Posts in Category: CMS

How the CVIS Strengthens the EHR  

Electronic Health Records are essential tools for healthcare organizations. But they don't obviate the need for a Cardiovascular Information System (CVIS). In fact, changing payment models, new government mandates, and evolving care practices are making the CVIS more important than ever.

Both the clinical and operational aspects of cardiovascular services are highly complex, and they require a technology solution that can match the complexity of the services themselves. A comprehensive CVIS is specifically designed to collect and manage the vast amount of data required by cardiovascular services, and works in tandem with the EHR by:

  • Capturing queryable data to enable analytics and support outcomes improvements
  • Facilitating structured reports
  • Providing the level of detailed information needed to care for heart patients

Learn why cardiovascular services require dedicated information systems in our white paper, "Bridging the Gaps: A True CVIS and the EHR." This document outlines how the CVIS complements the EHR so cardiovascular services can improve efficiency, reduce costs and deliver best-quality patient care. The paper is the result of communications and observations with current LUMEDX clients, as well as with prospective clients who have completed a deep-dive comparison of our CVIS with their EHR systems.

Download your copy today.

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.

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.

Early Reaction to MACRA Rule Mostly Positive 

Last weekend was a busy one for those trying to parse the new MACRA rule released on Friday. At 2,202 pages, the Medicare Access and CHIP Reauthorization Act rule wasn't exactly beach reading, and it gave the health IT community plenty to talk about on social media and in policy statements.

The dust is still settling, but it appears that early reaction to the rule was mostly positive. Healthcare organizations praised the CMS for being responsive to concerns they had raised during the comment period leading up to the rule's finalization. In fact, about 80 percent of the 2,000+ pages are comments CMS received and its responses.
The American Medical Association was pleased with the permanent elimination of the Sustainable Growth Rate (SGR) formula. "The new law," according to the AMA's press release, "gives many physicians the opportunity to be rewarded for the improvements they make to their practices and for delivering high-quality, high-value care to Medicare patients."
Other features that drew favorable reactions included:

  • The rule's overarching theme that improving the organization and payment models for medical care must stress quality over quantity.
  • Greater reporting flexibility for clinicians, as well as support for innovation in the delivery of care.
  • The formal adoption of a transition year during 2017, which makes major changes to the Quality Payment Program (QPP) reporting requirements, and provides a longer time frame for those transitioning to the QPP.
  • Emphasis on helping clinicians educate themselves about the rule.
  • Easing of the policy defining the Advanced Alternative Payment Model (APM), which will allow additional programs to quality.

But the rule is not without its detractors. "It's disappointing that the flexibility provided for quality reporting in 2017 largely disappears in 2018 and beyond," the Medical Group Management Association said in a policy statement.
Other organizations complained that the nominal risk standard defining the Advanced APM remains too high.

Want to know more? Healthcare Dive has a great breakdown of the rule changes you need to know. And for even more information on the new rule, click here. 
What's your take on the final MACRA rule? Share your thoughts in our comment section below.

The Best of Cardio and Health IT News: 4/14/16 

News stories you won't want to miss!

Higher patient ratings equal fewer readmissions, lower mortality

The scores patients assign their hospitals appear to correspond with the quality of the hospitals' patient outcomes, according to a study published in JAMA Internal Medicine. Researchers analyzed the scores patients assigned to the Centers for Medicare & Medicaid Services' star-rating system for more than 3,000 hospitals. Hospitals' star ratings were inversely proportional to their rates of death within a month of discharge. 

Hospitals reap $1.6M from specialists, including cardiologists

While the average primary care physician is generating less income for hospitals ($1.4 million in 2016 versus $1.56 million in 2013), that’s offset by specialist doctors, whose contribution to hospital revenues jumped 14% to $1.6 million, compared with $1.42 million three years ago. Among specialists, orthopedic physicians bring in the most business ($2.75 million each), followed by invasive cardiologists ($2.45 million) and neurosurgeons ($2.44 million.

5 ways make employees happy in a healthcare workplace

Healthcare organizations named to Fortune's 20 Best Workplaces in Health Care share a sense of camaraderie and pride in their work, and offer lessons to other hospitals and systems that strive to create a positive work environment that can attract and retain the best talent. The winning organizations overcame the natural hierarchy of a healthcare organization to create a friendly, emotionally supportive workplace where coworkers feel as though everyone is equal and they can count on coworkers to support them.

Heart, vascular department at Aurora St. Luke’s receives top accreditations

Building on its rich history as the premier heart hospital in Wisconsin and a global destination for heart care, Aurora St. Luke’s Medical Center has received two prestigious accolades from the Accreditation for Cardiovascular Excellence (ACE). Both acknowledgments from ACE reinforce Aurora St. Luke’s positioning as a global leader in cardiovascular excellence.

Momentum building for national unique patient IDs

As digitization of the healthcare system increases, issues around data exchange and medical records exchange make patient identification more challenging than ever. In the absence of a unique patient identifier system, doctors use a patient’s name and birth dates to identify them, and there can be hundreds or thousands of identical or similar names and dates in EMR systems. Get it wrong, and a diagnosis or treatment may be missed — sometimes with dire consequences.

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.

The Best of Cardio and Health IT News: Week of 2/15/16 

Don't miss out on this week's top stories


CMS and health insurers announce alignment and simplification of quality measures

The Centers for Medicare & Medicaid Services (CMS) and America's Health Insurance Plans (the health plans' trade group)  announced that they have agreed on seven sets of clinical quality measuresThe standardized measures are designed to help payers and consumers shopping for high-quality care. "These measures support multi-payer alignment, for the first time, on core measures primarily for physician quality programs," according to the CMS. This work is informing the CMS’s implementation of the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA).

Supreme Court: What will happen to healthcare cases after Justice Scalia's death?

A number of healthcare-related cases are in limbo following the death of conservative U.S. Supreme Court Justice Antonin Scalia, who died on Feb. 12. "The court is weighing a case about data sharing with potential implications for insurers and state healthcare reform efforts," Modern Healthcare reports. "Another case has the potential to reduce—or increase—the number of False Claims Act suits brought against healthcare providers and other companies." Also before the court is a case involving the contraception mandate in the Affordable Care Act. 

CMS anticipates giving out $7.7 billion in ACA reinsurance payouts

Healthcare insurance companies could receive as much as $7.7 billion as part of the Affordable Care Act's reinsurance program. Reflecting data from the 2015 benefit year, the payouts are to be issued this year. "The Affordable Care Act created the temporary, three-year reinsurance program to protect insurers during the early years of the new individual marketplaces," according to Modern Healthcare"Insurers pay into the reinsurance pool, and those funds are then paid out to health plans that had members with extremely high medical claims." 

Still stalled: Federal healthcare rule that ties Medicare, Medicaid payments to disaster-preparedness plans

A proposed federal rule that would require healthcare facilities and hospitals to create emergency-preparedness plans in order to receive Medicare and Medicaid funding is stalled in the Office of Management and Budget, undergoing a legally required review. It would affect more than 68,000 providers, according to a New York Times news analysis."Industry groups have been critical of the time and expense they said would be involved in steps such as test backup power generators more frequently and for longer periods, or to pay staff overtime during drills," according to FierceHealthcare.com.

Harvard researchers say PCI readmission metric could be model

A model for improving the quality and value of cardiology care may be found in a pilot program from the Centers for Medicare and Medicaid Services and the National Cardiovascular Data Registry (NCDR), according to Harvard researchers. The program evaluated and reported risk-adjusted 30-day readmission rates after PCI. "The researchers noted that preventing readmissions could improve the quality of care and reduce costs for cardiology patients," according to CardiovascularBusiness.com.

 

Best of Health IT News: Week of 06/04/15 

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.

An Ideal Transition: Multi-Campus Rollout of Echo CVIS at Orlando Health 

Read the latest case study from Diagnostic & Interventional Cardiology to learn how Orlando Health has successfully implemented LUMEDX's physician structured reporting and image management solution across five of its campuses. Read how the hospitals use standardized reports for echo in order to improve efficiency and streamline workflow.

Million Hearts Model Rewards Physicians for Prevention 

According to Medscape, the Center for Medicare & Medicaid Innovation (CMMI) recently announced a 5-year, randomized controlled trial to test the idea of paying physicians for reducing the long-term cardiovascular risk of their high-risk patients. CMMI will enroll 720 practices in the clinical trial between June and September, and the trial is scheduled to begin in January 2016. 

Improving Physicians' Communication Skills

Hospitals & Health Networks Daily reports on how patients are now rating their physicians' communication skills on the Center for Medicare & Medicaid Services' HCAHPS Survey. The survey shows that higher performance leads to better clinical outcomes, and the ratings will be linked to hospital reimbursements. 

Best of Health IT News: Week of 05/28/15 

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.

An Ideal Transition: Multi-Campus Rollout of Echo CVIS at Orlando Health

A new case study from Diagnostic and Interventional Cardiology reveals how Orlando Health has implemented LUMEDX's physician structured reporting and image management solution across five campuses. The new system has allowed Orlando Health to reduce report turnaround time, standardize the workflow, and support quality improvement programs.

What Exactly is "Population Health," Anyway?

Healthcare IT News discusses the definition of population health with a group of industry experts, including hospital CEOs, doctorpreneurs, startup executives, and more. The CEO of St. Joseph Hospital in Nashua, N.H., Richard Boehler, MD calls population health: "... the ability of a provider to effectively manage the healthcare needs of a defined group across the continuum of services either through direct provision of care or through structured relationships with other providers."

Infographic: The Future of Clinical & Business Intelligence in Healthcare

A new infographic from the HIMSS Analytics 2015 Clinical & Business Intelligence Study has found that there has been a 6% increase in the number of healthcare organizations using a C&BI solution since 2013. Additionally, 52% of those polled said that they currently use their EHR/HIS vendor for C&BI. 

Report Includes Bypass, Heart Failure in Hospital Ratings

According to Cardiovascular Business, U.S. News and World Reports now bundles heart bypass and other operations with the conditions congestive heart failure and chronic obstructive pulmonary disease (COPD) in a rating called "Best Hospitals for Common Care." The new rating breaks hospitals down into three categories: high, average, and below performers. 

Page 1 of 2 1 2 > >>
  • RSS

Statistics

  • Entries (217)
  • Comments (449)

Categories