multiple Sclerosis
Caroline Chen for Bloomberg
“GoogleX announces its second foray into healthcare through a partnership with Biogen, by which they will study patients diagnosed with Multiple Sclerosis. The goal of the partnership is not directly tied to creating new drugs, but rather to use novel data sources – derived through applications of hardware and software – to get a better understanding of the disease itself, and why it varies from patient to patient. Biogen has dabbled with Fitbits and iPads before – but this partnership seems to focus more on data analysis than capture.” – Naveen

Can This Treatment Help Me? There’s a Statistic for That
Austin Frakt and Aaron E. Carroll for The New York Times
“A really good review of the ‘N.N.T.’ (Number Needed to Treat) concept by Austin Frakt and Aaron Carroll in the NY Times. In the wake of President Obama’s State of the Union speech last week, there has been a lot of talk about ‘precision medicine’ which has several areas including more ‘sexy’ topics like genomics-tailored therapies for individual patients. The article explains the origin & provides an overview of N.N.T., provides several illustrative examples and makes a compelling point about more work being done on this topic would provide value in the interim towards moving genomics-tailored therapies. Not only would it help to make better policy recommendations on recommended treatment but educating patients and reporters who cover medical treatments on this topic would go a long way to helping them better understand the risk and rewards of various medical treatments.” – Matt

’60 Minutes’ Just Called Obamacare A Disaster. Here’s What They Didn’t Tell You
Dan Diamond for Forbes
“A lucidly written piece by Dan that patiently rebuts some of the fiery criticism of the Affordable Care Act to date, most notably those arguments made by Stephen Brill in his new book. Worth a quick scan, if only for nice nuggets like this one: “And as economist Austin Frakt points out — because lawmakers deftly got the ACA passed, now they can steadily start pressuring the industry. “To make eventual losers feel like winners, you’ve got to go slow,” Frakt astutely cautioned in the law’s early days. ‘To do otherwise spells immediate political failure.'” – Naveen

Under siege from storm, hospitals get creative
Kay Lazar for The Boston Globe
“It may have been ”snowmageddon” here in Boston this week but healthcare never stops or even slows down. Babies were born, surgeries went off without a hitch, and hospital discharge rates remained as they always are. The Globe describes how hospital employees shoveled the walks of discharged patients which I am pretty sure is not reimbursable under IPPS or any other plan. No healthcare story would be complete without an element of payment dysfunction and this article does not disappoint with the tale of couple with a newborn whose payer wanted to discharge them into the height of Tuesday night’s blizzard.” – Brian

Community Factors and Hospital Readmission Rates
Jeph Herrin, et al in Health Services Research
“According to a new report from the Health Research and Educational Trust, community factors play a key role in a hospital’s readmission rates. The research found 58 percent of national variation in hospital readmission rates from 2007-2010 could be explained by the county in which the hospital was located. Specifically, a community’s access to primary care and high-quality nursing home care showed as one of the strongest correlations to a hospital’s readmission trends.

This is just another research study that shows that hospitals’s ‘scope of control’ to adequately address and control their readmissions rate is somewhat limited regardless of what they initiatives they put in place. While the readmissions program is a worthwhile endeavor, the program needs to be readjusted to better reflect what hospitals can control and the populations that that they serve to better reflect the performance of what hospitals can actually control.” – Matt

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