Posts in Category: President Barack Obama

Parts of Obama's Healthcare Legacy Will Likely Continue Under Trump 

President-elect cites popular provisions he'd like to keep

As the dust settles after the presidential election, it appears that Donald Trump is already softening some of his positions, especially his position on Obamacare. Media outlets have speculated that President Obama pushed hard for the continuance of his signature healthcare program when he met with Trump at the White House following the election.

During the presidential campaign, Trump disparaged the Affordable Care Act and called for its repeal, although he didn't spell out what he would put in its place. A wholesale repeal of the ACA could leave as many as 22 million people without health insurance--a prospect that industry insiders consider unlikely.

Healthcare attorney Michael P. Strazzella told FierceHealthcare that Trump will focus on the ACA on the first day of his presidency, but that he doesn't expect anything dramatic to happen immediately. (Strazzella is co-head of Buchanan, Ingersoll & Rooney's District of Columbia office.)

"Repeal is good campaign language, but it's a 2,000-plus page bill and not everything can be repealed," Strazzella pointed out. To actually repeal all of Obamacare would require a 60-vote Senate supermajority, which Trump could not get unless some Democrats crossed party lines.
Other factors to consider:

  • The Republican Party is far from united under Trump, whom some GOP leaders have distanced themselves from, so the new president may not be able to count on the party's backing his every move.
  • Republicans may be wary of taking away well-liked provisions of Obamacare, especially if that doesn't play well with their constituencies.
  • The ACA's mandate that patients must not be denied coverage due to pre-existing conditions is very popular with voters, as is the act's provision for young people to be kept on their parents' insurance plans till age 26.*

What other aspects of healthcare might change under the Trump presidency? The future of pilot programs such as the Accountable Care Organizations under the Medicare Shared Savings Programs--like so many other Obama administration healthcare provisions--is murky. But many in the healthcare industry maintain that value-based care is here to stay. 

The credit ratings and research company Fitch Ratings issued this prediction: "The shift toward linking pricing to patient outcomes will continue as patients and health insurers grapple with the growing burden of healthcare costs over the longer term." 

*UPDATE: Trump recently told "60 Minutes" that he is in favor of keeping at least two provisions of Obamacare: the requirement that insurance companies accept patients with pre-existing conditions, and the provision that allows young adults to stay on their parents' health insurance plans until they reach the age of 26. He also signaled that he would not end Obamacare without having some other program in place.

Will the election of Trump impact your organization? Share your thoughts in our comment section below.

The Best of Cardio and Health IT News: Week of 3/7/16 

Readmissions, Obamacare, and more

CMS targets hospital readmissions after CABG 

A proposed rule from the Centers for Medicare & Medicaid Services (CMS) would penalize hospitals that perform an index coronary artery bypass graft (CABG) and then have an unexpected 30-day readmission, even if the patient was discharged from a different hospital. "The proposed CABG 30-day readmission measure includes Medicare beneficiaries who are 65 years old or older who at the time of the index admission had been enrolled in a Medicare fee-for-service program for at least 12 months," Cardiovascular Business reports. "CMS intends to add CABG to its readmissions reduction program in 2017."

Most support keeping, building on Obamacare

The Affordable Care Act (Obamacare) continues to have public support, with 36 percent of those surveyed saying it should be expanded, according to the latest Kaiser Health Tracking Poll. That's the position advocated by presidential candidate and former Secretary of State Hillary Clinton. Nearly a quarter of respondents would like to see a single government plan, as advocated by Vermont Sen. Bernie Sanders, while 16 percent would repeal the ACA and not replace it. Repealing the act and replacing it with a Republican alternative was favored by 13% of respondents.

Analysis: U.S. health spending wouldn't be substantially decreased by price transparency

"Menu-izing the costs of care doesn’t turn the average American into a skilled healthcare shopper, but don’t blame the consumer," says Health Exec. "While some 43 percent of U.S. healthcare spending does indeed go into 'shoppable,' non-emergent care—everything from flu shots and blood tests to colonoscopies and electively timed surgeries—only around 7 percent of out-of-pocket spending goes to such services. The result, according to a new analysis from the Health Care Cost Institute, is that the healthcare system as a whole wrings little cost benefit out of the push for price transparency."

Cardiovascular risk increases with heavy alcohol consumption

Drinking alcohol is associated with higher cardiovascular risk immediately after consumption, according to systematic review and meta-analysis. "After 24 hours, there was a lower risk for moderate drinkers," Cardiovascular Business reports. "But the risk increased in heavy drinkers for the following day and week."

Major markets could see mega-regional healthcare systems

Consolidation is a trend expected to continue in the healthcare industry, according to Fierce Healthcare. The trend, with increased leverage and revenues, has led to the creation of super-regional system in several large markets. "In Chicago, consolidation reached a crescendo in 2014 when fully integrated health system Northwestern Memorial HealthCare and Winfield, Illinois' Cadence Health finalized a merger, with Northwestern expanding to include four hospitals under the deal," reported Becker's Hospital Review. Since then, Northwestern has expanded its reach, finalizing a deal with KishHealth in Dekalb, Illinois. The system now boasts six hospitals and more than 4,000 workers.

This Week in Cardio and Health IT News 

EHR developments, top hospitals list, and more

Here are some of this week's top stories in cardiology and health IT.

Big names in healthcare pledge to facilitate interoperability, EHR accessibility

The Obama administration has announced an agreement to increase interoperability by top U.S. health information technology developers and many of their larger customers. Signing on to the pledge--which requires signees to ease patient access to electronic health records--were Allscripts, Athenahealth, and Cerner Corp., among others. About 90 percent of U.S. hospitals use at least one of the vendors who signed on. 

Top 100 Hospital List released by Truven

Truven Health Analytics has released its list of the 100 top hospitals in the United States. In researching the hospitals, Truven discovered a trend toward reduced expense per patient among the majority of top-performing hospitals. This year's trend appeared for the first time in the awards' 23-year history. 

More patients survive when hospitals adhere to cardiac arrest protocol

Hospitals that closely followed recommended care protocols after in-hospital cardiac arrest (IHCA) had the highest survival rates. That's the conclusion of a new study published in JAMA Cardiology, which found that more than 24,000 lives could be saved annually if all hospitals operated at the level of the highest-scoring provider. 

Payer-provider collaborations called key to improved patient outcomes 

Payers and hospitals must overcome their differences to reduce readmissions, according to a special report by FierceHealthcare.com. "As providers increasingly move toward value-based care models, they must work with their counterparts in the payer sector to coordinate care and prevent readmissions," the report says. "But the transition is proving bumpy in some cases due in part to the historic mistrust between payers and providers."

Questioning whether readmission rates are a reliable care quality measure

Hospital readmission rates are not an outcome, but a measure of utilization, says one Harvard School of Public Health professor. He pointed to new federal research demonstrating that hospitals don't use observation status as a way to create the appearance of decreased readmissions, which had been a concern prior to the research. Readmission rates can decline for a number of reasons, including difficulty in being readmitted or better hospital-to-patient communication, he says.

The Best of Cardio and Health IT News: Week of 2/22/16 

Security breach, telehealth, and Obamacare

LUMEDX does the research for you! Here are some of the top stories in healthcare this week.

Security: Hospital pays ransom to get its data back from hackers

Security experts are concerned that a Southern California hospital paid a $17,000 ransom in bitcoins to hackers who infiltrated and disabled its network, saying that agreeing to the ransomers' demands could set a bad precedent. The hackers had encrypted the hospital's computer network and demanded the ransom to provide a digital decryption key to unlock it.

Healthcare could be major issue in presidential race

The future of U.S. healthcare--especially Obamacare, Medicare, and Medicaid--will be determined in this year's presidential election, and the candidates are offering starkly different visions. Democrat Hillary Clinton would uphold and expand the Affordable Health Act, while her primary opponent, Bernie Sanders, would replace it with a single-payer system. Republican Donald Trump expressed support for some facets of the ACA, while Republican Sens. Marco Rubio and Ted Cruz vow to end it.

51 hospitals settle with Justice Department in ICD case

The Department of Justice has reached settlements with 51 hospitals that allegedly improperly implanted implantable cardioverter defibrillators (ICDs) in Medicare patients. The department said it had reached settlements worth a total of more than $23 million with hospitals in 15 states for allegedly improperly implanting the cardiac devices.

Forbes blogger predicts expansion of concierge healthcare model

An opinion piece in  Forbes suggests that hospitals should consider offering concierge healthcare. The concierge model could help financially struggling providers by making them more attractive to wealthier patients who will pay for expedited access to high-caliber physician talent.

Experts call Zika 'the scariest virus since HIV'

As experts learn more about the mosquito-borne Zika virus, they are becoming more alarmed. The American Council on Science and Health referred to Zika as  "possibly the scariest virus since HIV" because it is carried by hard-to-escape mosquitoes and causes serious birth defects.

The Best of HealthIT News: Week of 2/8/16  

Population health, Obamacare, and cost containment

Did you have a chance to check out the latest news from the healthIT community? Let us help keep you up to date on the stories you won't want to miss.

Companies Form New Alliance to Target Healthcare Costs

Hoping to hold down the cost of healthcare benefits, 20 large companies—including American Express, Macy’s  and Verizon—have come together to use their collective data and market power. Members of the new alliance will share data about employee healthcare spending and outcomes, possibly using the data to change how they contract for care. "Some members say they could even form a purchasing cooperative to negotiate for lower prices, or try to change their relationships with insurance administrators and drug-benefit managers," Yahoo news reports.

Federal Insurance Marketplace Signs Up Millions of New Obamacare Users

The Obama administration reports that approximately 12.7 million new patients signed up for health insurance under the Affordable Care Act, or automatically renewed their policies during Obamacare's third annual open enrollment season. Sylvia Mathews Burwell, the secretary of the Department of Health and Human Services, told the New York Times that the signups show that “marketplace coverage is a product people want and need.” Most of the plan selections were for people in the 38 states—more than 9.6 million—who used the federal website, HealthCare.gov, the Times reported. The other 3.1 million people were enrolled in states that run their own marketplaces.

Healthcare Economics: Court Allows Some Hospitals to Save Money by Classifying Themselves as Both Rural and Urban

While an earlier Health and Human Services (HHS) rule had barred both urban and rural classifications at once, a new federal appeals court ruling removed the barrier for dual hospital classification. The recent court decision applies only to hospitals within the 2nd U.S. Circuit Court of Appeals, but some hope that—combined with an earlier similar decision in a different circuit—the 2nd Circuit Court's ruling will inspire HHS to change the regulation across the country. "The Center for Medicare & Medicaid Services allows hospitals to classify themselves as rural (which providers typically leverage for discounts on drug purchases) while also classifying themselves as urban, (an important factor to attract qualified clinicians)," according to Reuters. 

Population Health: Hospital-based Wellness Centers Are Changing the Healthcare Model

Wellness centers housed in hospitals are helping communities prioritize preventive care and management of chronic conditions. The centers are part of the population health management model that focuses on preventing illnesses rather than simply treating them when and if they occur. The idea is to get patients to seek treatment before their conditions worsen, thus easing the burden on emergency rooms and acute care centers—and saving money.

Cost Control: Surgical Safety Checklists Can Save Lives and Reduce Hospital Stays

Surgical safety checklists—if implemented correctly—can save time, lives, and money. After the checklists were implemented, one study found, the average length of a hospital stay dropped from 10.4 days to 9.6 days. In addition, the checklists led to a 27 percent drop in the risk of death following surgery. Proper and consistent implementation is critical, however, for the checklists to work.

The Best of Cardio and Healthcare News for the Week of 2/1/16 

Trending topics in HealthIT

Leave the researching to us! LUMEDX surveys the top healthcare and health IT stories of the week.

Healthcare economics: Basing healthcare decisions on Medicare data might not be best practice

A recent study found that the correlation between total spending per Medicare beneficiary and total spending per privately insured beneficiary was 0.14 in 2011, while the correlation for inpatient spending was 0.267. “What that suggests is that policy for Medicare doesn’t necessarily make better policy for the privately insured,” one researcher told Health Exec.

Reducing readmissions among minorities: 7 population health strategies

A new guide from Medicare gives hospitals methods for addressing ethnic and racial healthcare disparities in readmissions. The guide comes amid increasing concerns about racial and ethnic disparities in healthcare outcomes, and frustration about federal penalties that some say unfairly punish providers in high-risk communities. 

Sharing of medical-claim data would be allowed under proposed #CMS rule

"Some medical data miners may soon be allowed to share and sell Medicare and private-sector medical-claims data, as well as analyses of that data, under proposed regulations the CMS issued," Modern Healthcare reports. "Quality improvement organizations and other 'qualified entities' would be granted permission to perform data analytics work and share it with, or sell it, to others, under an 86-page proposed rule that carries out a provision of the Medicare Access and CHIP Reauthorization Act of 2015" (#MACRA). 

Federal gender pay equity rule: What will it mean for healthcare industry?

Nearly 80 percent of hospital employees are women. How might they be affected by President Obama's recent announcement that the Equal Employment Opportunity Commission will begin requiring companies that employ 100 or more people to report wage information that includes gender, race, and ethnicity?

The price of healthcare miscommunication: $1.7B and nearly 2,000 lives

New research shows that healthcare miscommunication has cost nearly 2,000 lives, and was a contributing  factor in 7,149 cases (30 percent) of 23,000 medical malpractice claims filed between 2009 and 2013. Communication failures were also to blame for 37 percent of all high-severity injury cases.

Physical fitness can decrease mortality risk following first heart attack

Being physically fit may not only help to reduce the risk of heart attacks, but may also decrease the risk of mortality following a first heart attack, according to a new study. The study used multivariable logistic regression models to assess how exercise affected the risk of mortality at 28, 90, and 365 days after a heart attack.

 

Best of Cardio and Healthcare News: Week of 11/23/15  

Did you have a chance to check out the latest news from the cardiology community? We've captured the top industry stories from this week that you won't want to miss.

After Obamacare implementation, public still rates healthcare good or excellent

Implementation of the Affordable Care Act (AKA Obamacare) hasn’t changed how Americans rate their healthcare, according to a new Gallup poll. More than half of the respondents rated their healthcare good or excellent, but less than 24 percent were satisfied with healthcare costs. Healthcare coverage was rated positively by only 33 percent.

Diagnostic ECG waveform reading in Carestream Vue Motion viewer cleared by FDA

The U.S. Food and Drug Administration (FDA) has given clearance for diagnostic reading of electrocardiogram (ECG) waveforms on mobile tablets and desktop displays using Carestream’s Vue Motion universal viewer. The new capability would allow physicians to give faster responses to ST segment elevation myocardial infarction (STEMI) and other serious heart conditions. It would also allow physicians to simultaneously view current and prior ECGs using tools that include pan, zoom, line measurement, caliper, and gain and speed adjustments.

Cardiac outcomes improved after using intravascular ultrasound in stent implantation

After one year, patients with long coronary lesions who were implanted with an intravascular ultrasound-guided everolimus-eluting stent had a significantly lower rate of major adverse cardiac events compared with those implanted with an angiography-guided stent, according to cardiovascularbusiness.com. “Patients were implanted with an everolimus-eluting stent (Xience prime, Abbott Vascular) for long coronary lesions and randomized to receive intravascular ultrasound-guided or angiographic-guided stent implantation immediately after their pre-PCI angiogram,” the site reports. One year later, 2.9 percent of patients undergoing intravascular ultrasound-guided stent implantation suffered major adverse cardiac events, compared with 5.8 percent of patients in the angiographic-guided group.

Cardio-diagnostic processes improve with smart ECG stethoscope attachment

Rijuven’s CardioSleeve for Pediatrics, the first device that adds electrocardiogram (ECG) capabilities to transform stethoscopes into smart, mobile-connected devices, has been cleared by the FDA. The device, which can be attached to any stethoscope, can analyze for arrhythmia or murmur and identify heart failure. 

Number and severity of migraine headaches reduced by dual antiplatelet therapy following transcatheter ASD closure

The use of dual antiplatelet therapy consisting of clopidogrel and aspirin–as opposed to aspirin alone–led to fewer and less severe migraine headaches for patients undergoing transcatheter atrial septal defect (ASD) closure. That’s according to a randomized, double-blind trial. About 15 percent of patients had new-onset migraine episodes following transcatheter ASD closure, previous studies found. 

Remote monitoring system for patients with implantable pacemakers gets FDA approval

The first app-based remote monitoring system in the U.S. for patients with implantable pacemakers–called MyCareLink Smart Monitor–was approved by the FDA on Nov. 17. The system, manufactured by Medtronic, has a mobile app that is available for free on Android and Apple platforms. It also features a handheld portable device reader.

National Health IT Week: Joining the Conversation 

This week we are celebrating the ninth year of National Health IT Week – a collaboration between healthcare providers, government agencies, payers, research foundations, and healthcare IT vendors designed to raise awareness about the growing role of technology in healthcare. 

Because healthcare in this country is currently undergoing many changes, all of us in the industry need to work together to advance technology that can reduce costs while improving care.

Our National Health IT Week blog topics are:

  • Tuesday, Sept. 16: Learn about why data analytics is a growing segment of the healthcare technology industry, and how providers can use analytics to monitor performance and drive quality improvement initiatives
  • Wednesday, Sept. 17: Prepare for the new ICD-10 compliance date with information about documentation changes that will impact cardiology departments
  • Thursday, Sept. 18: Read about how The Christ Hospital Health Network is using technology to support quality improvement initiatives

And on Twitter:

  • Friday, Sept. 19: Patrick Cambas, Vice President of Consulting and Strategic Services at LUMEDX, will weigh in during the @HIMSS Twitter Chat on September 19, 9am PT/11am CT/Noon ET. The discussion will focus on successes, pain points, and the future of defining and realizing health IT value. Join us on Twitter @LUMEDX

Best of Health IT News: Week of 12/19/13 

Did you have a chance to check out the latest healthcare IT news stories around the Web? We’ve captured the top industry news stories from this week that you won’t want to miss. 

My Favorite Health IT Quotes of 2013 

Healthcare Informatics Contributing Editor David Raths compiles a list of his favorite moments in healthcare IT in 2013. One favorite quote was Farzad Mostashari's statement that "...Our longer term vision is that every healthcare interaction benefits from all the world's knowledge." 

Healthcare analytics market growth to skyrocket

FierceHealthIT reports on a new report from MarketsandMarkets that projects that the global healthcare analytics market will be worth more than $21 billion by 2020. Federal mandates, technological advances, increased healthcare IT adoption, and venture capital investments are cited as strong market drivers.

Continued Troubles with Healthcare.gov May Drive Up Costs

CBS reports that the problems with the Healthcare.gov website may lead to higher prices for many Americans if the technical problems deter young people from signing up. Enrollment continues to lag behind in projections, and more younger, healthier customers are needed in order to address an age imbalance. 

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