ONC, CMS get an earful on EHRs

With help from Arthur Allen (@arthurallen202) and Darius Tahir (@dariustahir) YOUR PRODUCT SUCKS: ONC and CMS officials got an earful during a daylong listening session at HHS on Thursday about reducing provider burden from health IT. Speaker after speaker said physicians and nurses are on the edge of nervous breakdown over the depressing hours they spend struggling with bad EHR workflows and government reporting requirements.Story Continued Below “Bloated notes. Inaccurate medication lists. Tremendous broken promise around interoperability, which never happened,” said a Maryland pulmonologist. “I’ve had a chronic disease for 40 years,” said a patient advocate. “None of my excellent physicians ever caught a drug-drug interaction. The systems you are forced to use suck and don’t do what they’re supposed to be doing.” “What are we collecting? How is it helping provide better care?” asked a primary care doctor. “The only way out is Open APIs.” ‘’Meaningful use is really a four letter word.” “The actual important information is buried in the overwhelming minutiae of data.” “Too much reporting.” “Too many hours, too many FTEs.” “Too much.” “I don’t think you can fix a caked that’s been ill-baked. The only solution is to throw it out.” John Fleming, ONC deputy secretary for reform, boiled down the complaints into four priorities: streamlining documentation, getting EHR-based preapprovals for tests, referrals and medications; making quality reporting less laborious, and better PDMPs for controlled substances. “Our work won’t be done until EHRs and other health IT tools are things that providers can’t imagine taking care of patients without, because they need them,” concluded Andy Gettinger, chief medical information officer at ONC. “I didn’t get that sense today. So we Continue Reading

MeMD® Launches Behavioral Telehealth Services for Businesses and Consumers Nationwide, Treating Emotional and Psychological Concerns in a Virtual Setting

Comprehensive solution utilizes measurement and outcome-based model to assess progress, track improvements over time SCOTTSDALE, Ariz.--(BUSINESS WIRE)--#healthcare--To improve access to mental health care for employees and consumers across the country, national telehealth provider MeMD® launched behavioral health services through its online platform at memd.me. With mental health professionals nationwide, Arizona-based MeMD offers online therapy for depression, anxiety, substance misuse, trauma, marital and family problems, eating disorders, grief, and numerous other emotional and mental health issues. “The importance of mental and emotional health cannot be overstated, yet access to therapy is limited, and it’s not typically available through employer health plans,” said MeMD President Glenn Dean. “Increasing access through telehealth is the next frontier in behavioral health. Not only does this service help fill a critical counseling gap, but it enables businesses to conveniently and confidentially address their employees’ wellbeing, which can ultimately improve productivity, satisfaction and loyalty.” The shortage of U.S. behavioral health services is well documented. According to Kaiser Family Foundation, more than 100 million Americans live in areas where behavioral health services are severely limited. Often times, people must travel long distances or wait months to see a provider. It’s no surprise Mental Health America reports nearly 60 percent of U.S. adults with a mental health condition do not receive proper treatment. Available to employer groups and individuals, MeMD members can connect with a therapist in as few as 48 hours from their computer or mobile device. Patients simply log on 24/7 to select their desired appointment date and time. Sessions are 50 minutes. “For business owners, this means employees have simple and convenient Continue Reading

State to release health care scorecard in coming months

The state plans to release a website that will provide a snapshot of where Delaware stands in terms of certain health measures, including preventative care and screenings for diseases. The Delaware Health Care Commission has been developing the Common Scorecard since 2014. Funding for the initiative came from a $35 million Center for Medicare & Medicaid Innovation grant, which is intended for the state to find ways to improve the health of Delawareans while reducing costs.While the scorecard was originally for physicians and providers, it's now being viewed as a tool to measure quality of care and serve as a companion to the state's health care cost benchmark.  More: Delaware Medicaid program to cover obesity treatment visits in 2019 In the fall, the state began efforts to rein in health care costs. State officials want to create a benchmark rate, which essentially is a cap on the amount they want to spend each year. That amount would be expressed as a percentage of how much health care spending could grow in a year. The state would use that number as a guideline when making funding and payment decisions. Right now, health care costs currently consume 30 percent — or $1 billion — of the state's budget and are on track to double in the next decade. Dr. Nancy Fan, chair of the healthcare commission, said when the state began developing the scorecard, officials were trying to help practices transition to value-based care, meaning they're paid for their quality of care instead of fee-for-service. When practices see how they fall within certain health metrics, doctors can compare themselves to their peers and the state average as well as reduce unnecessary costs. Read: Massachusetts, Oregon could influence health care spending in Delaware But it became difficult — and expensive — to make sure the data was "apples to apples," Fan Continue Reading

VA needs increased financial and political support

Editor's note: This letter originally listed the wrong location for the VA hospital that hired a physician who had faced more than a dozen malpractice claims. The hospital is in Iowa City.The Des Moines Register recently reported that the VA Hospital in Iowa City hired a physician who consistently provided dangerous care to vets. Other media reports suggest substandard care is provided at VA facilities around the country.In 1994, responding to criticism of the VA system, President Clinton appointed Dr. Kenneth W. Kizer to head the VA. Kizer changed an entrenched top-down conglomerate, which was dirty and dangerous, into a decentralized, community clinic-focused, quality-driven system, which became a model for the rest of the country. By 2000, in an amazing turnaround, the Veterans Health Administration had become a leader in clinical research and performance improvement. In 2002, the National Committee for Quality Assurance rated the VHA tops. Studies reported in 2003 showed that vets fared significantly better than commercial HMO and Medicare patients on a host of quality measures. The Washington Monthly trumpeted the VHA under the headline, “Best Care Anywhere.”My own family experience with the VHA system confirmed this. My father, a World War II vet, regularly used VHA services and received excellent care, evidenced by his good health through the age of 92. My brother, a Korean War-era vet, received excellent care at the VHA hospital in Kansas City, including brain surgery to remove a cancerous tumor. Not only did they receive quality care, but the facilities were also first class and the staff was caring, professional, communicative and extremely capable.Unfortunately, the Bush administration allowed this model healthcare system to deteriorate by not providing the financial and political support the VHA needed to accommodate the substantial increase in vets needing care due to the Afghanistan and Iraq wars. Obama was stymied Continue Reading

Coordinated care with doctors and hospitals can improve health and save money

 Robin Gladden's most traumatic moments weren't due to her being raised by abusive, drug-addicted parents in a violence-plagued community. Instead, she says it was because of mistakes and neglect by the health care system. Gladden, 62, is a thyroid cancer survivor who also has diabetes, bursitis, high blood pressure, acid reflux and sciatica. She’s now a satisfied patient of Kaiser Permanente, a more established form of accountable care organization (ACO) that both treats and insures its patients. More typical accountable care organizations are groups of doctors and hospitals that coordinate the care of patients. Kaiser Permanente employs all of Gladden’s doctors and is the insurer she pays her insurance premiums to each month. That means Kaiser loses money if her conditions aren’t managed correctly. This financial incentive is supposed to lower the cost and improve the quality of care. ACOs are a big part of the Affordable Care Act's strategy to focus health care more on quality than the quantity of services provided. But it's one that 's far more likely to survive efforts to undermine and replace the law. Although the Trump administration has rolled back or delayed other ACA reforms, such as paying orthopedic surgeons a lump sum for some surgeries, ACOs remain popular with both Republicans and Democrats in Congress.  “The idea is good: To give the doctors and hospitals a reasonable pot of money and put them, not insurers, in charge of how it is used to help patients,” says physician Adams Dudley, director of the Center for Healthcare Value of the University of California San Francisco. “This has led to some very beneficial interventions, like patient education programs to help people monitor and control their own diabetes, which can save money and improve outcomes.” But sometimes, especially for organizations with a short-term view, giving doctors and Continue Reading

Dolores Lindsay became the change she sought 50 years ago in Lincoln Heights

LINCOLN HEIGHTS – Dolores Lindsay faced another deadline Tuesday.Chief executive of the HealthCare Connection, she had to complete an application to request another $1 million from the state capital budget for the Mount Healthy Health Center. The plan is to break ground in May.Lindsay co-founded the organization 50 years ago. It opened in October 1967 in a four-room rented house on Matthews Drive as the Lincoln Heights Health Center. Expansion to other parts of northern Hamilton County led to the corporate name change in 2005. During the first year in Lincoln Heights, volunteer doctors and nurses saw 500 patients upstairs in exam rooms that had been bedrooms. Volunteer dentists set up shop in the basement. The kitchen became the center's lab. Volunteer receptionist Dolores Lindsay  –  with the youngest of her five children, a 3-year-old daughter, at her side – worked in the living room."Women and children needed health care," she said. "We fought the perception that anything good could come out of Lincoln Heights."At the time, Lincoln Heights was the largest self-governed African-American community in the nation. It had a population of 7,800 at its peak in 1960, but no doctors or dentists practiced within its limits.Lindsay became the change she sought.Today, closing in on her 81st birthday, she has become synonymous with the Lincoln Heights Health Center and the HealthCare Connection. It has grown to 10 locations and treated 18,061 individual patients with 44,409 visits in 2016.The board named Lindsay executive director in 1972. She has been in charge ever since.The new Mount Healthy clinic, which will replace a family practice center opened in a strip mall in 1987, will be Lindsay's last major project. She and her staff have worked on it since 2011.She said they needed eight years to make the Lincoln Heights Health Center and HealthCare Connection corporate offices a reality. That 42,000 Continue Reading

How to choose a good doctor

Americans consider insurance and a good bedside manner in choosing a doctor, but will that doctor provide high-quality care? A new poll shows that people don't know how to determine that. Being licensed and likable doesn't necessarily mean a doctor is up to date on best practices. But consumers aren't sure how to uncover much more. Just 22 percent of those questioned are confident they can find information to compare the quality of local doctors, according to the poll by The Associated Press-NORC Center for Public Affairs Research. Today, 6 in 10 people say they trust doctor recommendations from friends or family, and nearly half value referrals from their regular physician. The poll found far fewer trust quality information from online patient reviews, health insurers, ratings web sites, the media, even the government. "I usually go on references from somebody else, because it's hard to track them any other way," said Kenneth Murks, 58, of Lexington, Alabama. His mother suggested a bone and joint specialist after a car accident. "I guess you can do some Internet searches now," he added, but questions the accuracy of online reviews. The United States spends more on health care than most developed nations, yet Americans don't have better health to show for it. A recent government report found we miss out on 30 percent of the care recommended to prevent or treat common conditions. At the same time, we undergo lots of unneeded medical testing and outmoded or inappropriate therapies. Yet people rarely see a problem. In the poll, only 4 percent said they receive poor quality care. About half believe better care is more expensive, even as the government, insurers and health specialists are pushing for new systems to improve quality while holding down costs. It's hard to imagine buying a car without checking rankings, but checking out a doctor is much more difficult. Many specialists say standardized measures of health outcomes are key, Continue Reading

BCBST’s ‘solid’ 2016 weathered specialty Rx wallop and individual loss

After months of tumult about its premium increases and presence — or lack there-of — on the individual market, BlueCross BlueShield of Tennessee grew the number of members it covers across all lines of business and spotted some emerging trends in its individual market in 2016.The company grew membership by 3.4 percent and posted strong financial performance for its commercial, TennCare and Medicare Advantage subsidiaries, which helped offset a $103 million loss on the individual market.The financial performance coupled with ratings from consumer and quality organizations was a relief to the insurer, which racked up heavy losses on the individual market, often called Obamacare exchange, in recent years. “That’s a good year, that’s a really good year… solid performance, it's certainly heading in the right direction,” said Roy Vaughn, senior vice president of communications BCBST.Overall the company posted $118 million in net gain, and paid $548 million in taxes in 2016. Its reserves grew to $1.9 billion, of which $1.7 billion is required by the Tennessee Department of Commerce and Insurance based on its membership and claims. Its reserves could cover 65 days of claims. More: Insurance chief talks ACA stability, rates ahead of filing season Exchange business posts another loss, yet patterns emergeThe individual market is a small portion of the insurer's portfolio, although it carried a heavy financial in for the first few years of the exchange. BCBST about $300 million in 2014 and 2015.BCBST decided in early fall to scale back where it sold individual insurance plans in the state in 2017 as a way to stem losses. It opted to stay in five rating areas where there was either one or no other insurer even though rural areas were more costly to cover than metro areas. The insurer, which like other companies around the country, has struggled to understand how people on the exchange were using services and Continue Reading

DeVos grilled by Democratic leaders over her advocacy for school choice

WASHINGTON – Betsy DeVos, a Michigan advocate for school choice and vouchers and President-elect Donald Trump’s nominee for education secretary, vowed Tuesday to protect any schools – public, private or otherwise – as long as they are working for students and parents and serving their needs.Facing Democrats who questioned DeVos’ support of school choice and what it may mean for public schools, DeVos said she supports “any great school” – including public schools and those beyond what “the (public school) system thinks is best for kids to what moms and dads want, expect and deserve.”“Not all schools are working for the students that are assigned to them. I’m hoping we can work together to find common ground,” DeVos said, rebuffing a request by U.S. Sen. Patty Murray, D-Wash., that she vow not to propose funding cuts for any public schools.DeVos, 59, stepped before the Senate Health, Education, Labor and Pensions Committee for a rare nighttime confirmation hearing, facing a broad spectrum of questions that ranged from early childhood education, free college and the Obama administration’s crackdown on college sexual assaults to her own personal beliefs about sexual orientation and any support she gave for controversial “conversion therapy,” which she denied.“I believe in equality and I firmly believe in the intrinsic value of each individual, and that every student should have the assurance of a safe and discrimination-free place to become educated,” said DeVos, telling U.S. Sen. Tammy Baldwin, D-Wis., that as regards the alleged support, she might “be confusing some other family members in some of those contributions, and also looking at contributions from 18 or 20 years ago.”“As a mom I just can’t imagine having a child that would feel discriminated against for any reason, and I would want my child in a safe environment,” she said. Continue Reading

Delaware provides tax shelter for multimillion-dollar masterpieces

Geneva, Monaco, Luxembourg and ... Delaware?Long a darling of secretive limited liability companies, the First State is building a reputation as a prime location for out-of-state art collectors and investors to park their multimillion-dollar masterpieces and reap the tax benefits.In the last two years, New Castle County has seen a proliferation of maximum-security art storage companies, including several Manhattan offshoots, that lock up hundreds of millions of dollars worth of paintings and sculptures by Old Masters and buzzworthy emerging artists.But ordinary citizens will likely never see this work, including a 10-piece rocket installation. That's because many of these one-of-a-kind creations will never leave their crates.Art buyers, including those more passionate about diversifying their portfolios than enjoying their artwork, can ship their purchases directly to Delaware storage facilities and avoid paying sales tax for as long as the items remain here. For the Manhattanite, that amounts to a nearly $900,000 savings on a $10 million painting.The advantages don't stop there. Delaware doesn't tax inventory, it recently repealed its estate tax and it offers less expensive land for storage facilities ideally situated between New York and Washington, D.C., art experts say.As Geneva and New York crack down on an opaque art market reeling from money laundering and tax evasion scandals, Delaware shines as a pro-business beacon, one that is, arguably, less likely to suffer loss from terrorists, natural disasters or art capers. STORY: Delaware's unemployment rate continues to climb, bucking national trend STORY: DTC's 'Something Wicked': Dazzling theatrical rocket ride Several storage companies offer direct, weekly shuttle service from Delaware to New York –– and back again. Masterworks are transported from cavernous warehouses straight out of "Raiders of the Lost Ark" to New York City Continue Reading