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. 

The Promise of Predictive Analysis 

If hospitals could accurately predict which patients were going to experience complications down the road, they could intervene early with those patients, and perhaps prevent them from having to be rehospitalized. Reducing readmissions is one of the potential benefits of predictive analysis, and it’s a big one.

“We have 750 patients every day. Instead of looking at everybody, if we can look at 20 patients, that would be a great advantage,” said Jose Azar, M.D., of Indiana University Health, in an H&HN article.

Also highlighted in the Hospitals & Health Networks article is Christiana Care Health System, which has been using predictive analytics for about five years. The Wilmington, Delaware, nonprofit health system set up its homegrown analytics system in 2012 with $10 million in grant funding from the Centers for Medicare & Medicaid Innovation Center.

Predictive analytics has helped Christiana Care improve on financial and utilization metrics, but administrators cautioned that predictions are no help if an organization doesn’t have the resources to respond to them. That means everyone – from doctors and care managers to nurses and social workers, and even clerical staff – needs to be ready to intervene based on predictions about patients.

“You need to be able to respond to and receive information in real time,” said Terri Steinberg, M.D., chief health information officer at Christiana Care. “That’s the cost of entry,” Steinberg told H&HN. “Without a robust care-management program, there’s no point” in making predictions.

Complimentary webinar recording available

A recent LUMEDX/Christiana Care webinar is now available as an online download or on CD. "Delivering Clinical and Business Excellence — The Power of Data Transparency: How Christiana Care Leverages Cardiology Data to Improve Care Quality and Contain Costs" can be downloaded by clicking hereIf you prefer to have a CD mailed to you, please click here.

 

ACC, NCDR Events Coming Up This March in Washington, D.C. 

March will be a busy month for the health IT and cardiology communities. If you need an excuse to visit Washington, D.C., in the spring, these events are it. Here's what's coming up:

  • LUMEDX's ACC User Group: March 13, 2017, featuring complimentary education sessions for LUMEDX clients
  • NCDR's Annual Conference:  March 13-15, 2017, which brings together 1,500 registry professionals, quality experts, CV administrators and physicians
  • ACC's 66th Annual Scientific Sessions & Expo: March 17-19, 2017, featuring educational opportunities ground-breaking science and interactive debates and discussion

Both the User Group and NCDR Annual Conference will take place at the Gaylord National Resort and Convention Center, Washington, D.C.  ACC.17, also in the nation's capital, will be held at the Walter E. Washington Convention Center.

Going to NCDR or ACC? Stop by the LUMEDX booth to say hi. We'll be at Booth 2411 for ACC; our NCDR booth number is 5.

Click here to register for any of these events.

Related: ACC says Trump's travel ban will prevent some cardiologists from attending its Scientific Sessions & Expo this March. 

Posted by Tuesday, January 24, 2017 4:47:00 PM Categories: ACC cardiology health information technology healthcare today industry news Lumedx NCDR

Webinar to Highlight a Winning Data Analysis Strategy 

Christiana Care Health System, one of the largest healthcare providers in the mid-Atlantic, has achieved wide-ranging improvements in both clinical performance and business outcomes after implementing strategies designed to ensure top-quality care delivery while at the same time containing costs.

Christiana's success began with a data strategy that will be laid out in a complimentary webinar called Delivering Clinical and Business Excellence: The Power Of Data Transparency. Subtitled How Christiana Care Leverages Cardiology Data to Improve Care Quality and Contain Costs, the webinar will take place on Thursday, Feb. 2.

It will include discussions on: 

  • How data transparency drives cost and outcome awareness and impacts the CV service line
  • Christiana Care's experience comparing the costs and benefits of undertaking a costing model
  • The value of case attributes

Presented by Leslie Mulshenock, Director of Heart & Vascular Services, and Matthew Esham, Heart & Vascular Service Line Manager, the webinar will also include a summary of the costs and benefit of Christiana's strategic improvement plan, which has resulted in optimal reimbursement, lower costs-per-case and higher patient satisfaction. 

A live Q & A will conclude the Feb. 2 event, which will take place at 1 p.m. Eastern time, 12 p.m. Central and 10 a.m. Pacific.

Click here to register for this complimentary event.

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. 

3 New Clients Join LUMEDX Family 

Hospitals in Alabama, Massachusetts and Texas begin CVIS implementation

LUMEDX is happy to welcome to our family three new clients: Marshall Medical Centers; Holyoke Medical Center; and Baylor Scott & White Health, the largest not-for-profit healthcare organization in Texas.

The first Baylor Scott & White location to implement the LUMEDX solution is Baylor Jack and Jane Hamilton Heart and Vascular Hospital in Dallas. LUMEDX is providing the hospital with comprehensive cardiovascular data management that:

  • Connects isolated data sources,
  • Integrates with the enterprise electronic health record (EHR), and
  • Eliminates redundant data collection.

Holyoke Medical Center has gone live with our PACS with Echo Workflow software. After all phases of the CVIS deployment are completed, the secure, cloud-delivered software-as-a-service (SaaS) solution will provide the medical center-located in Holyoke, Massachusetts-with comprehensive management of its Echo, Nuclear, ECG, Holter and Stress workflows, and will offer remote access for physicians, allowing them to access data and complete reports from any location.

The deployment for Marshall Medical Centers is taking place at two hospitals: Marshall Medical North in Guntersville, Alabama; and Marshall Medical South in Boaz, Alabama. Both hospitals have implemented Echo Workflow and ECG-Holter software, which will help them improve performance and quality of care while containing costs and minimizing inefficiency.

We look forward to long and productive relationships with our new partners!

 

Latest Healthcare Cyberattack Highlights Need for Prevention 

How would you like to have to tell 34,000 patients that their data had been hacked? That’s the situation that Quest Diagnostics found itself in recently after hackers stole health information including names, birth dates, telephone numbers and lab results.

The clinical laboratory services company is just the latest victim in a long string of cyberattacks targeting protected health information. One in 13 patients stand to have their records stolen because of a healthcare provider breach, according to Accenture, an industry consulting firm. Healthcare organizations that have been the recent target of cybercriminals include:
Hollywood Presbyterian Medical Center, which paid a $17,000 ransom in bitcoin to regain control of its computer systems after a hack.
Anthem Inc., the second-largest U.S. health insurer, which had the records of nearly 80 million customers stolen.
MedStar Health, where hackers encrypted data from 10 hospitals, causing widespread confusion and delays in treatment because providers were unable to access records.
What can healthcare providers do to protect against such cyberattacks? We’ve collected a number of articles offering advice.
Tips for protecting hospitals from ransomware as cyberattacks surge
Hospitals Battle Data Breaches With a Cybersecurity SOS
Protecting a vulnerable industry against cyber attacks
5 Ways Providers Can Prevent Patient Data Breaches

What is your organization doing to protect itself from hackers? Share your strategies in our comments 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.

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
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