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#WWBR Week of September 29, 2014

by John Moore lll | October 03, 2014

Doctors Find Barriers to Sharing Digital Medical Records
Julie Creswell for The New York Times
“A non-technical overview at the issue of Interoperability, with a focus on everyone’s favorite bad-guy vendor, Epic Systems. Nothing we don’t already know, but some of the details – like Epic’s recent hiring of a DC lobbyist – show just how far down interoperability truly is on their list of priorities.” – Naveen
“Yet another article about interoperability or lack thereof across the healthcare landscape. All share the blame here, from EHR vendors desiring high switching costs, to providers looking for low cost solutions but with poor interop capabilities, to administrators not investing in user training and regulators that did not make this a primary requirement from the beginning of the MU cycle. It will take years to sort this one out.” – John
“When articles about healthcare interoperability impossibilities make into mainstream newspapers, I always pay attention. This one quickly turned into a critique of Epic and its ambitions re the DOD’s HIT revamp. While it focuses on Epic, it does point out that it is but one of the EHR vendors to benefit from $24 billion in EHR incentives. I am pretty sure that this kind of coverage does not really cut through the noise of routine political coverage and engage the average non-healthcare reader.” – Brian

What’s Behind the Slowdown in Health Care Costs
Kimberly Leonard for US News
“A look ahead at future healthcare costs finds that the silver tsunami that many feared would completely crash the US economy, may not be so bad after all. What is surprising in this analysis is that the mix of spending remains constant.” – John

Changing my mind on SES Risk Adjustment
Ashish Jha An Ounce of Evidence (blog)
“Harvard professor, Ashish Jha, has a change of heart regarding the use of SES (social economic status) data for calculating readmission scores and subsequently penalties. A more nuanced topic than what appears at first blush.” – John
“A worthwhile read about how introducing SES data into the risk adjustment process might play out. As analytics engines develop capabilities to layer in additional data, reimbursement based on that deeper context will become the next step. The issue there is how to strike a balance between penalizing hospitals for seeing poorer (and sicker) patients, versus getting them off the hook for delivering substandard care just because someone is poor. ” – Naveen

The Payment Reform Landscape: Value-Oriented Payment Jumps, And Yet…
Suzanne Delbanco for Health Affairs Blog (see also: Forbes article on VBR)
“Insight blog post by Suzanne Delbanco regarding the 2014 National Scorecard on Payment Reform survey by the Catalyst for Healthcare Payment Reform. Survey found a huge shift in ‘valued-based payments’ among commercial plans to ~40% but also noted some key limitations too including that less than half of this was really risk-based (downside risk) and most of the payment reform has focused on hospital payments. Delbanco also points out that ‘pay for performance’ programs both in the US and UK over the past decade have had very mixed results. The other issue that it is quite difficult to evaluate the effects of these payment reforms because the current infrastructure to report and collect quality and safety information based upon actual clinical data is insufficient and burdensome.” – Matt

Hospital Group Sees Diseases of Rich Spurring Health Spending
Choong En Han for Bloomberg
“While we may not be in position to export US-style healthcare, we are apparently exporting US-style health concerns. This translates into opportunity for providers operating in economies where affluence-related obesity and metabolic disorders are increasing and where infectious diseases and malnutrition still are common. The sick who can pay are a growing segment of the population. We can only hope that the ongoing transformation of our healthcare system can help us turn care protocols for these problems into a legitimate export.” – Brian

Set Your EHR Data Free
Arcadia Solutions Blog
“For many healthcare organizations, predictive analytics may still sound like science fiction. But this post shows a few examples of how mining existing EHR data before an actual diagnosis is made, as indicated by claims data, can unlock existing value that goes deeper than crunching CCDs.” – Naveen

CMS: 44,000 Have Applied for Hardship Exemption
Gabriel Perna for Healthcare Informatics
“Approximately 44,000 eligible providers (EPs) have applied for a meaningful use exemption, the CMS or roughly ~14% of the EPs who have registered. The exemption is for providers who will not attest to meaningful use in 2015. CMS is sorting through the applications and notifying each provider of their status. CMS stated the majority of exemption requests are coming from first-time attestations that are experiencing issues with their 2014 certified electronic health record technology (CEHRT).” – Matt

HCA: The Bashful Giant
Jeff Goldsmith for The Healthcare Blog
“This short blog does a quick and dirty compare of HCA’s market approach to the rest of the world. It concludes that HCA is doing just fine even though it has not embraced many of the changes to care and payment. Could HCA be right?” – Brian

Benefits innovation ‘stuck in neutral’
Andrea Davis for Employee Benefits News
“Keynote speaker from a Benefits conference this week in Florida noted that employer wellness programs have seen little innovation of the past decade. Noted that these programs consist of the same components including biometric screenings, health risk assessments, telephonic coaching based on the results of the screening and HRA, and participation-based incentives and that ‘one size does not fit all’ in regards to wellness programs.” – Matt


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