Infographic: Today’s Wired Patient

March 2nd, 2015 by Melanie Matthews

Americans are ready and willing to leverage health apps and wearable devices to improve their personal health, according to the findings released from the Fifth Annual Makovsky/Kelton "Pulse of Online Health" Survey.

Designed to uncover shifts in consumer behaviors around online healthcare information use, this year's survey reveals consumer readiness to disclose online personal health data as a path to improve treatment options. Data also cite trust and quality of health information as important factors in consumer selection of online health sources. Highlights from the survey are depicted in an infographic by Makovsky.

2014 Healthcare Benchmarks: Remote Patient MonitoringRecent market data on telehealth in general and the patient-centered medical home in particular identified home health monitoring as a key care coordination strategy for individuals with complex illnesses as well as a host of vulnerable populations.

2014 Healthcare Benchmarks: Remote Patient Monitorings delivers a comprehensive set of metrics from more than 100 healthcare organizations on current practices in and ramifications of remote monitoring for care management of chronic illness, the frail elderly and remote populations.

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Infographic: Medicare Advantage Patient Satisfaction, Quality of Care

February 27th, 2015 by Melanie Matthews

Medicare Advantage beneficiaries are overwhelmingly satisfied with the coverage the plans provide, according to a new AHIP infographic.

The infographic breaks down satisfaction scores by beneficiaries among six key measures and looks at the impact of Medicare Advantage plans on readmission rates and clinical quality measures.

Physician Reimbursement for Chronic Care Management: Identifying New Practice Revenue OpportunitiesStarting this year, Medicare is reimbursing physician practices for select Chronic Care Management (CCM) services not previously eligible for reimbursement, underscoring the vital role of care management in primary care.

Physician Reimbursement for Chronic Care Management: Identifying New Practice Revenue Opportunities offers practical guidance to prepare physician practices to maximize CCM reimbursement in the year ahead.

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Overcoming ‘Clinical Inertia’ and 7 Other Barriers to Remote Patient Monitoring

February 26th, 2015 by Cheryl Miller

It's important to identify potential barriers from both patients and providers before implementing a telehealth program, says Susan Lehrer, RN, CDE, associate executive director of the telehealth office for the New York City Health and Hospitals Corporation (NYCHHC), because both groups need to change behaviors. Resistance to change is universal, and if you’re changing any kind of work flow or communication, there will be initial resistance.

  • Slow buy-in and some resistance by clinicians (referrals).
  • Clinicians concerned with appearance of decreased productivity.
  • Resistance to change in clinic work flow.
  • Inability to “integrate” Web site data and electronic medical records (EMRs).
  • Language and literacy.
  • Complexity of chronic disease management.
  • Lack of protocols for use of email in coordination of care.
  • Not all clinicians utilize secure email system.
  • Source: Remote Monitoring of High-Risk Patients: Telehealth Protocols for Chronic Care Management

    http://hin.3dcartstores.com/Remote-Monitoring-of-High-Risk-Patients-Telehealth-Protocols-for-Chronic-Care-Management_p_5008.html

    Remote Monitoring of High-Risk Patients: Telehealth Protocols for Chronic Care Management profiles a successful eight-year initiative by New York City Health and Hospitals Corporation's (NYCHHC) House Calls Telehealth Program that significantly lowered patients' A1C blood glucose levels. Susan Lehrer, RN, BSN, CDE, associate executive director of the telehealth office for NYCHHC, shares key aspects of the real-time monitoring program, including how the program blends telehealth, electronic medical records, electronic communication with providers and direct communication with patients by nurse case managers, and much more.

    Infographic: What’s on the Mind of Healthcare IT Security Professionals?

    February 25th, 2015 by Melanie Matthews

    A new infographic by Lockheed Martin examines the key questions for healthcare IT security professionals:

    • Am I investing in the right things?
    • What's keeping me up at night?
    • How do I know I'm cyber secure?

    The infographic provides an overview of the areas of concerns for healthcare IT professionals.

    Business Associate ManualBusiness Associate Manual is template-style manual that can be easily adapted to align with your compliance needs as a business associate (BA). All content complies with the Omnibus Rule.

    It is specifically developed to help BAs meet complex privacy & security compliance requirements.

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    12 Things to Know About Chronic Care Management

    February 24th, 2015 by Cheryl Miller

    Despite new CPT codes that reimburse physician practices for select chronic care management (CCM) services, almost half of healthcare organizations lack a formal CCM program, leaving critical reimbursement dollars on the table, according to 125 respondents to the Healthcare Intelligence Network’s (HIN) 2015 Chronic Care Management survey, conducted in January 2015.

    However, 92 percent of respondents believe the Medicare CCM reimbursement codes that became effective January 1, 2015 will prompt equivalent quality overtures from private payors, underscoring care coordination’s importance in a value-based healthcare system.

    We also asked respondents how they structured their CCM programs, and who had primary responsibility for CCM services. Following are their responses.

    • Almost 45 percent of respondents to HIN’s 2015 CCM survey have yet to launch a CCM initiative, the survey determined.
    • A diagnosis of diabetes is the leading criterion for admission to a CCM initiative, said 89 percent of respondents with existing CCM programs.
    • A primary care physician or healthcare case manager most often bears primary responsibility for CCM, say 29 percent of survey respondents.
    • Just over one-third of respondents — 35 percent — are currently reimbursed for CCM-related activities.
    • Patient engagement is the most difficult challenge of CCM, according to one-third of survey respondents.
    • The majority of CCM tasks are conducted telephonically, say 88 percent of respondents.
    • Almost three-quarters of respondents — 72 percent — admit patients with hypertension to CCM programs, respondents said.
    • Healthcare claims are the most frequently mined source of risk-stratification data for CCM, say 72 percent of respondents.
    • More than half of respondents — 51 percent — include palliative care or management of advanced illness in CCM programs.
    • On average, each CCM patient is seen monthly, say 29 percent of respondents.

    Source: 2015 Healthcare Benchmarks: Chronic Care Management

    http://hin.3dcartstores.com/2015-Healthcare-Benchmarks-Chronic-Care-Management_p_5003.html

    2015 Healthcare Benchmarks: Chronic Care Management captures tools, practices and lessons learned by the healthcare industry related to the management of chronic disease. This 40-page report, based on responses from 119 healthcare companies to HIN's industry survey on chronic care management, assembles a wealth of metrics on eligibility requirements, reimbursement trends, promising protocols, challenges and ROI.

    Infographic: Quality Improvement Results from Colorado Hospitals

    February 23rd, 2015 by Melanie Matthews

    Colorado hospitals and health systems, participating in a three-year quality improvement project led by the Colorado Hospital Association (CHA), prevented 2,800 patient harms for an estimated cost savings of $14.8 million. The results are based on data collected from 32 acute care hospitals from January 2012 through June 2014.

    A new infographic by CHA breaks down each of the 11 areas targeted for improvement and the impact these improvements had on healthcare utilization and costs.

    Value-Based Reimbursement Answer Book: 97 FAQs on Healthcare Models, Measures and MethodologyIf one trend has transformed the healthcare industry post-ACA more than any other, it is the market's new business model rewarding value over volume.

    Value-Based Reimbursement Answer Book: 97 FAQs on Healthcare Models, Measures and Methodology provides a framework for healthcare's new value proposition, with advice from thought leaders steeped in the delivery and reimbursement of value-based care.

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    Medicare Chronic Care Management Code: Stepping Stone to Medical Home, ACO

    February 23rd, 2015 by Patricia Donovan

    New CCM codes offer physician practices both a business opportunity and a path to providing value-based healthcare.

    For physician practices yet to embrace a patient-centered medical home or accountable care organization (ACO), the new Medicare Chronic Care Management (CCM) code offers another benefit besides added revenue: the chance to test-drive a value-based healthcare delivery model.

    Billing via the new CPT code 99490 is "an opportunity for practices to develop the infrastructure to become a medical home or to participate in an ACO," noted Nicole Liffrig Molife, counsel with Arnold & Porter during a February 2015 webinar, Chronic Care Management Reimbursement Compliance: Overcoming Obstacles and Meeting Requirements.

    The law firm, which counts the American Geriatric Society among its clients, has closely monitored the development by CMS of the CCM code, which reimburses practices for select non face-to-face care coordination tasks previously bundled into Evaluation and Management (E&M) codes.

    "[CMS] has been pretty explicit...that they conceive of this code as a transition toward an alternative payment model," added Paul Rudolf, MD, a partner with Arnold & Porter. The transitions seems inevitable, given the federal payor's aggressive timeline for transitioning Medicare payments to value-based models announced last month.

    Transforming themselves via this added CCM payment would jump-start development of the technology, communications and staff required for practices to provide complex, coordinated care management for Medicare beneficiaries with multiple chronic conditions, said Dr. Rudolf, a former practicing physician—activities at the heart of patient-centered healthcare models.

    The two attorneys walked through the requirements to bill CCM, including patient eligibility, professional eligibility, patient consent, care coordination services, specified practice capabilities, and specified use of an electronic health record (EHR).

    They also identified several gray areas in the CCM requirements, offering guidance on handling the following:

    • The scope of diseases or conditions considered 'chronic;'
    • Credentials for clinical staff performing CCM services;
    • Activities and requirements of 'general supervision;'
    • Handling retroactive patient consent;
    • CCM activities that must be documented in the electronic health record;
    • Access by contracted staff of the patient's care plan;
    • Location where the care plan must reside;

    Until Medicare provides more clarity, practices should thoroughly document CCM activities and, where necessary, consult their in-house ethical professionals and specialty societies to protect themselves, Dr. Rudolph said.

    Noting the proliferation of CCM guidance in the marketplace, some of which may appear inconsistent and conflicting in nature, he advised providers to vet thoroughly any CCM advice before implementation.

    Infographic: Telemedicine Market Growth

    February 20th, 2015 by Melanie Matthews

    Telemedicine is one of the fastest growing sectors in healthcare, according to a new infographic by MANA. With increased pressure for healthcare cost efficiency and cost reduction, this growth is expected to accelerate.

    The MANA infographic compares the telehealth market in 2010 and expectations for 2016, along with expected growth rates for home-based and hospital-based telehealth technology.

    Remote Monitoring of High-Risk Patients: Telehealth Protocols for Chronic Care ManagementReal-time remote management of high-risk populations curbed hospitalizations, hospital readmissions and ER visits for more than 80 percent of respondents and boosted self-management levels for nearly all remotely monitored patients, according to 2014 market data from the Healthcare Intelligence Network (HIN).

    Remote Monitoring of High-Risk Patients: Telehealth Protocols for Chronic Care Management profiles a successful eight-year initiative by New York City Health and Hospitals Corporation's (NYCHHC) House Calls Telehealth Program that significantly lowered patients' A1C blood glucose levels.

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    Risk Stratification Targets the High-Risk, Curbs Utilization Across Continuum

    February 19th, 2015 by Cheryl Miller

    Preventive care and utilizing hospital and discharge information are critical for stratification, say a number of thought leaders from organizations like Humana, Adventist Health, Taconic Professional Resources, Monarch Healthcare (a Pioneer ACO), and often lead to improved clinical and financial outcomes. Here, some advice from these thought leaders.

    Across the healthcare continuum, improved clinical and financial outcomes at organizations like Humana, Adventist Health, Taconic Professional Resources, Monarch Healthcare (a Pioneer ACO), and Ochsner Health System were preceded by rigorous risk stratification of populations served.

    “Humana encourages preventive care, and we are trying to prevent the most costly interventions by making sure we address things before they become big problems,” notes Gail Miller, vice president of telephonic clinical operations in Humana’s care management organization, Humana Cares/SeniorBridge. “It is successful so far. We have been able to reduce hospitalizations from what we expected by about 42 percent. We have been able to decrease our hospital readmission rate to 11 percent.”

    Hospital admission and discharge information is critical for stratification, adds Annette Watson, RN-BC, CCM, MBA, senior vice president of community transformation for Taconic Professional Resources. “Depending on the model in a primary care practice (PCP), if a physician is not the admitting physician—if the admission is from a specialist, hospitalist, or through the ER—it cannot be assumed the PCP has the admission and discharge information. People may think physicians know about their patients being in the hospital, but that is not always the case.”

    “Our first step in launching Monarch’s Pioneer ACO program was to develop a population disease profile in risk stratification analysis,” contributes Colin LeClair, executive director of accountable care at Monarch HealthCare. “With the help of Optum Actuarial Solutions, we identified the eight most prevalent and costly conditions in our population. We then identified the largest cohort of high-risk patients best suited for Monarch’s care management programs. Ultimately we isolated the top 6 percent of high-risk patients with a diagnosis of diabetes, congestive heart failure (CHF), chronic obstructive pulmonary disease (COPD), or renal disease and found that of those patients, 6 percent account for 43 percent of total medical cost across the entire population. That analysis resulted in us targeting about 1,200 high-risk patients who have a similar constellation of issues.”

    “You want to look at your high utilizers of care, because they’re using a great deal of care,” concludes Elizabeth Miller, RN, MSN, vice president of care management at White Memorial Medical Center, part of Adventist Health. “There’s potential for decreasing procedures, tests, ED visits, hospitalizations.”

    Source: 2014 Healthcare Benchmarks: Stratifying High-Risk Patients

    http://hin.3dcartstores.com/2014-Healthcare-Benchmarks-Reducing-Hospital-Readmissions_p_4786.html

    2014 Healthcare Benchmarks: Stratifying High-Risk Patients captures the tools and practices employed by dozens of organizations in this prerequisite for care management and jumping-off point for population health improvement—data analytics that will ultimately enhance quality ratings and improve reimbursement in the industry's value-focused climate.

    Guest Post: Following Anthem Breach, 5 Preventive Steps to Protect Businesses Against Electronic Data Theft

    February 19th, 2015 by Kevin Watson

    Kevin Watson is CEO of Netsurion, a provider of cloud-managed IT solutions.


    The country’s second largest health insurer, Anthem Inc., has confirmed it is the latest to join a growing list of major corporations to have suffered a serious data breach. Kevin Watson, CEO of Netsurion, outlines some of the consequences of stolen healthcare data and suggests five steps businesses can take to protect themselves from electronic data theft.

    Unlike many recent data breaches, Anthem was quick to publicly announce the breach only days after discovering that personal information on as many as 80 million of its customers and employees had been stolen. In this case, it appears the hackers used rather sophisticated methods, managing to gather names, dates of birth, social security numbers, addresses and email addresses. Although it does not appear any medical information or financial records were exposed, the information that was taken is more than enough to steal the identities of the affected individuals.

    For so long, the focus of data breaches has been on credit card data, as stolen credit card data can so readily be turned into cash or goods. However, with the increasing popularity of EMV or chip and pin enabled credit cards, the prevalence of data breaches involving personal information may again rise to the forefront. This is especially true when one realizes the value of a stolen identity can often be far greater over the long term than the value of a stolen credit card.

    If access to insurance plan information were to have been stolen along with identity information, data thieves would have a good indicator as to which identities were of higher value based on the value of the insurance plan. If thieves focus on the individuals with the highest plan costs, these are likely the people who are more established in their lives, have families, higher incomes and better credit, meaning their identities are worth even more on the black market.

    This breach highlights that data security is not an issue limited to those processing credit cards. Businesses of all types must think of the type of information stored in their systems and realize they are only as secure as their weakest system. The following checklist outlines simple methods can help protect businesses from electronic data theft:

    1. Protect a Location’s Incoming Internet Traffic

    The first step in stealing data is finding an avenue into the targeted business. All of a business’ data circuits and its Internet connections must be protected by a robust and adaptable firewall; protecting the business from unwanted incoming traffic.

    2. Implement Secure Remote Access

    When permitting remote access to a network, it is essential that this access is restricted and secure. At a minimum, access should only be granted to individual (not shared) user accounts using two-factor authentication and strong passwords. Remote access activities should also be logged so that an audit trail is available.

    3. Keep Anti-Malware Software Up-to-Date

    It is critical to keep all anti-virus/anti-malware software up to date with the latest versions and definitions. The companies that make anti-malware software monitor threats constantly and regularly update their packages to include preventive measures and improvements to thwart malware seen in other attacks.

    4. Update all Operating Systems as Security Patches are Released

    Much like anti-virus/anti-malware updates, designers of operating systems are constantly improving their software to prevent hackers from stealing data, especially if a criminal manages to bypass the built-in security. It is essential that the latest security releases and patches be installed on all systems.

    5. Limit Outbound Internet Traffic

    In addition to blocking unwanted traffic from getting into a location, it is always a good practice to selectively block outgoing traffic as well. Many modern breaches involve software that becomes resident on a company network and then tries to send sensitive data to the hacker’s system via the Internet. No system can completely prevent unwanted malware or viruses, so a good last line of defense is making sure secure data doesn’t leave the network without prior knowledge. The same firewall used in Step One should be configured to monitor outgoing traffic as well as incoming.

    Netsurion is a leading provider of cloud-managed IT security services that protect small- and medium-sized businesses' information, payment systems and on-premise public and private Wi-Fi networks from data breaches and other risks posed by hackers. Netsurion's patented remote installation technology and PCI compliant cloud-based solutions simplify the implementation process and ongoing support. Any sized branch or remote office, franchise or sole proprietor operation can use Netsurion without the costs of onsite support. The company serves the retail, hospitality, healthcare, legal and insurance sectors.

    HIN Disclaimer: The opinions, representations and statements made within this guest article are those of the author and not of the Healthcare Intelligence Network as a whole. Any copyright remains with the author and any liability with regard to infringement of intellectual property rights remain with them. The company accepts no liability for any errors, omissions or representations.