Posts in Category: healthcare reform

Registries play a role in MIPS reporting  

​MIPS, the Medicare physician reimbursement program set to begin in 2019, is causing healthcare providers to consider the use of registries, if they haven't already, as part of their workflow practices.

This Merit-Based Incentive Payment System, part of the Quality Payment Program (QPP) created under the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), directs clinicians to meaningfully use certified electronic health record (EHR) technology, according to the American College of Cardiology.

One effect of the regulations is the promotion of the use of registries to help clinicians manage the reporting of the EHRs. MIPS allocates five bonus points in its scoring mechanism to clinicians who are using registries. "An eligible clinician can earn bonus points by completing additional measures under the Public Health and Clinical Data Registry Reporting objective, such as reporting to a specialized registry (i.e., the PINNACLE Registry) or using certified EHR technology to complete certain activities in the Improvement Activities category, such as managing referrals and consultations," the American College of Cardiology reports.

It makes good sense to incentivize use of registries, says Raymond R. Russell, III, MD., Ph.D., because they can help physicians and their teams face a challenge to develop systems that help fulfill reporting requirements with minimal burden. "For many cardiologists, an effective, efficient approach to reporting quality measures data is to take advantage of the registries at our disposal," he writes in Cardiovascular Business.

Qualified Clinical Data Registries (QCDRs), allow clinicians to report on specialty-developed measures that are robust and uniquely geared to their area of practice, thus fulfilling CMS reporting requirements while closely tracking the quality of their practices.

"As the cardiovascular community moves forward with the new value-based models for performance evaluation and reimbursement, it will be essential to develop effective tools that support efficient completion of requirements," Russell suggests. "Some tools, such as registries, are proven and available to us now."

LUMEDX, as the leading independent provider of ACC and STS registry software, believes registries are the cornerstone ao cardiovascular data intelligence and the foundation of a true CVIS (Cardiovascular Information Systems). For more information, visit our Registries page: http://www.lumedx.com/registries.aspx.

LUMEDX webinar outlines the benefits of clinical data integration  

Orlando HealthHospital leaders can gain many advantages from aggregating financial, clinical and operational data to create dashboards that help them run their CV service line more effectively.

The LUMEDX webinar, "Improving Performance with Clinical Data Integration: How Orlando Health Used Dashboards to Better Manage its CV Service Line," will outline how to achieve these outcomes.

The complimentary webinar will take place Thursday, May 4, at 10 a.m. PT, 12 p.m. CT and 1 p.m. ET.

In this webinar, Rick Jones, RPH, Business Support Manager, Cardiovascular Service, Surgery and Pharmacy, Orlando Health, will outline how this comprehensive private, not-for-profit healthcare network in Florida is integrating data and making it available to decision-makers on a regular, refreshable basis to improve productivity, clinical and financial outcomes.

Click to Register

Cardiac Bundled-Payment Program to Go Forward Despite Change in Administration 

The bundled-payment program for cardiac care will go forward despite the Trump administration and the confirmation of new Health & Human Services Secretary Tom  Price, a critic of the program. July 1 remains the start date for the initiative, according to an HHS official who spoke to Modern Healthcare.

Under the bundled-payment model, hospitals in 98 designated markets can keep the savings they achieve if they spend less than the target price for a 90-day episode of care for bypass and heart attack patients. However, hospitals that exceed the target price must repay Medicare -- and Target prices will be determined retrospectively.

The HHS spokesman confirmed that the start of the initiative will not be slowed by the Trump administration, which previously had moved to delay the effective date for a rule that launched it. Nor does it appear that Price will stand in the way of its implementation.

Last fall, Price criticized bundled payments in a letter to then-President Obama. Price objected to the mandatory nature of the initiative, arguing that the Centers for Medicare & Medicaid had exceeded its authority and upset the balance of power between Congress and the president.

CMS predicts that the program--which also covers knee and hip replacement--will save the federal government as much as $159 million between now and 2021. In 2014, the CMS said, heart attack treatment for 200,000 patients cost Medicare more than $6 billion. 

From one hospital to another, the cost of treating heart attack patients varies by as much as 50 percent. Does your hospital have a plan to meet the target prices for bypass and heart attack patients? LUMEDX's Cardiovascular Performance Program can help. Click here to find out how. 

Are You Ready for the New Cardiac Bundled-Payment Program? 

Heart hospital across the country are preparing for the new mandatory bundled-payment program for cardiac care. Set to begin this July, the program makes hospitals in certain markets accountable for the quality and cost of care for bypass and heart attack patients until 90 days after discharge.

CMS predicts that the program-which also covers knee and hip replacements-will save the federal government as much as $159 million between now and 2021. In 2014, the CMS said, heart attack treatment for 200,000 patients cost Medicare more than $6 billion. From one hospital to another, the cost of treating heart attack patients varies by as much as 50 percent, according to Modern Healthcare.

The bundled-payment model allows hospitals to keep the savings they achieve if they spend less than a target price for an episode of care. However, hospitals that exceed the target price must repay Medicare. Target prices will be determined retrospectively.

LUMEDX offers a path to meeting or beating those targets. Our Cardiovascular Performance Program helps facilities gather the consolidated CV data they need to see and manage quality and cost of care in real time. The program helps CV service lines analyze their data, identify higher-risk patients and act to ensure they are performing at or better than national targets so they can keep any savings they have realized-and avoid repaying Medicare. 

Inpatient costs are likely to account for most of the cost of the 90-day bundled-payment period, and LUMEDX is uniquely positioned to help providers reduce those expenses. Our Cardiovascular Performance Program can help CV service lines contain costs while improving outcomes by reducing:

  • Door-to-balloon time
  • Door-to-Troponin-testing time
  • PCI and CABG complications
  • PCI and CABG cost-per-case variation

These are just a few of the many ways LUMEDX solutions can help heart hospitals demonstrate best-quality, best-value care delivery-and uncover the solutions to radical improvement. 

How will the bundled-payment program impact your CV service line? Share your thoughts in our comment section, below. 

Meet Seema Verma, Trump's nominee to head CMS 

President-elect Donald Trump’s nomination of Seema Verma to head the Centers for Medicare and Medicaid has been largely overshadowed by his choice of Rep. Tom Price for director of the Department of Health and Human Services. But for those reading the tea leaves about the future of healthcare, especially the Affordable Care Act, Verma’s selection is well worth examining.

Verma, a healthcare consultant who runs a national health policy consulting company, has extensive experience with Medicaid. As president, CEO and founder of SVC, she was involved in expanding Medicaid in Indiana under then-Gov. Mike Pence, the Vice president-elect. SVC also assisted in formulating Medicaid expansion plans in Iowa, Kentucky, Michigan and Ohio. Here are a few more things to know about her:

  • She is an advocate of making patients more financially responsible for their healthcare, and supports freezing coverage for those who don’t pay their premiums, even those living below the poverty line.
  • She worked across party lines to push the Pence administration’s positions into the Indiana Medicaid expansion, known as the Healthy Indiana Plan, or HIP.
  • She supports requiring that Medicaid enrollees look for work, and that they reapply for coverage on time. Those who don’t, she maintains, could lose coverage for up to a year.
  • Patient advocacy groups predict she may call for a replacement of the Affordable Care Act before agreeing to its repeal. Her potential push-back might help mitigate the loss of coverage for those who received coverage through Medicaid expansions in the ACA—about 12 million people.
  • Indiana Rep. Charlie Brown, a Democrat, opposed many of Verma’s positions during debate over the Healthy Indiana Plan, but told National Public Radio that she is “a smooth operator, and very, very persuasive.”
  • The Indianapolis Star reported in 2014 that Verma was paid millions by Indiana for her work on the Indiana Medicaid expansion, and was also paid by Medicaid vendor Hewlett-Packard, which was paid more than $500 million by the state.
  • The American Medical Association, American Hospital Association and America's Essential Hospitals support Verma’s nomination, which—like Price’s—must be approved by Senate.

Leapfrog List Puts Focus on Patient Safety 

Patient safety is once again in the news with the recent release of the Leapfrog Group's Fall 2016 Hospital Safety Grade List. Almost all the hospitals on the list received a passing grade. Of the 2,633 hospitals evaluated, 844 earned an "A," 658 earned a "B," 954 earned a "C," 157 earned a "D" and 20 earned an "F."

Leapfrog's biannual program assigns A, B, C, D and F letter grades to the hospitals surveyed. When compared to previous lists, several states showed significant improvement this time. North Carolina, for example, climbed to No. 5 in this fall's list, up from No. 19 in spring 2013.

Hawaii ranked No. 1 for the first time, while Alaska, Delaware, and North Dakota, along with Washington, D.C., brought up the rear. None of the bottom-ranked states had a hospital that earned an A grade.

Improving patient safety is, of course, a major priority for healthcare providers. Research published in The Journal of Health Care Finance found that medical errors cost the United States $19.5 billion in 2008 alone. A 2016 study estimated that these mistakes cause 251,000 deaths a year in the U.S., where they are the third-leading cause of death (after heart disease and cancer). 

For more information on the Leapfrog list, including a full description of the data and methodology used, click here.
 

 

Posted by Tuesday, November 01, 2016 10:03:00 AM Categories: health IT healthcare reform healthcare today HIT hospitals patient experience of care patient satisfaction

AUC and the CVIS 

Leveraging Appropriate Use Criteria for Better Outcomes—and Collateral Benefits

Appropriate Use Criteria (AUC) is intended to help physicians achieve the best outcomes using the most appropriate treatment plan for any situation. Ensuring that physicians comply with established AUC guidelines is crucial to the overall success of a facility. Demonstrated AUC excellence can impact: 

  • Patient outcomes and satisfaction
  • Hospital reputation
  • Reimbursement in the value-based care era

While the goal of all physicians is to provide best-quality, appropriate care for their patients, in the real world this can be challenging to accomplish—and to document—because of the lack of point-of-care access to complete, longitudinal patient information. Providing physicians with access to relevant patient data, and ensuring they have a clear understanding of AUC guidelines, can lead to improved outcomes—and cost savings as well. 


Rachanee Curry, LUMEDX Service Line & Analytics Consultant, explains how LUMEDX solutions help physicians access the patient data they need to comply with Appropriate Use Criteria.

Leveraging Appropriate Use for Cost Savings & More

With the shift to value-based care, service line leaders must seek out every cost-control opportunity. The good news is that there are collateral benefits to AUC compliance: In addition to improved clinical outcomes, collecting and serving up data so physicians can provide appropriate care helps heart and vascular centers improve their financial performance by:

  • Providing the right information, at the right time, to support appropriate clinical decision-making and best-quality care. When you deliver best-quality care, you are avoiding redundant or excessive treatment that can drive up costs; 
  • Delivering clinical workflows wherein quality data can be captured at or as close to the point of care as possible, optimizing efficiency and minimizing redundant manual work. This saves labor costs because clinicians spend more time on direct patient care rather than administrative tasks; 
  • Providing integrated clinical and operational data in near-real time so service line leaders can monitor their programs' performance and take action to improve.

In addition, when you demonstrate that your facility is consistently AUC-compliant, you are better positioned to work with payers on providing best-value care for that patient population. 

LUMEDX HealthView CVIS: Serving Up the Right Data at the Right Time 

HealthView CVIS helps heart hospitals navigate AUC and value-based care standards. The system collects point-of-care data and delivers actionable insights, facilitating better clinical decision-making and helping to improve business operations through increased efficiency and cost savings. 
HealthView CVIS can play a critical role in any hospital's move toward better patient care, greater efficiency, and improved fiscal performance. 


Healthcare Cybersecurity Failings Draw the Ire of Accountability Office 

GAO Recommends Corrective Action by Department of Health and Human Services

More than 113 million electronic health records were breached in 2015, a year that saw a total of 56 cybersecurity attacks in healthcare alone. That's a 13-fold increase from 2006 to 2015.
The Government Accountability Office isn't going to let those cybersecurity failures go unremarked upon. The GAO last week came down hard on the Department of Health and Human Services, pointing out a number of weaknesses in efforts by HHS to help health plans and other providers protect data.
"HHS has established an oversight program for compliance with privacy and security regulations, but its actions did not always fully verify that the regulations were implemented," wrote the GAO in a report released Sept. 26. The report also called out HHS for giving technical assistance "that was not pertinent to identified problems" in cybersecurity, and for failing to follow up on cases it investigated. 
In short, the GAO found, loss or misuse of health information is not being adequately addressed by HHS. To help healthcare organizations comply with HIPAA and prevent further data breaches, the Office said, HHS should take the following corrective actions:

  • Update its guidance for protecting electronic health information to address key security elements.
  • Improve technical assistance it provides to covered entities.
  • Follow up on corrective actions.
  • Establish metrics for gauging the effectiveness of its audit program. 

HHS generally concurred with the recommendations and stated it would take actions to implement them.

UPDATE: On Oct. 4, HHS announced that it had awarded funding to help protect the health sector against cyber threats. Learn who received the funding, and how it is intended to help healthcare organizations.

Medical Errors Are Made at an Alarming Rate 

How Integrated Systems Can Help 

Medical errors are dangerous, deadly, and all too common. Research published in The Journal of Health Care Finance found that these mistakes cost the United States $19.5 billion in 2008 alone. A 2016 study estimated that medical errors cause 251,000 deaths a year in the U.S., where they are the third-leading cause of death (after heart disease and cancer). 

To Err is Human, the groundbreaking report by the Institute of Medicine, found that nearly half of all deaths attributed to medical errors were preventable. What's even more disturbing is the limited improvement that has occurred since the publication of that 1999 report. "The overall numbers haven't changed, and that's discouraging and alarming," Kenneth Sands of Beth Israel Deaconess Medical Center told the Washington Post.


Mickey Norris, National Vice President of Sales for LUMEDX, discusses how a CVIS can help reduce medical errors.

Medical errors can obviously result from many factors. Some relate to process or people issues, such as the inability to read another physician's handwritten notes, verbal communication breakdowns between medical professionals, or delays in adding notes to a case after treatment occurs.

But many errors stem from the lack of having accurate, up-to-date, or complete information about a patient readily available to clinicians at the point of care. In most cases this is a technology problem, yet technology can also be the solution.

Technology Can Help Reduce Medical Errors

The best technology solutions take an analog process and make it more efficient and accurate through a digital solution. The same is true in healthcare. The effectiveness of patient treatment hinges on getting the right information in front of the right caregivers at the right time. And historically that has been a challenge because the data physicians need is often located in multiple systems. These systems don't always communicate with each other.

For example, a physician may check a pharmacy log to determine which medications have been administered to a patient. But the patient may have been given additional medications in the cath lab, which weren't documented in the same log. This lack of complete information could result in drug interactions or overdoses, or in simply repeating tests. Similarly, the results of tests conducted outside a hospital may not be immediately available to a physician in a hospital. 

Integrating critical patient data from multiple systems automatically, and making it accessible to physicians and clinicians where and when they need it, helps reduce medical errors and improve care overall. Indeed, by minimizing the "number of hands" and number of times information is entered into a system, data quality improves, as there are fewer chances of error. 

Integrating data also reduces costs, because integration minimizes duplicative manual work. Clinicians can spend less time entering redundant data into silo'd systems and more time working with patients. Complete, accessible, high-quality data and improved operational efficiency in CV care are critical to the financial success of a facility.

LUMEDX HealthView CVIS: Increase Efficiencies, Reduce Errors

LUMEDX HealthView CVIS has the ability to interface digitally with almost every point-of-care device in use, and is completely vendor-neutral. Our suite of clinical interfaces allows device and clinical system data-ECG, hemodynamic systems, PACS, cardiac ultrasounds and more-to be captured automatically so that physicians and clinicians always have the most up-to-date information at their fingertips. And our structured reporting applications and registry modules support improved workflow efficiency and clinical quality, while minimizing redundant data entry and the potential for human error. 

HealthView CVIS also complements established workflows. It collects more than 30,000 discrete data points-from point-of-care devices to physician reporting. The robust analysis and reporting engine provides meaningful insights in the areas of treatment options, clinical evaluation and training, and service-line optimization. It's an important addition to any heart hospital's electronic records system, turning it into a robust and dynamic dataset where new information is added in near real-time. Fresh, relevant data that enables better medical care is a critical step in reducing medical errors. 


Spotlight on Analytics, Part 5 

Q & A with Gus Gilbertson, Product Manager for LUMEDX

Predictive Analytics

Q: How much of the healthcare industry has adopted predictive analytics?

A: By definition, negotiations between providers and payers are a game of who can better predict patient outcomes. Win-win scenarios can certainly be devised, but a lack of predictive ability puts an organization at risk for poor contract structuring.

Clinical outcomes are increasingly a game of predicting outcomes and identifying the levers that affect those outcomes so providers are able to improve on future outcomes. Operational predictions are also important, as misunderstanding patient care needs can lead to expensive outlier care patterns or care variations that break capacity management efforts and budgets.

Q: How do you see predictive analytics having an impact on healthcare organizations, and specifically on heart hospitals?

A: Outcome prediction and risk profiling will increasingly guide care pathway selection and tailor care patterns to targeted patient profiles. Predicting and applying the care pathway that leads to the best health outcome at the lowest cost is the foundation of healthcare in the value-based purchasing era.

The dynamics of heart health are increasingly being researched and documented, leading to continued technical evolution and improved outcomes. Being able to predict which technology will lead to the best patient outcomes per dollar spent--whether it be a TVR, and VAD, or an aspirin—is a crucial skill for providers.

Q: What is the role of predictive analytics in affecting areas like heart failure readmissions?

A: Estimates continue to suggest that as much as 20 percent or more of care is wasted. Access to predictive models for identifying patients at risk for readmissions--and providing better targeted treatment up front--are the keys to reducing readmission. Those who best understand their care pathways and patient risk profiles will be the ones who can provide the best value in heart failure care. They will be the ones who can best explain the risk factors inherent in their readmission outcomes to stakeholders from patients to community groups and regulators.

Stay tuned for Part 6 of this series!

 

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