Free EHR, EHR and Healthcare IT Newsletter Want to receive the latest updates on EHR, EMR and Healthcare IT news sent straight to your email? Get all the latest EHR News for FREE!

McKesson Health Solutions Extends VBR Portfolio with ClarityQx Value-Based Payment Technology

Acquisition expands McKesson’s ability to support health plans in scaling bundled payment programs

NEWTON, Mass. and KING OF PRUSSIA, Pa.—July 12, 2016Last month McKesson Health Solutions released a national study that found value-based reimbursement (VBR) has firmly taken hold but that payers and providers are struggling to operationalize some of the fastest growing payment models.

Today McKesson Health Solutions announced it has expanded its portfolio to include ClarityQxvalue-based payment technology through the acquisition of HealthQX™.  This technology enhances McKesson’s ability to help customers rapidly and cost-effectively transition to value-based care by automating and scaling complex payment models, such as retrospective and prospective bundled payment.

Health plans use ClarityQx for analytics and for automation of retrospective bundled payment models and McKesson’s Episode Management™ to support automation of prospective bundled payment. Pairing ClarityQx with McKesson’s Episode Management gives health plans the ability to automate retrospective bundled payment processes today and move to prospective payment as they are ready.

“The growth of bundled payment is something payers and providers can’t ignore, and we want to ensure our customers have all the tools they need to succeed,” said Carolyn Wukitch, senior vice president of McKesson Health Solutions. “These new value-based payment analytics, reconciliation, and automation capabilities complement our value-based reimbursement suite, because they give our customers the capabilities to prepare for and scale bundled payment.”

Payers and providers are under immense pressure to operationalize bundled payments. Bundled payment is projected to be 17% of medical reimbursement by 2021, making it the fastest growing payment model. And the CMS is now mandating bundled payment in one out of every five metropolitan areas as part of its goal to make alternative payment 50% of reimbursement by 2018. Yet just half of payers and only 40% of providers are ready to implement bundles, and nearly 75% don’t have the tools they need to automate these complex models.

Now, with the addition of ClarityQx, McKesson can offer health plans a more complete portfolio that can automate their medical policy, payment policy, value-based reimbursement models, provider management, and contract management.

In addition to ClarityQx, McKesson’s Network and Financial Management portfolio also includes McKesson Episode Management™ prospective bundled payment automation solution,McKesson ClaimsXten™ advanced claims auditing rules engine, McKesson Reimbursement Manager™, McKesson Contract Manager™, McKesson Provider Manager™, and McKesson Payer Connectivity Services™.

ClarityQx was developed by HealthQX, a leading vendor of value-based payment analytic solutions for health plans and providers, which McKesson acquired in June.

“We’re thrilled to be joining McKesson Health Solutions,” said Mark McAdoo, CEO of HealthQX. “The integration of our two companies is reflective of our customers’ needs to rapidly transition from volume to value-based payments.”

About McKesson

McKesson Corporation, currently ranked 5th on the FORTUNE 500, is a healthcare services and information technology company dedicated to making the business of healthcare run better. McKesson partners with payers, hospitals, physician offices, pharmacies, pharmaceutical companies, and others across the spectrum of care to build healthier organizations that deliver better care to patients in every setting. McKesson helps its customers improve their financial, operational, and clinical performance with solutions that include pharmaceutical and medical-surgical supply management, healthcare information technology, and business and clinical services. For more information, visit www.mckesson.com.

July 12, 2016 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

RelayHealth Financial Automates Creation, Management and Tracking of Denied Claim Appeals

RelayAssurance Appeals Assist helps improve revenue health by increasing collection rates on denied claims

ALPHARETTA, Ga., June 27, 2016RelayHealth Financial today introduced RelayAssurance™ Appeals Assist, a new tool that lets providers quickly and easily identify, create, file, and track appeals for denied claims. Now hospital and health system CFOs and revenue cycle leaders can enhance their denial prevention strategy with a way to expedite the appeals process– helping to reduce the associated time and costs, and improving the collection rate on initially denied claims.

While an estimated 6.4% of all provider-submitted claims are initially denied by payers1, two thirds of those claims are recoverable2. Yet many healthcare providers do not appeal denied claims at all, while others dedicate in-house staff or enlist outsourcing firms, which can result in lost revenue, wasted productivity due to manual processes, and significant expense. With RelayAssurance Appeals Assist, denied claims are flagged, the appropriate appeal forms are assembled and completed, and their progress is tracked–all within the same RelayAssurance Plus workflow used to monitor and manage claims.

“Despite providers’ best efforts to submit clean claims, a substantial number still get denied,” said Marcy Tatsch, vice president and general manager, Reimbursement Solutions, for RelayHealth Financial. “An effective denial prevention strategy doesn’t just focus on pre-submission, but also on the other points along the claims continuum. RelayAssurance Plus already offers the robust editing, claim status, and lifecycle visibility capabilities that are essential to denial prevention, and now builds on that functionality with the ability to track a claim’s progress and quickly respond when help is required.”

RelayAssurance Appeals Assist complements the RelayAssurance Plus claims management suite by offering:

  • Integrated Denial Management–Users can quickly and efficiently identify that an appeal is needed, then create, print, and file that appeal and track its progress directly within the same RelayAssurance Plus workflow where claim status/tracking takes place.
  • Forms Library–Built-in standard Medicare appeal forms, templates and letters, along with state-by-state appeals submission requirements help reduce the time and effort required to file appeals.
  • Appeals Dashboard–Visual icons indicate the status of appeals (Created, Submitted, Denied, Succeeded), whether an appeal follow-up has been established based on payer-specific time thresholds, and alert users to filing deadlines–all to ensure active management of appeals.

RelayAssurance Appeals Assist is the latest module available to users of RelayAssurance Plus, RelayHealth Financial’s cloud-based, analytics-driven claims and remittance management solution. Other modules available to complement RelayAssurance Plus include: the new Status Amplifier™, which automatically tracks down, inspects, and reports accurate reasons for non-payment on claims; RelayAssurance™  Medicare Direct Entry, for integrated Medicare claim processing, and automatically-generated secondary claims; Host Integration Services, which helps reduce the need to manually post transmitted claim status information; and Eligibility Claim Edits to monitor for insurance changes.

For more information on RelayHealth Financial’s revenue cycle management solutions, visit our website, learn from our experts at the RelayHealth blog, or follow us on Twitter at @RelayHealth.

For more information on McKesson Health Solutions, please visit our website, hear from our experts at MHSdialogue, follow us on Twitter, like us on Facebook, or network with us on LinkedIn.

1 2015 RelayHealth data

2 “An ounce of prevention pays off: 90% of denials are preventable” Advisory Board, 2014

June 27, 2016 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

Health Insurance Marketplace Open Enrollment Snapshot

Week 6: December 6 – December 12, 2015

More than 1.3 million consumers signed-up for health coverage through the HealthCare.gov platform between December 6 and December 12, the last full week before the deadline for January 1 coverage, bringing the total number of plan selections made since Open Enrollment began on November 1 to 4.17 million consumers.  Approximately 500,000 were new consumers, for a cumulative total of about 1.5 million new consumers since the beginning of Open enrollment.

“The unprecedented demand over the last several days continues to show that coverage through HealthCare.gov is something millions of Americans want and need,” said Department of Health and Human Services Secretary Sylvia Burwell. “We urge those who left their names with the Marketplace to come back to Healthcare.gov or the call center and complete their application for coverage starting January 1.”

Because of the unprecedented demand and volume of consumers contacting our call center or visiting HealthCare.gov, we extended the deadline to sign-up for January 1 coverage until11:59pm PST December 17. Hundreds of thousands have already selected plans on December 14 and 15 and approximately 1 million consumers have left their contact information to hold their place in line.

Similar to last year, each week, the Centers for Medicare and Medicaid Services (CMS) will release weekly Open Enrollment snapshots for the HealthCare.gov platform, which is used by the Federally-facilitated Marketplaces and State Partnership Marketplaces, as well as some State-based Marketplaces. These snapshots provide point-in-time estimates of weekly plan selections, call center activity and visits to HealthCare.gov or CuidadoDeSalud.gov. The final number of plan selections associated with enrollment activity to date could fluctuate as plan changes or cancellations occur, such as in response to life changes like starting a new job or getting married. In addition, the weekly snapshot only looks at new plan selections, active plan renewals and, starting at the end of December, auto-renewals and does not include the number of consumers who paid their premiums to effectuate their enrollment.

HHS will produce more detailed reports that look at plan selections across the Federally-facilitated Marketplace and State-based Marketplaces later in the Open Enrollment period.

Definitions and details on the data are included in the glossary.

Federal Marketplace Snapshot

Federal Marketplace Snapshot

Week 6

Dec 6 – Dec 12

Cumulative

Nov 1 – Dec 12

Plan Selections (net)

1,326,946

4,171,714

New Consumers

38 percent

36 percent

Consumers Renewing Coverage

62 percent

64 percent

Applications Submitted (Number of Consumers)

1,604,633

6,147,257

Call Center Volume

1,511,082

5,383,321

Average Call Center Wait Time

22 minutes 44 seconds

9 minutes 55 seconds

Calls with Spanish Speaking Representative

89,262

338,906

Average Wait for Spanish Speaking Rep

19 seconds

14 seconds

HealthCare.gov Users

3,601,900

13,512,506

CuidadoDeSalud.gov Users

208,935

480,269

Window Shopping HealthCare.gov Users

1,357,120

4,718,633

Window Shopping CuidadoDeSalud.gov Users

21,249

80,195

 

HealthCare.gov State-by-State Snapshot

Consumers across the country continued to explore their health insurance options by reaching out to a call center representative at 1-800-318-2596, attending enrollment events in their local communities, or visiting HealthCare.gov or CuidadoDeSalud.gov. Individual plan selections for the states using the HealthCare.gov platform include:

Week 6

Cumulative

Nov 1 – Dec 12

Alabama

88,108

Alaska

9,344

Arizona

94,928

Arkansas

26,608

Delaware

11,139

Florida

834,938

Georgia

229,552

Hawaii

8,060

Illinois

154,947

Indiana

73,943

Iowa

24,442

Kansas

50,000

Louisiana

88,175

Maine

37,210

Michigan

138,765

Mississippi

33,773

Missouri

129,536

Montana

25,103

Nebraska

43,944

Nevada

43,876

New Hampshire

21,277

New Jersey

121,592

New Mexico

22,440

North Carolina

280,080

North Dakota

9,344

Ohio

97,786

Oklahoma

58,621

Oregon

74,523

Pennsylvania

212,605

South Carolina

112,745

South Dakota

13,905

Tennessee

125,777

Texas

474,616

Utah

80,887

Virginia

178,465

West Virginia

15,615

Wisconsin

112,457

Wyoming

12,588

 

Glossary

Plan Selections:  The weekly and cumulative metrics provide a preliminary total of those who have submitted an application and selected a plan. Each week’s plan selections reflect the total number of plan selections for the week and cumulatively from the beginning of Open Enrollment to the end of the reporting period, net of any cancellations from a consumer or cancellations from an insurer during that time.

Because of further automation in communication with issuers, the number of net plan selections reported this year account for issuer-initiated plan cancellations that occur before the end of Open Enrollment for reasons such as non-payment of premiums. This change will result in a larger number of cancellations being accounted for during Open Enrollment than last year. Last year, these cancellations were reflected only in reports on effectuated enrollment after the end of Open Enrollment. As a result, there may also be a smaller difference this year between plan selections at the end of Open Enrollment and subsequent effectuated enrollment, although some difference will remain because plan cancellations related to non-payment of premium will frequently occur after the end of Open Enrollment.

Plan selections will include those consumers who are automatically re-enrolled into their current plan or another plan with similar benefits, which occurs at the end of December.

To have their coverage effectuated, consumers generally need to pay their first month’s health plan premium. This release does not include totals for effectuated enrollments.

New Consumers: A consumer is considered to be a new consumer if they did not have Marketplace coverage at the start of Open Enrollment.

Renewing Consumers: A consumer is considered to be a renewing consumer if they had 2015 Marketplace coverage at the start of Open Enrollment and either actively select the same plan or a new plan for 2016 or are automatically re-enrolled into their current plan or another plan, which occurs at the end of December.

Marketplace: Generally, references to the Health Insurance Marketplace in this report refer to 38 states that use the HealthCare.gov platform. The states using the HealthCare.gov platform are Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, Georgia, Hawaii, Illinois, Indiana, Iowa, Kansas, Louisiana, Maine, Michigan, Mississippi, Missouri, Montana, Nebraska, New Hampshire, New Jersey, Nevada, New Mexico, North Carolina, North Dakota, Ohio, Oklahoma, Oregon, Pennsylvania, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, West Virginia, Wisconsin, and Wyoming.

HealthCare.gov States: The 38 states that use the HealthCare.gov platform for the 2016 benefit year, including the Federally-facilitated Marketplace, State Partnership Marketplaces and State-based Marketplaces.

Applications Submitted:  This includes a consumer who is on a completed and submitted application or who, through the automatic re-enrollment process, which occurs at the end of December, had an application submitted to a Marketplace using the HealthCare.gov platform. If determined eligible for Marketplace coverage, a new consumer still needs to pick a health plan (i.e., plan selection) and pay their premium to get covered (i.e., effectuated enrollment). Because families can submit a single application, this figure tallies the total number of people on a submitted application (rather than the total number of submitted applications).

Call Center Volume:  The total number of calls received by the Federally-facilitated Marketplace call center over the course of the week covered by the snapshot or from the start of Open Enrollment. Calls with Spanish speaking representatives are not included.

Calls with Spanish Speaking Representative:  The total number of calls received by the Federally-facilitated Marketplace call center where consumers chose to speak with a Spanish-speaking representative. These calls are not included within the Call Center Volume metric.

Average Call Center Wait Time: The average amount of time a consumer waited before reaching a customer service representative. The cumulative total averages wait time over the course of the extended time period.

HealthCare.gov or CuidadodeSalud.gov  Users: These user metrics total how many unique users viewed or interacted with HealthCare.gov or CuidadodeSalud.gov , respectively, over the course of a specific date range. For cumulative totals, a separate report is run for the entire Open Enrollment period to minimize users being counted more than once during that longer range of time and to provide a more accurate estimate of unique users. Depending on an individual’s browser settings and browsing habits, a visitor may be counted as a unique user more than once.

Window Shopping HealthCare.gov Users or CuidadoDeSalud.gov Users: These user metrics total how many unique users interacted with the window-shopping tool at HealthCare.gov or CuidadoDeSalud.gov, respectively, over the course of a specific date range. For cumulative totals, a separate report is run for the entire Open Enrollment period to minimize users being counted more than once during that longer range of time and to provide a more accurate estimate of unique users. Depending on an individual’s browser settings and browsing habits, a visitor may be counted as a unique user more than once. Users who window-shopped are also included in the total HealthCare.gov or CuidadoDeSalud.gov user total.

December 16, 2015 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

Health Insurance Marketplace Open Enrollment Snapshot

Week 5: November 29 – December 5, 2015

Heading into the final days before the December 15 deadline for January 1 coverage, more than 1 million new consumers signed-up for health coverage through the HealthCare.gov platform and about 1.8 million have returned to the Marketplace to renew their coverage for 2016. As expected, consumer interest in health coverage is increasing as we approach theDecember 15 deadline with over 800,000 people selecting plans during the fifth week of Open Enrollment. In total, 2.84 million consumers have made plan selections since November 1.

“I am pleased with the strong start to this year’s Open Enrollment,” Department of Health and Human Services Secretary Sylvia Burwell said.  “While we have more work to do, more than 1 million new consumers have signed up for affordable quality coverage through HealthCare.gov. And the average returning Marketplace consumer who has shopped and chosen a new plan will pay less in premiums after their tax credits this year than they were paying last year. Time is running out to sign up for a health plan that begins on January 1. With less than a week remaining before the December 15th deadline, we urge consumers to visit Healthcare.gov and get enrolled.”

This past week, there were more enrollments than over the same time period in the previous year – the third consecutive week that has occurred. The increase in new enrollments in this past week is particularly relevant.

Similar to last year, each week, the Centers for Medicare and Medicaid Services (CMS) will release weekly Open Enrollment snapshots for the HealthCare.gov platform, which is used by the Federally-facilitated Marketplaces and State Partnership Marketplaces, as well as some State-based Marketplaces. These snapshots provide point-in-time estimates of weekly plan selections, call center activity and visits to HealthCare.gov or CuidadoDeSalud.gov. The final number of plan selections associated with enrollment activity to date could fluctuate as plan changes or cancellations occur, such as in response to life changes like starting a new job or getting married. In addition, the weekly snapshot only looks at new plan selections, active plan renewals and, starting at the end of December, auto-renewals and does not include the number of consumers who paid their premiums to effectuate their enrollment.

HHS will produce more detailed reports that look at plan selections across the Federally-facilitated Marketplace and State-based Marketplaces later in the Open Enrollment period.

Definitions and details on the data are included in the glossary.

Federal Marketplace Snapshot

Federal Marketplace Snapshot

Week 5

Nov 29 – Dec 5

Cumulative

Nov 1 – Dec 5

Plan Selections (net)

804,338

2,844,768

New Consumers

37 percent

36 percent

Consumers Renewing Coverage

63 percent

64 percent

Applications Submitted (Number of Consumers)

1,065,877

4,542,624

Call Center Volume

1,087,987

3,872,239

Average Call Center Wait Time

12 minutes 14 seconds

6 minutes 9 seconds

Calls with Spanish Speaking Representative

66,994

249,644

Average Wait for Spanish Speaking Rep

16 seconds

13 seconds

HealthCare.gov Users

2,787,997

10,823,257

CuidadoDeSalud.gov Users

94,855

263,646

Window Shopping HealthCare.gov Users

1,054,206

3,692,345

Window Shopping CuidadoDeSalud.gov Users

15,718

63,263

 

HealthCare.gov State-by-State Snapshot

Consumers across the country continued to explore their health insurance options by reaching out to a call center representative at 1-800-318-2596, attending enrollment events in their local communities, or visiting HealthCare.gov or CuidadoDeSalud.gov. Individual plan selections for the states using the HealthCare.gov platform include:

Week 5

Cumulative

Nov 1 – Dec 5

Alabama

64,775

Alaska

6,068

Arizona

62,412

Arkansas

18,462

Delaware

7,730

Florida

598,279

Georgia

151,600

Hawaii

5,911

Illinois

97,551

Indiana

47,272

Iowa

16,495

Kansas

34,182

Louisiana

60,902

Maine

24,396

Michigan

89,673

Mississippi

23,224

Missouri

89,308

Montana

16,097

Nebraska

29,520

Nevada

31,173

New Hampshire

13,458

New Jersey

80,152

New Mexico

14,675

North Carolina

192,760

North Dakota

6,119

Ohio

62,181

Oklahoma

40,675

Oregon

49,825

Pennsylvania

146,975

South Carolina

78,238

South Dakota

9,456

Tennessee

88,007

Texas

317,094

Utah

53,872

Virginia

120,375

West Virginia

11,003

Wisconsin

75,938

Wyoming

8,935

 

Glossary

Plan Selections:  The weekly and cumulative metrics provide a preliminary total of those who have submitted an application and selected a plan. Each week’s plan selections reflect the total number of plan selections for the week and cumulatively from the beginning of Open Enrollment to the end of the reporting period, net of any cancellations from a consumer or cancellations from an insurer during that time.

Because of further automation in communication with issuers, the number of net plan selections reported this year account for issuer-initiated plan cancellations that occur before the end of Open Enrollment for reasons such as non-payment of premiums. This change will result in a larger number of cancellations being accounted for during Open Enrollment than last year. Last year, these cancellations were reflected only in reports on effectuated enrollment after the end of Open Enrollment. As a result, there may also be a smaller difference this year between plan selections at the end of Open Enrollment and subsequent effectuated enrollment, although some difference will remain because plan cancellations related to non-payment of premium will frequently occur after the end of Open Enrollment.

Plan selections will include those consumers who are automatically re-enrolled into their current plan or another plan with similar benefits, which occurs at the end of December.

To have their coverage effectuated, consumers generally need to pay their first month’s health plan premium. This release does not include totals for effectuated enrollments.

New Consumers: A consumer is considered to be a new consumer if they did not have Marketplace coverage at the start of Open Enrollment.

Renewing Consumers: A consumer is considered to be a renewing consumer if they had 2015 Marketplace coverage at the start of Open Enrollment and either actively select the same plan or a new plan for 2016 or are automatically re-enrolled into their current plan or another plan, which occurs at the end of December.

Marketplace: Generally, references to the Health Insurance Marketplace in this report refer to 38 states that use the HealthCare.gov platform. The states using the HealthCare.gov platform are Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, Georgia, Hawaii, Illinois, Indiana, Iowa, Kansas, Louisiana, Maine, Michigan, Mississippi, Missouri, Montana, Nebraska, New Hampshire, New Jersey, Nevada, New Mexico, North Carolina, North Dakota, Ohio, Oklahoma, Oregon, Pennsylvania, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, West Virginia, Wisconsin, and Wyoming.

HealthCare.gov States: The 38 states that use the HealthCare.gov platform for the 2016 benefit year, including the Federally-facilitated Marketplace, State Partnership Marketplaces and State-based Marketplaces.

Applications Submitted:  This includes a consumer who is on a completed and submitted application or who, through the automatic re-enrollment process, which occurs at the end of December, had an application submitted to a Marketplace using the HealthCare.gov platform. If determined eligible for Marketplace coverage, a new consumer still needs to pick a health plan (i.e., plan selection) and pay their premium to get covered (i.e., effectuated enrollment). Because families can submit a single application, this figure tallies the total number of people on a submitted application (rather than the total number of submitted applications).

Call Center Volume:  The total number of calls received by the Federally-facilitated Marketplace call center over the course of the week covered by the snapshot or from the start of Open Enrollment. Calls with Spanish speaking representatives are not included.

Calls with Spanish Speaking Representative:  The total number of calls received by the Federally-facilitated Marketplace call center where consumers chose to speak with a Spanish-speaking representative. These calls are not included within the Call Center Volume metric.

Average Call Center Wait Time: The average amount of time a consumer waited before reaching a customer service representative. The cumulative total averages wait time over the course of the extended time period.

HealthCare.gov or CuidadodeSalud.gov  Users: These user metrics total how many unique users viewed or interacted with HealthCare.gov or CuidadodeSalud.gov , respectively, over the course of a specific date range. For cumulative totals, a separate report is run for the entire Open Enrollment period to minimize users being counted more than once during that longer range of time and to provide a more accurate estimate of unique users. Depending on an individual’s browser settings and browsing habits, a visitor may be counted as a unique user more than once.

Window Shopping HealthCare.gov Users or CuidadoDeSalud.gov Users: These user metrics total how many unique users interacted with the window-shopping tool at HealthCare.gov or CuidadoDeSalud.gov, respectively, over the course of a specific date range. For cumulative totals, a separate report is run for the entire Open Enrollment period to minimize users being counted more than once during that longer range of time and to provide a more accurate estimate of unique users. Depending on an individual’s browser settings and browsing habits, a visitor may be counted as a unique user more than once. Users who window-shopped are also included in the total HealthCare.gov or CuidadoDeSalud.gov user total.

December 9, 2015 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

Logicalis US Explores the Impact of a Pending U.S. Interest Rate Hike on IT

Solution Provider Suggests CIOs, CTOs Ask Their CFOs Five Important Questions Now

NEW YORK, December 8, 2015 – It has been almost six years since the Federal Reserve raised interest rates, but if market indicators are correct, the central bank may vote to do just that when it meets later this month. What do interest rate hikes have to do with technology adoption? According to Logicalis US, an international IT solutions and managed services provider (www.us.logicalis.com), quite a lot.

“Because it hasn’t happened for so long, a rise in the interest rate will have a cascading effect on business that organizations may find difficult to anticipate,” says Rich Pirrotta, CFO, Logicalis US. “CIOs who have already prepared their budgets for 2016 may want to revisit their plans and talk with their CFOs about sales projections, access to capital and anticipated cap-ex spends to ensure they’re ready. They should also investigate the smartest ways to finance their IT purchases if the interest rate increase does indeed occur.”

Five Important Questions CIOs Should Ask Their CFOs Now
Logicalis US says CIOs and CFOs should have proactive discussions today about capital purchases planned for 2016 in anticipation of a possible interest rate hike during the first quarter of the new year.  To help, Logicalis US finance experts Rich Pirrotta and Todd Yaekle, Vice President of Finance, suggest the following five questions as conversation starters:

1. Can we access the capital we need for 2016 IT projects? The risk profile for organizations looking for capital today is already fairly high, and if rates go up, it could go even higher further restricting access to capital.
2. Should we be thinking about leasing? In the past, CIOs and CFOs considered leasing only when they were able to negotiate favorable terms.  With an interest rate hike pending, however, the decision about turning to leasing will be less about terms and more about the weighted cost of capital. Leasing costs, as a rule of thumb, don’t increase proportionately with capital interest rates. Imagine, for example, the fed agrees on a 25-basis-point increase; interest on debt will rise by that same 25 basis points, while the cost of leasing may only increase 10 to 15 basis points. As a result, as interest rates rise, constrained access to capital will make leasing a much more inviting option.
3. How can we better negotiate with suppliers to mitigate the impact? Instead of negotiating with technology suppliers on the price of their IT purchases, consider negotiating on terms instead.  If you have net 30 terms now, how would a change to net 45 impact your business? CIOs and CFOs should be talking now about the vendor terms and conditions that could help offset the costs incurred due to an interest rate increase.
4. What will a stronger U.S. dollar mean to international sales? An increase in interest rates yields benefits in terms of strengthening the U.S. dollar, but for organizations doing business abroad, it also creates questions about the validity of existing sales forecasts.  If forecasts change, what impact will there be on the business and its ability to fund proposed capital expenses?
5. As the CIO or CTO, what can I do that will help? This may be the perfect time for organizations that have been considering a move to the cloud to consider taking the next step.  Are there cost savings that could be gleaned from a move to a hybrid cloud strategy? Would tapping as-a-service IT offerings save costs internally?  What savings might be possible by partnering with an experienced managed services provider?  These are just a few of the questions top technology pros should be asking themselves now as they look for ways to drive value and innovation in the coming year.  If considerations like these have been on the back burner, it might be time to accelerate those plans.
Want to Learn More?
  • The real value of a business’ IT infrastructure comes from its use, not its ownership.With an interest rate hike pending, leasing can provide a valuable resource for organizations considering a major technology purchase in the coming year.Learn more here:http://ow.ly/VzKGj.
  • Is now the time to consider outsourcing internal “lights-on” tasks like 24x7x365 monitoring and management of your IT systems to an experienced partner? Read about the six surprise benefits of managed services, watch a video about managed services, find out how managed services works, then explore the business benefits of managed services here: http://ow.ly/V1WCa.
  • Wondering if a move to the cloud could save your business money? Take part in a Cloud Readiness Workshop to find out: http://ow.ly/V1Ytl.

About Logicalis
Logicalis is an international IT solutions and managed services provider with a breadth of knowledge and expertise in communications and collaboration; data center and cloud services; and managed services.

Logicalis employs over 4,000 people worldwide, including highly trained service specialists who design, deploy and manage complex IT infrastructures to meet the needs of over 6,500 corporate and public sector customers. To achieve this, Logicalis maintains strong partnerships with technology leaders such as Cisco, HP, IBM, EMC, NetApp, Microsoft, VMware and ServiceNow on an international basis. It has specialized solutions for enterprise and medium-sized companies in vertical markets covering financial services, TMT (telecommunications, media and technology), education, healthcare, retail, government, manufacturing and professional services, helping customers benefit from cutting-edge technologies in a cost-effective way.

The Logicalis Group has annualized revenues of over $1.5 billion from operations in Europe, North America, Latin America and Asia Pacific and is one of the leading IT and communications solution integrators specializing in the areas of advanced technologies and services.

The Logicalis Group is a division of Datatec Limited, listed on the Johannesburg and London AIM Stock Exchanges, with revenues of over $6 billion.

For more information, visit www.us.logicalis.com.

December 8, 2015 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

AMIA Urges CMS to Rethink Informatics Policies as New Models of Care Emerge

Outcomes-oriented payment policy should enable more outcomes-oriented informatics policy

(BETHESDA, MD) — In comments submitted to the Centers for Medicare & Medicaid Services (CMS), the nation’s leading data scientists in healthcare urged federal officials to use new payment policies to reassess how providers are required to use informatics tools, and rethink how quality is measured in a digital world. Officials from the American Medical Informatics Association (AMIA) said new and novel ways to deliver care will rely on dynamic uses of information technology (IT) and other informatics tools, so government policies dictating the use of IT should be flexible and evolve as more experience is gained with new care models.

CMS issued a request for information (RFI) in October asking for stakeholder input on how best to implement a range of policies required by the Medicare Access and CHIP Reauthorization Act (MACRA) of 2015 (PL 114-10). The Merit-based Incentive Payment System (MIPS) and Alternative Payment Models (APMs) established by MACRA will replace the current Fee-For-Service payment model for Medicare by 2017 and 2019, respectively. This system of reimbursement will rely heavily on electronically-specified clinical quality measures (eCQMs) to pay physicians based on how well their patients recover, rather than the number of services delivered. In comments, AMIA said it supported this move to value-based reimbursement, but voiced concern with the industry’s ability to generate accurate and complete eCQMs, and urged more focus on outcomes-oriented quality measurement.

“AMIA supports the overall direction of moving to an outcomes-based payment system, predicated on demonstrating value for payment,” the organization said in comments. “As we transition away from fee-for-service payment, so too must we move away from the quality measurement paradigm underlying that system. Despite earnest efforts, quality measurement has not become ‘a by-product of care delivered,’ as envisioned, and we are concerned the current mode is insufficient to enable this.”

To improve the current approach, AMIA urged officials to devote more resources to testing both the accuracy of the measure calculation, as well as the feasibility of the data collection requirements, and pilot all new eCQMs before their release for use. CMS should also establish a regular cadence of updates/revisions to eCQMs, ensuring adequate time is allowed for implementation of revisions by both the vendor and provider. Further, AMIA suggested these policies create new opportunities to develop better outcome measures, rather than relying on current process measures.

Additional questions posed by the RFI sought input on how officials should implement policies that require the use of certified EHR technology, and whether new certification criteria are needed to help providers succeed within new payment models. AMIA recommended federal officials avoid overly prescriptive requirements to determine how providers use informatics tools within APMs, but rather focus on the outcomes sought by the use of such tools.

“Ours is a dynamic environment of innovation and invention,” said Blackford Middleton, MD, MPH, MSc, FACMI and current AMIA Board Chair.  “AMIA sees policy development for MIPS and APMs as not just an opportunity to change our payment system, but as an opportunity to revisit policies meant to spur adoption and guide use of health IT.”

AMIA President and CEO Douglas Fridsma, MD, PhD, FACP, FACMI continued, “In much the same way that fee-for-service era policies skewed incentives and provider behavior, overly prescriptive documentation and ‘use’ requirements of the same era have influenced how health IT is developed, implemented and leveraged to improve care.  We must evolve both sets of policies if we are going to succeed in this new paradigm.”

Click here to read AMIA’s full comments to the CMS RFI regarding implementation of MIPS and promotion of APMs.

###

AMIA, the leading professional association for informatics professionals, is the center of action for 5,000 informatics professionals from more than 65 countries. As the voice of the nation’s top biomedical and health informatics professionals, AMIA and its members play a leading role in assessing the effect of health innovations on health policy, and advancing the field of informatics. AMIA actively supports five domains in informatics: translational bioinformatics, clinical research informatics, clinical informatics, consumer health informatics, and public health informatics.

November 16, 2015 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

Kareo and AAPP Partner to Launch Annual Survey

Survey Measures Perceptions and Benefits of Various Practice Models

Irvine, CA – June 10, 2015 – Kareo, the leading provider of cloud-based solutions for independent medical practices, today announced it has released a survey, in partnership with the American Academy of Private Physicians (AAPP). This survey seeks to gain a better understanding of independent physicians’ perceptions around various payment models, including private pay, concierge and traditional fee-for-service. The results of the survey will be released at the AAPP 2015 Fall Summit, taking place September 25-26 in Washington D.C.

Industry Research has shown that many independent physicians are moving toward concierge and direct-pay models to off-set the burden of slow reimbursements from traditional plans like Medicare and third-party payers. This year, Kareo partnered with AAPP to investigate this trend more broadly, seeking to understand the challenges and benefits of each payment structure. Furthermore, this survey seeks to determine if a hybrid practice model, which takes into account various payment models, could solve issues of contention that physicians have with their current practice model.

“Kareo’s mission to help ease the administrative burdens of running a practice aligned perfectly with the goal of this survey,” said Tom Blue, Chief Strategy Officer of AAPP. “The information we will gain from this survey is invaluable to furthering our understanding around what physicians are using which payment models, and why.”

“We are very excited to partner with the AAPP for this survey as we work together to understand the needs of independent physicians across the country,” said Rob Pickell, Chief Strategy Officer of Kareo. “It is our hope that the insights gleaned from this survey will allow Kareo to expand our offerings to better support all practice models.”

Healthcare providers and those who manage their practices can access the survey through the following link for a chance to win an Apple Watch, an iPad, or a one year AAPP membership: Private Practice Model Perspective 2015.

About Kareo
Kareo is the only cloud-based medical office software and services platform purpose-built for small practices. At Kareo, we believe that, with the right tools and support, small practices can do big things. We offer an integrated solution of products and services designed to help physicians get paid faster, find new patients, run their business smarter, and provide better care. Our practice management software, medical billing solution, practice marketing tools and free, award-winning fully certified EHR help more than 30,000 medical providers more efficiently manage the business and clinical sides of their practice. Kareo has received extensive industry recognition, including the Deloitte Technology Fast 500, Inc. 500/5000, Red Herring Top 100 Company, and Black Book #1 Integrated EHR, Practice Management and Billing Vendor. Headquartered in Irvine, California, the Kareo mission is to help providers spend their time focused on patients, not paperwork. For more information, visit www.kareo.com.

About American Academy of Private Physicians
The American Academy of Private Physicians (AAPP) is a nonprofit organization founded in 2003 for the purpose of supporting and fueling the growth of medical practices that provide “concierge” and other forms of personalized, value-based medical care. AAPP members are united by their common efforts and dedication to making medical care more accessible and convenient to patients by redefining and re-pricing medical services in ways that are not possible for medical practices that rely solely on insurance payers for their revenue.

August 11, 2015 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

CMS Begins Implementation of Key Payment Legislation

Proposed Update to Physician Fee Schedule is First Since Repeal of SGR

Today, CMS released the first proposed update to the physician payment schedule since the repeal of the Sustainable Growth Rate through the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA).  The proposal includes a number of provisions focused on person-centered care, and continues the Administration’s commitment to transform the Medicare program to a system based on quality and healthy outcomes.

“CMS is building on the important work of Congress to shift the Medicare program toward a system that rewards physicians for providing high quality care,” said Andy Slavitt, Administrator of CMS.  “Thanks to the recent landmark Medicare and children’s health insurance program legislation, CMS and Congress are working together to achieve a better Medicare payment system for physicians and the American people.”

In the proposed CY 2016 Physician Fee Schedule rule, CMS is also seeking comment from the public on implementation of certain provisions of the MACRA, including  the new Merit-based Incentive payment system (MIPS). This is part of a broader effort at the Department to move the Medicare program to a health care system focused on the delivery of quality care and value.

The proposed rule includes updates to payment policies, proposals to implement statutory adjustments to physician payments based on misvalued codes, updates to the Physician Quality Reporting System, which measures the quality performance of physicians participating in Medicare, and updates to the Physician Value-Based Payment Modifier, which ties a portion of physician payments to performance on measures of quality and cost.  CMS is also seeking comment on the potential expansion of the Comprehensive Primary Care Initiative, a CMS Innovation Center initiative designed to improve the coordination of care for Medicare beneficiaries.

The proposed rule also seeks comment on a proposal that supports patient- and family-centered care for seniors and other Medicare beneficiaries by enabling them to discuss advance care planning with their providers. The proposal follows the American Medical Association’s recommendation to make advance care planning services a separately payable service under Medicare.

The release of the rule triggers a 60-day comment period, during which time CMS welcomes the input of stakeholders and the public.  A final rule will be published this fall. For a fact sheet on the proposed rule, please see here. For further information, please see the rule on display here.

July 8, 2015 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.