October 4th Health Exec Briefing

Top Stories

Harken, experiment of UnitedHealthcare, dumps ACA
Start-up insurer that began as an experimental subsidiary of UnitedHealthcare, Harken Health, recently announced its pulling out of ACA markets in Chicago and Atlanta for 2017. Harken’s experiment offered free, unlimited primary care and behavioral visits at its own staff-run clinics. Although Harken did not discuss the specific details around its departure, it struggled financially like many other insurers, losing nearly $70 million during the first six months of 2016.
(Healthcare Dive, October 3)

Demand for RCM outsourcing on the rise, according to physician survey
According to a Black Book RCM survey, 2,000 independent physician practices and 200 hospital-based physician practices showed traditional patient billing solutions continue to negatively impact profit margins. Rising healthcare expenditures and the complex technology to succeed under value-based care is creating the urgent demand for cost-effective, technically advanced business office outsourcing solutions in physician practices across the country.
(Becker’s Hospital CFO, September 30)

What’s New in Healthcare

Aetna touts social support as next step to advance health
A new study funded by Aetna Foundation supports the company’s position on attacking chronic disease through community projects that support healthy lifestyles. The timing of the platform announcement ties in with the presidential election, as Aetna takes advantage of the forward momentum to position its new focus as one to embrace with whatever refreshed take on healthcare reform comes with new administration in 2017.
(Healthcare Dive, September 28)

CMS Names Awardees of $5M Grant to Aid MACRA Implementation
The three-year award will be used to help primary and specialist care providers adopt Alternative Payment Models that will further the healthcare industry’s value-based care transition. During the first year of the award, Virginia Cardiac Services Quality Initiative and the American Psychological Association will receive $670,673 and $723,600 respectively.
(Health IT Analytics, October 3)

Healthcare Innovations

Children’s Mercy Hospital, Idaho company pair up to improve rural telemedicine
Idaho-based Cradlepoint will improve the hospital’s ability to diagnose patients remotely, allowing secure internet access for a portable telemedicine network in rural areas. Children’s Mercy Hospital’s director of telemedicine Morgan Waller expresses her excitement for the new partnership and how it will be able to connect patients and providers with their organizations.
(Becker’s Health IT & CIO Review, September 28)

Big Data: Healthcare must move beyond the hype
Assistant professor at Harvard Medical School Leonard D’Avolio explains how good design and application of technology are essential to developing new technologies such as big data in healthcare. “New technology evolution starts with a peak of inflated expectations, then hits a trough of disillusionment, then a slope of enlightenment, and finally a plateau of productivity,” states D’Avolio.
(Healthcare IT News, September 28)

Jeff Myers: Medicaid-like plans, value-based drug pricing is key to cost control
Top-performing ACA exchange products have solved the question of how to offer low-cost, high-value medical services according to Medicaid Health Plans of America CEO Jeff Myers. Negotiating with pharmaceutical companies to pay for drugs on a value-based model would be the next step to control costs.
(Fierce Healthcare, September 28)

Innovation in payment for chronic disease management will have more impact on US health than all other healthcare innovations
Finding new ways of paying for chronic care management can have a huge impact on the health of U.S. residents. As a nation, more than 75% of our healthcare spending is on people with chronic conditions, and seven out of 10 deaths each year are from chronic diseases. Read about high-value care and how primary care physicians can push back health spending and improve the overall health of patients.
(Becker’s Hospital Review, September 29)


Patient Engagement News

Power patient engagement with technology: 10 tips for enhancing care by empowering and educating patients
Research shows smart patient engagement strategies can also lower costs and improve health outcomes. Read about the various ways organizations can combine healthcare technology and patient interaction at home and in the office.
(Healthcare IT News, September 29)

CRM is the new RCM: How strategic customer relationship management helps hospitals increase revenue and grow market share
Hospitals and health systems are looking to customer relationship management platforms to achieve financial success due to the transition from traditional fee-for-service care to fee-for-value care. Healthcare organizations are losing predictable revenue streams as they try to keep patients out of the hospital. Read about how different platforms are helping organizations acquire new patients.
(Becker’s Hospital CFO, October 3)

Demonstrating Value Key to Consumer-Centered Healthcare
In order to survive a changing financial landscape, providers will need to deliver consumer-centered healthcare and demonstrate their value-based care efforts. The Healthcare Financial Management Association defines consumerism as “a trend that reflects the growing importance of consumer choice in the healthcare marketplace.”
(Patient Engagement HIT, September 28)

EHR News

Researchers tap Mayo, Christiana Care EHR data to fight sepsis
Delayed diagnosis and treatment of sepsis have made it one of the most deadly and costly medical conditions confronting U.S. hospitals, with more than 1 million cases each years. Funded by the National Science Foundation, this research project is a collaborative effort with the Mayo Clinic in Minnesota and Christiana Care Health System in Delaware.
(Health Data Management, September 29)

CMS Reviews Clinical Quality Measure Reporting Options in 2016
Eligible professionals, eligible hospitals, and critical access hospitals all have several reporting options for clinical quality measures in 2016. Eligible professionals must submit nine out of the possible 64 measures with at least three covering patient and family engagement, patient safety, care coordination, population/public health, efficient use of healthcare resources, and clinical process/effectiveness.
(EHR Intelligence, September 28)

How Strong EHR Contracts Can Improve EHR Replacement Projects
According to a recently released ONC Health IT Playbook, robust contract negotiations may lead to more successful EHR replacement projects which are usually more complicated than buying and installing a new software. ONC states that, “Switching EHRs can present a range of operational and clinical risks and require considerable planning on the part of the healthcare organization.
(EHR Intelligence, September 28)

Health Security and Analytics

5 mistakes that can kill analytics projects
According to co-founder and COO at CB/I Digital, Mike Le, implementing an effective digital analytics strategy has proven to be very challenging for many organizations. Learning to avoid common analytics mistakes will help save a lot of resources to focus on core metrics and factors that can drive businesses ahead. Read about the importance of establishing goals and focusing on core metrics when working with analytics projects.
(Health Data Management, September 29)

Chief Nurse Informaticists Tackle EHRs, Big Data Analytics
Nurses are often the heaviest users of EHRs and are frequently tasked with completing day-to-day population health management tasks, clinical quality reporting, and other IT projects. A strong clinical background often propels data-minded nurses to the forefront of technology optimization and implementation projects, while advanced academic degrees prepare them for the intricacies of complex healthcare data science projects.
(Health IT Analytics, September 28)