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CMS releases new proposal to improve Accountable Care Organizations

Shared Savings Program Proposed Rule reflects focus on primary care and improved incentives for participation, quality, and efficiency

The Centers for Medicare & Medicaid Services (CMS) today released a proposal to strengthen the Shared Savings Program for Accountable Care Organizations (ACOs) through a greater emphasis on primary care services and promoting transitions to performance-based risk arrangements. The proposed rule reflects input from program participants, experts, consumer groups, and the stakeholder community at large. CMS is seeking to continue this important dialogue to ensure that the Medicare Shared Savings Program ACOs are successful in providing seniors and people with disabilities with better care at lower costs.

CMS Administrator Marilyn Tavenner said, “This proposed rule is part of our continued commitment to rewarding value and care coordination – rather than volume and care duplication.  We look forward to partnering with providers and stakeholders to continuously refine and improve the Medicare Shared Savings program.”

Through the Affordable Care Act, ACOs encourage doctors, hospitals and other health care providers to work together to better coordinate care when people are sick and keep people healthy, which helps to reduce growth in health care costs and improve outcomes.  ACOs become eligible to share savings with Medicare when they deliver that care more efficiently while meeting or exceeding performance benchmarks for quality of care.

The Shared Savings Program now includes more than 330 ACOs in 47 states, providing care to more than 4.9 million beneficiaries in Medicare fee for service. Recently, CMS announced first year Shared Savings Program (SSP) results:

  • 58 SSP ACOs held spending below their benchmarks by a total of $705 million and earned shared savings payments of more than $315 million.
  • Another 60 ACOs had expenditures below their benchmark, but not by a sufficient amount to earn shared savings.

Other Affordable Care Act initiatives to improve care and reduce costs have helped reduce hospital readmissions in Medicare by nearly 10 percent between 2007 and 2013 – translating into 150,000 fewer readmissions – and quality improvements have resulted in saving 15,000 lives and $4 billion in health spending during 2011 and 2012.

CMS is seeking comment on a number of adjustments to improve the Medicare Shared Savings Program, including:

  • Providing more flexibility for ACOs seeking to renew their participation in the Program. Many ACOs elect to enter the Program under a one-sided risk model, where the organization participates in shared savings with the Medicare program, but does not take on additional performance-based risk. More experienced ACOs that are ready to share in financial losses in return for the opportunity for a higher share of savings may elect to enter a two-sided model. CMS is proposing to give ACOs the option of a longer lead time to transition to a two-sided performance risk model after their first agreement period. ACOs would have the opportunity to renew under the one-sided model for one additional agreement period. ACOs that enter the Shared Savings Program under the two-sided performance risk model would see no change.
  • Encouraging ACOs to take on greater performance-based risk and reward. CMS is proposing to create a new two-sided risk model, called “track 3,” which integrates some elements from the Pioneer ACO model, such as higher rates of shared savings and prospective attribution of beneficiaries – a list of assigned beneficiaries provided at the start of the performance year, and no further beneficiaries will be added to the list during the performance year.
  • We are seeking comments on a number of care coordination tools that would make two-sided performance risk models more attractive to ACOs such as expanded use of telehealth, beneficiary attestation, and more flexibility around post-acute care referrals to help ACOs better coordinate care for beneficiaries using these services. These tools could all help encourage participating providers to improve quality and care coordination for Medicare beneficiaries, which in turn would result in better patient experiences and greater shared savings for both the ACO and the Medicare program.
  • Emphasis on primary care. CMS proposes to refine the way Medicare beneficiaries are assigned to an ACO to place greater emphasis on primary care services delivered by nurse practitioners, physician assistants and clinical nurse specialists and to allow certain specialists not associated with primary care to participate in multiple ACOs.
  • Alternative methodologies for benchmarks. CMS seeks comment on alternative methodologies that would make ACO benchmarks for determining shared savings and losses gradually more independent of the ACO’s past performance and more dependent on the ACO’s success in being more cost efficient relative to its local market. For example, we are considering whether shared savings received by an ACO should be added back to the benchmark in future performance periods.
  • Streamlining data sharing and reducing administrative burden. CMS proposes to streamline the process for ACOs to access beneficiary claims data necessary for health care operations such as quality improvement activities and care coordination while retaining the opportunity for beneficiaries to decline to have their claims data shared with the ACO.

A fact sheet with more information about the proposed rule is available at: http://www.cms.gov/Newsroom/MediaReleaseDatabase/Fact-sheets/2014-Fact-sheets-items/2014-12-01.html

The proposed rule will be open to a 60-day comment period.

The proposed rule is available for viewing at:  http://www.ofr.gov/(X(1)S(tofvuj12vvyo3oiwkp3jkln3))/inspection.aspx?AspxAutoDetectCookieSupport=1

Comments may be submitted at: http://www.regulations.gov/
This document is scheduled to be published in the Federal Register on 12/08/2014 and available online at http://federalregister.gov/a/2014-28388

December 1, 2014 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.

New Affordable Care Act Initiative to Support Care Coordination Nationwide

The Centers for Medicare & Medicaid Services (CMS) today announced the availability of a new initiative for Accountable Care Organizations (ACOs) participating in the Medicare Shared Savings Program. Made possible by the Affordable Care Act, ACOs encourage quality improvement and care coordination through the use of health information technology, helping to move our health care system to one that values quality over quantity and preventing illness over treating people after they get sick.

The new ACO Investment Model is designed to bring these efforts to better coordinate care to rural and underserved areas by providing up to $114 million in upfront investments to up to 75 ACOs across the country.

“The ACO Investment Model will give Medicare Accountable Care Organizations more flexibility in setting quality and financial goals, while giving them greater accountability for delivering quality care efficiently,” said CMS Administrator Marilyn Tavenner. “We are working with these organizations to make necessary investments that encourage doctors, hospitals and other health care providers to work together to better coordinate care and keep people healthy.”

Through the CMS Innovation Center, this initiative will provide up front investments in infrastructure and redesigned care process to help eligible ACOs continue to provide higher quality care. This will help increase the number of beneficiaries – regardless of geographic location – that can benefit from lower costs and improved health care through Medicare ACOs. CMS will recover these payments through an offset of an ACO’s earned shared savings.

Eligibility is targeted to ACOs who joined the Shared Savings Program in 2012, 2013, 2014, and to new ACOs joining the Shared Savings Program in 2016. The application deadline for organizations that started in the Shared Savings Program in 2012 or 2013 will be December 1, 2014.  Applications will be available in the Summer of 2015 for ACOs that started in the Shared Savings Program in 2014 or will start in 2016.

Recently, ACOs in the Pioneer ACO Model and the Medicare Shared Savings Program generated over $372 million in total program savings for Medicare ACOs while also improving the quality care delivered to Medicare beneficiaries.

ACOs are one part of the overall effort provided by the Affordable Care Act to help lower costs and improve care and quality. For example, the Affordable Care Act has helped reduce hospital readmissions in Medicare by nearly 10 percent between 2007 and 2013 – translating into 150,000 fewer readmissions – and quality improvements has resulted in saving 15,000 lives and $4 billion in health spending during 2011 and 2012.

For more information on the ACO Investment Model, please visit: http://innovation.cms.gov/initiatives/ACO-Investment-Model/

ACO Investment Model CMS Fact Sheet: http://www.cms.gov/Newsroom/MediaReleaseDatabase/Fact-sheets/2014-Fact-sheets-items/2014-10-15.html

October 15, 2014 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.

Inland Empire Health Plan Selects MedHOK Platform

TAMPA, Fla. – April 2, 2013 – MedHOK, which delivers industry leading actionable healthcare solutions across an integrated cloud-based platform, announced today that Inland Empire Health Plan will deploy its comprehensive platform for care, quality and compliance to enhance patient population management and improve patient care.

“Successfully managing patient populations requires that health plans maintain a very ‘high-touch’ relationship with both their providers and the patients they care for,” said Dr. Bradley Gilbert, Chief Executive Officer, Inland Empire Health Plan. “MedHOK’s software will allow us to enhance this process by improving patient and provider interactions and providing the comprehensive information we need to improve the member experience.”

Located in San Bernardino, Calif., Inland Empire Health Plan (IEHP) is a not-for-profit public health plan serving more than 590,000 residents of Riverside and San Bernardino counties through government-sponsored programs including Medi-Cal, Healthy Kids and a Medicare Advantage Special Needs Program.

“Inland Empire Health Plan is growing rapidly and MedHOK’s platform will become increasingly important as the volume of information that we need to successfully manage our growing patient population rapidly expands,” said IEHP Chief Information Officer Michael Deering.

MedHOK’s single platform for care, quality and compliance, provides payers, pharmacy benefit managers (PBMs), accountable care organizations (ACOs) and integrated health networks with the tools they need to view patient information in real time and make it immediately available across the care continuum. By doing so in a manner that is meaningful to each end user, the MedHOK platform creates actionable healthcare wherein individual providers and integrated delivery systems can proactively close care gaps, comply with federal and state regulations, enhance care management and improve Star, HEDIS® and other quality scores.

Its unique Platform-as-a-Service (PaaS) model allows clients to rapidly deploy and easily maintain MedHOK’s scalable solutions, while incurring lower up-front and ongoing costs. Fully NCQA-certified for HEDIS®, Pay for Performance and Disease Management Performance Measures, MedHOK’s software is compliant with CMS and State regulations to ensure consistent application of rules and regulations.

“For a rapidly growing health plan like Inland Empire, selecting a solution that is easily scalable and rapidly deployed is key to success,” said Anil Kottoor, President and CEO, MedHOK. “By utilizing the full array of services provided across our integrated cloud-based platform, Inland Empire will also be well-positioned to improve care management, meet all federal and state mandates and gain a competitive advantage in the marketplace.”

About MedHOK

Tampa, Fla.-based MedHOK has more than 23 million lives in production, making it one of the healthcare industry’s fastest-growing platform-as-a-service (PaaS) companies. Its integrated single platform for care management, quality and compliance helps health plans, PBMs, ACOs and public and private payers meet objectives across business lines by facilitating real-time information sharing with all stakeholders to address disease management and care coordination, clinical quality and utilization review, and quality and financial measures. MedHOK’s platform holds 2013 HEDIS® certification and 2012 Pay for Performance and Disease Management performance measures certification.

April 8, 2013 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.

MedHOK Platform Named 2013 BizTech Innovation of the Year

TAMPA, Fla. – March 15, 2013 – MedHOK, which delivers industry leading actionable healthcare solutions for care, quality and compliance across an integrated cloud-based platform, has been named the winner of the Tampa Bay Business Journal’s 2013 BizTech Innovation of the Year Award.
The award recognizes MedHOK as an organization in the Tampa Bay area who continues to make substantial gains in the development, implementation and utilization of their technology across their entire enterprise, including their valued clients. Winners were determined by a distinguished panel of judges in the Tampa Bay business community and announced yesterday during the 2013 BizTech Innovation Awards luncheon.
“This recognition is a true testament to the hard work and dedication our team has put into the development and maintenance of our proprietary platform,” said Anil Kottoor, president and CEO, MedHOK. “As an organization that is dedicated to utilizing the latest technological innovations to improve care, quality and compliance for healthcare organizations, it is an honor to be recognized for our achievements in this arena.”
MedHOK’s single platform for care, quality and compliance, provides insurance carriers, pharmacy benefit managers (PBMs), accountable care organizations (ACOs) and integrated health networks with the tools they need to view patient information in real time and make it immediately available across the care continuum. By doing so in a manner that is meaningful to each end user, MedHOK’s platform creates actionable healthcare wherein individual providers and integrated delivery systems can proactively close care gaps, comply with federal and state regulations, enhance care management and improve Star, HEDIS® and other quality scores.
The unique Platform-as-a-Service (PaaS) model allows clients to rapidly deploy and easily maintain MedHOK’s scalable solutions, for lower up-front and ongoing costs. MedHOK’s software is fully NCQA-certified for HEDIS®, Pay for Performance and Disease Management Performance Measures and compliant with CMS and State regulations, to ensure consistent applicatio n of rules and regulations.
 
About MedHOK
Tampa, Fla.-based MedHOK has more than 23 million lives in production, making it one of the healthcare industry’s fastest-growing PaaS (platform as a service) companies. Its integrated single platform for care management, quality and compliance helps health plans, PBMs, ACOs and public and private payers meet objectives across business lines by facilitating real-time information sharing with all stakeholders to address disease management and care coordination, clinical quality and utilization review, and quality and financial measures. MedHOK’s platform holds 2013 HEDIS® certification and 2012 Pay for Performance and Disease Management performance measures certification.
March 27, 2013 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.

MedHOK Named Finalist for 2013 BizTech Innovation of the Year Award

TAMPA, Fla. – March 5, 2013 – MedHOK, which delivers industry leading actionable healthcare solutions for care, quality and compliance across an integrated cloud-based platform, has been named a finalist for the Tampa Bay Business Journal’s 2013 BizTech Innovation of the Year Award. This recognition acknowledges MedHOK as an organization in the Tampa Bay area who continues to make substantial gains in the development, implementation and utilization of their technology across their entire enterprise, including their valued clients.
Finalists for the2013 BizTech Awards were determined by a distinguished panel of judges in the Tampa Bay business community. Winners will be announced on March 14, 2013 during the BizTech Innovation Summit awards luncheon.
“Developing a platform that meets the rapidly evolving needs of the healthcare industry and that utilizes the latest advances in technology and cloud-computing is at the center of all that we do,” said Anil Kottoor, president and CEO, MedHOK. “It is an honor to be named among the most innovate technology providers in the Tampa Bay region. It acknowledges the hard work that our team has put into developing and maintaining our integrated platform.”
MedHOK’s single platform for care, quality and compliance, provides insurance carriers, pharmacy benefit managers (PBMs), accountable care organizations (ACOs) and integrated health networks with the tools they need to view patient information in real time and make it immediately available across the care continuum. By doing so in a manner that is meaningful to each end user, MedHOK’s platform creates actionable healthcare wherein individual providers and integrated delivery systems can proactively close care gaps, comply with federal and state regulations, enhance care management and improve Star, HEDIS® and other quality scores.
The unique Platform-as-a-Service (PaaS) model allows clients to rapidly deploy and easily maintain MedHOK’s scalable solutions, for lower up-front and ongoing costs. MedHOK’s software is fully NCQA-certified for HEDIS®, Pay for Performance and Disease Management Performance Measures and compliance with CMS and State regulations, to ensure consistent application of rules and regulations.
 
About MedHOK
Tampa, Fla.-based MedHOK has more than 23 million lives in production, making it one of the healthcare industry’s fastest-growing PaaS (platform as a service) companies. Its integrated single platform for care management, quality and compliance helps health plans, PBMs, ACOs and public and private payers meet objectives across business lines by facilitating real-time information sharing with all stakeholders to address disease management and care coordination, clinical quality and utilization review, and quality and financial measures. MedHOK’s platfo rm holds 2013 HEDIS® certification and 2012 Pay for Performance and Disease Management performance measures certification.
March 6, 2013 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.

Artificial Medical Intelligence Announces EMscribe Computer Assisted Coding Software; Now with Clinical Document Improvement

EMscribe CDI Provides More Accurate and Complete Clinical Documentation Enabling Hospitals to Receive Faster, More Accurate Reimbursement

 LAS VEGAS-HIMSS Conference—March 4, 2012Artificial Medical Intelligence (AMI) today announced that its Computer Assisted Coding (CAC) solution, EMscribe now has integrated Clinical Documentation Improvement (CDI).

AMI takes CDI to the next level by integrating more than 300 different quality measures that have been registered and approved into AMI’s Natural Language Processing CAC solution. The clinical documentation guidelines give hospital personnel the information they need to support documentation decisions regarding patient severity, acuity, and risk of mortality.  EMscribe CDI provides tangible improvement outcomes through software monitoring, searchable data, user-defined reports and real time performance monitoring and clinical updates.

EMscribe CDI also integrates smoothly with quality initiatives such as The Physician Quality Reporting System, National Healthcare Safety Network, and Accountable Care Organizations.  It allows users to flag customized diagnoses or procedures along with the real time status on physician and healthcare worker documentation updates.   EMscribe CDI ultimately helps hospitals better reflect reimbursement services provided.

“Since January 2005, we have built a platform that provides usability and innovation for useable Natural Language Processing technology for all types of healthcare systems globally,” said Stuart Covit, COO of Artificial Medical Intelligence Inc.  “By integrating CDI into the EMscribe CAC technology, we are delivering tremendous usability and a customizable process that supports the entire CDI team. In the last six months AMI has accelerated its product innovation efforts with its releases offering E & M, Robotic Computer Coding Automation and now CDI.  AMI will continue to push our development efforts through our innovative approach that is well received in the industry.”

EMscribe CDI combines site specific and global best practices, evidence-based medicine, clinical case management, benchmark metrics and utilization review through its proprietary usage of Natural Language Processing business intelligence which is at the heart of the EMscribe core technology. Additionally, the CDI software is functionality designed to augment in-house or outsourced dedicated specialists assigned for clinical documentation improvement at or with remote access to healthcare sites.

AMI’s EMscribe Computer Assisted Coding with CDI is available immediately. The product can be seen at the upcoming HIMSS Conference March 3-7 in New Orleans at the AMI booth 6951.

About AMI

Founded in 2002, Artificial Medical Intelligence is a healthcare informatics software developer focusing on increasing efficiency within Health Information Management. Its patent pending core solution, EMscribe, provides suggested coding and abstractions using Natural Language Processing for both the inpatient and outpatient encounter. EMscribe® is also now processing the E & M level with its next generation NLP algorithms for both the professional and facility based patient encounter.  The innovative solutions are very adaptable and can automate certain patient record types with no coder input needed. The technology can also automatically abstract Principal and Admit Diagnoses.  NLP is used to generate Present on Admission diagnoses, and Hospital Acquired Condition, as well as a variety of other patient values, thus making it the most comprehensive hospital tested HIM-Coding solution available. AMI’s solutions are targeted at hospital healthcare facilities, larger clinics and physician practices that are looking to automate process management and improve the processing of medical documents.  The Powered by EMscribe® technology is available to partners and is sold directly to hospitals nationwide. The company is headquartered in Eatontown, New Jersey.

March 4, 2013 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.

American Sentinel University Details How Cloud Computing Has the Potential to Revolutionize Health Care

– Cloud-based Applications Benefit Nurses and Patients at Point of Care –

AURORA, Colo. – February 12, 2013 – Cloud computing has the potential to revolutionize health care administration by allowing providers to access information from a patient’s medical file at anytime from any where and that means patients receive better and more efficient quality care.

“Everything in health care today is so dependent on computers and cloud computing is the repository for all of these transactions,” says Suzanne Richins, DHA, MBA, FACHE, RN, chair, health information management and health care administration at American Sentinel University.  “Cloud computing benefits nurses at point of care because no matter where the patient has a diagnostic test, the cloud ensures that data is available everywhere.”

The ‘cloud’ is an intangible, but ubiquitous presence in our tech-laden lives, allowing health care professionals to access all patient data across multiple devices and from any location with an Internet connection.

As an IT strategy, cloud computing took the business world by storm, allowing companies to store massive amounts of data virtually, rather than making a huge investment in developing and maintaining their own information system storage. Yet, health care has been a relative latecomer to cloud computing, largely because of the industry’s unique data security, regulatory, and patient privacy concerns.

“Laws require protection of pertinent information to ensure both confidentiality and privacy and before a health care organization contracts with a cloud organization, management needs to ensure that the cloud can meet the requirements of both HIPPA and meaningful use,” says Richins.

The mandate to widely adopt electronic medical records (EMRs), however, is expected to change that and a recent report by research firm MarketsandMarkets projected health care-related cloud computing will become a $5.4 billion global industry by 2017, encompassing both clinical and non-clinical applications.

Health Care Benefits from Cloud Computing
The most significant benefit cloud computing offers health care is data access.

When patient information is stored in the cloud, providers can access lab results, imaging scans and other pertinent test results at anytime and in any place, allowing for improved care coordination and better decision-making.

“As the move toward accountable care organizations (ACOs) drives the need for a better flow of information between primary care providers, specialists and case managers, clinical use of the cloud is likely to expand to include mobile applications that deliver data to tablets and smartphones,” adds Richins.

Most importantly, cloud-based platforms can allow collaboration between providers in real-time, from nearly any device that can connect to the Internet so health care organizations can manage data with more agility when working in the cloud.

Cloud Computing at the Bedside
Cloud computing benefits IT staff, nurse informaticians involved with EMR implementation and even the hospital’s bottom line. But Richins points out that health care will start seeing innovative, cloud-based applications that benefit nurses and patients at the point of care.

One example is Ultimate Caregiver, a nurse call system which merges pull cord technology with the power of cloud computing and mobile devices to allow for wireless paging and generated staff response reports.

When a patient rings for a nurse, the call signal is processed in the cloud and alerts are sent to nurses in the form of texts, e-mails, pages, or phone calls. This allows nurses to be more efficient on the floor, as the closest staff member can respond quickly to the patient and no one is tied to a nursing station to track patient call signals.

The use of cloud computing will also have a positive impact on career nursing opportunities in nursing informatics.

Richins notes that all of the third-party payers, including the government require reporting of quality measures and nurse informaticists are responsible for analyzing the data for reporting to these organizations.

“Nurse informaticists are critical to identification of problems, the root cause and identification of solutions and now that the payers do not reimburse for certain diagnoses, readmissions and hospital-acquired infections, nurse informatics are critical to the process as all decision-making requires evidence that comes from the data,” says Richins.

Cloud-based computing is also a boon to home health nurses, giving them easy access to accurate data, allowing them to document visits and update charts in real-time and freeing them from the cumbersome daily synchronization routine.

Richins notes that health care is in need of nurses who can analyze technologies from both the bedside and IT perspectives.

“Health informatics is the new frontier of health care and one of the fastest growing fields today. Nurses with a nursing informatics specialization will be in high demand to manage health information systems critical to the mission of health care delivery,” says Richins.

She points out that while opportunities in nursing informatics are plentiful, nursing informatics is not an entry-level career.

“RNs who find work in this specialty typically have several years of experience and professional education in both information systems and nursing,” adds Richins.

A registered nurse with an associate degree in nursing can purse a nursing informatics degree by taking the RN to BSN courses or RN to MSN courses. If a nurse already has a BSN, they can enter directly into the MSN program with a concentration in nursing informatics.

American Sentinel University helps prepare nurses for a variety of careers in nursing informatics with an online Master of Science in Nursing, Nursing Informatics specialization degree program that emphasizes understanding the infrastructure necessary to improve practice while safeguarding the security and privacy of data.

Learn more about American Sentinel University’s CCNE-accredited Master’s of Science in Nursing, Nursing Informatics program at http://www.americansentinel.edu/health-care/m-s-nursing/m-s-nursing-nursing-informatics.

About American Sentinel University
American Sentinel University delivers the competitive advantages of accredited online nursing degree programs in nursing, informatics, MBA Health Care, DNP Executive Leadership and DNP Educational Leadership. Its affordable, flexible bachelor’s and master’s nursing degree programs are accredited by the Commission for the Collegiate Nursing Education (CCNE). The university is accredited by the Distance Education and Training Council (DETC). The Accrediting Commission of DETC is listed by the U.S. Department of Education as a nationally recognized accrediting agency and is a recognized member of the Council for Higher Education Accreditation.

February 14, 2013 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.

Solution to Help Providers Navigate Shifting Risk Models

First Combination of Population Health Management Tools with Claims-Based Analytics to Help Providers Manage Costs under Value-Based Reimbursement

Waltham, MA, Jan. 17, 2013 – Phytel, the leader in automated, provider-led population health improvement, and Verisk Health, a leader in data-driven risk assessment and performance management technologies, announced today a strategic agreement to develop an integrated solution that combines claims-based risk assessment and medical cost management with enterprise-level care management based on real-time clinical data.  The new solution will give healthcare providers and provider-led accountable care organizations (ACOs) key tools and capabilities they require to succeed under health reform.

As healthcare payment models shift from transactional fee-for-service arrangements to provider risk contracts, market demand is growing for solutions that combine financial analytics, risk assessment, and quality improvement with care management tools. Phytel’s Atmosphere Population Management platform aggregates data from electronic health records (EHRs) and practice management systems in hundreds of physician groups nationwide, offering a suite of tools for automating population health management, including modalities for patient outreach, care gap identification, risk stratification, care management, patient engagement, transitions of care, and performance evaluation. Verisk Health’s Provider Intelligence solution helps identify and target inappropriate use of medical resources, manage in-network and out-of-network costs and utilization, and drive physician and practice-level strategies focused on improving the patient experience and maintaining business stability and profitability.

Combined, these services will deliver a key platform that links financial and performance analytics with case management and population health tools within existing care delivery models. The resulting solution will provide healthcare organizations the ability to identify and address high-cost or low-performing areas within their organization while engaging patients to improve the health of their entire population.

Steve Schelhammer, CEO of Phytel, said, “By automating population health management, Phytel enables healthcare organizations to improve care coordination, identify and close patient care gaps, implement care management of high-risk patients, engage patients in managing their own health, and improve critical transitions of care. We’re excited to work with Verisk Health to help our customers better manage financial risk while providing improved care to their patients. By enabling them to both automate population health and draw actionable insights from claims data, this agreement positions our customers to optimize system performance and manage medical costs so they can optimize quality and financial outcomes associated with performance and risk based contracts.”

“The market demand to prove value is driving an unprecedented need to translate data into actionable information that can be used across the care continuum. All stakeholders — patients, providers, and payers — need access to complete sets of information at the right time and within the right context to drive change in behavior and outcomes,” said Joel Portice, president of Verisk Health. “We’re excited to be working with Phytel to provide a transformative solution that will facilitate physician-led teams to achieve increases in quality and cost-savings across their entire populations, effectively and efficiently, using both claims and clinical data.”

The Verisk Health/Phytel solution will provide both clinical information and claims-based risk assessments for an at-risk population engaged in a payer-provider risk contract. Clients will be able to use the solution to answer critical questions, such as:

•        What health risks characterize my patient population?

•        What targeted interventions can I offer to reduce the risks?

•        Which patients are at the greatest risk for hospitalization or ED services?

•        Where are there non value-add treatments/services that can be avoided to reduce cost?

•        Who are the patients I can engage to improve care?

•        How can I measure my effectiveness?

•        How does my effectiveness compare with my peers?

Upcoming Webinar for Providers

To learn more about how providers can better navigate shifting risk models, please join us for a complimentary webinar, February 6, 1 to 2 p.m. ET. To register, please visit www.veriskhealth.com/content/webinars.

About Verisk Health

Verisk Health drives performance excellence in the business of healthcare. By combining clinical and analytics expertise with robust technology and services, we empower customers to fully leverage their data to achieve long-term measurable results. Our data-driven risk assessment technologies and business decision analytics enable clients to proactively seize opportunities for improving clinical, financial and performance results including care management; risk identification and stratification; HEDIS compliance; benefit program measurement; fraud, waste, and abuse prevention; payment accuracy; and revenue cycle management. Verisk Health is a subsidiary of Verisk Analytics (Nasdaq:VRSK). For more information, visit www.veriskhealth.com.

About Phytel

The premier company empowering physician-led population health improvement, Phytel provides physicians with proven technology to deliver timely, coordinated care to their patients. Phytel’s state-of-the-art registry, which now encompasses more than 25 million patients nationwide, uses evidence-based chronic and preventive care protocols to identify and notify patients due for service, while tracking compliance and measuring quality and financial results. For more information, please visit www.phytel.com. Follow us on Twitter and find us on Facebook.

February 5, 2013 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.

MedHOK’s 360ACO® Positions ACOs to Reduce Hospital Readmissions, Benefit From Shared Savings

TAMPA, Fla. – Sept. 5, 2012 – Accountable care organizations (ACOs) that deploy 360ACO® from MedHOK, one of the healthcare industry’s fastest-growing software companies, are well-positioned to reduce hospital readmissions and meet quality outcomes as required to benefit from shared savings under the Centers of Medicare and Medicaid (CMS) program.

MedHOK offers fully NCQA–certified software for HEDIS®, pay-for-performance (P4P) and disease-management-performance measures. The company has more than 18 million lives in production and is on track to double this number within the year.

“Hospital readmissions are a major cost driver in Medicare, accounting for a startling $17.5 billion in additional inpatient spending each year. To combat this, CMS is incentivizing ACOs to take steps to reduce readmissions and improve follow-up care for patients with acute myocardial infarction, heart failure and pneumonia,” said Anil Kottoor, president and CEO, MedHOK. “The challenge for many ACOs will be tracking quality outcomes and facilitating the improved coordination of care necessary for timely interventions. MedHOK’s 360ACO overcomes those challenges and positions ACOs to share in the resulting savings.”

MedHOK’s 360ACO integrates patient information in real time and makes it immediately available to hospitals, physicians and other participating providers. The disease and case management modules allow the ACO to better manage care for high-risk patients, reducing unnecessary utilization and encouraging improved patient self-management. Further, 360ACO enables real-time monitoring of quality performance to ensure the ACO is on target to meet the rigorous quality standards that will allow it to share in any reductions in Medicare fee-for-service expenditures.

MedHOK’s integrated care management, quality and compliance platform facilitates improved clinical outcomes and care coordination while enhancing quality measures, compliance and financial performance. It accomplishes this by:

  • Providing real-time access to Star, HEDIS, P4P, and proprietary quality and performance measures, helping plans and providers to accurately monitor in real-time the data they need to achieve and maintain high-quality ratings
  • Triggering interventions when care gaps are identified, in particular for patients with multiple comorbidities and chronic conditions
  • Utilizing predictive analytics models to generate profiles based on clinical, quality and financial data for member, provider and local populations
  • Calculating risk scores for every member, enabling timely predictions of those at the highest risk and more accurate forecasting of care costs and utilization
  • Continuously monitoring for and addressing regulatory changes from CMS and state Medicaid agencies, ensuring clients stay ahead of the compliance curve

“MedHOK’s 360ACO is an end-to-end technology solution that positions ACOs to thrive in this new environment of care, quality and compliance,” said Kottoor. “By utilizing 360ACO, providers will be able to intervene before readmissions are necessary, resulting in increased savings and improved patient care.”

About MedHOK

Tampa, Fla.-based MedHOK has more than 18 million lives in production and expects to double that number in 2012, making it one of the healthcare industry’s fastest-growing software companies. It offers a cloud-based integrated software platform for care management, quality and compliance that enables physicians, ACOs, PCMHs, payers and TPAs to manage and measure care against national quality standards for optimal outcomes. Its innovative modular software helps healthcare organizations meet quality, care and compliance objectives across business lines by facilitating real-time information sharing with all stakeholders to address disease management and care coordination, clinical quality and utilization review, and quality and financial measures. ICD-10 compliant, HIE-ready and securely accessible on any device, the MedHOK platform is user-friendly, rapidly deployed and easily configurable for a low total cost of ownership and rapid return on investment. It holds 2012 HEDIS®, Pay for Performance and Disease Management performance measures certification.

September 9, 2012 I Written By

NextGen Healthcare Enters Into Reseller Agreement With Nuance Communications

Relationship to provide more streamlined, cost-effective approach to patient data entry

Horsham, Pa. – March 27, 2012 – NextGen Healthcare Information Systems, Inc., a wholly owned subsidiary of Quality Systems, Inc. (NASDAQ: QSII) and a leading provider of healthcare information systems and connectivity solutions, today announced a reseller agreement with Nuance Communications, Inc. (NASDAQ: NUAN), a leading provider of speech-driven clinical documentation, clinical language understanding and analytics solutions to more than 450,000 physicians and 10,000 healthcare institutions worldwide.

Under the agreement, NextGen Healthcare will resell Nuance’s Dragon Medical speech recognition software to its NextGen® Ambulatory EHR clients, enabling physicians and administrators to navigate, dictate and correct medical documents by voice, directly within the electronic health record (EHR). Dragon Medical software is currently used by more than 180,000 clinicians worldwide. By incorporating the software as part of the NextGen Ambulatory EHR workflow, healthcare organizations can:

  • Improve physicians’ clinical documentation productivity;
  • Minimize time and costs associated medical transcription;
  • Drive appropriate levels of reimbursement through more complete documentation;
  • Increase patient engagement by enabling providers to capture data at a discrete level; and,
  • Enhance the quality of clinical notes to facilitate better care coordination.

“Dragon Medical provides physicians and their staff the freedom to incorporate high-value, customized narratives as part of patients’ medical records,” said Janet Dillione, executive vice president and general manager of Nuance Healthcare. “Together, advanced voice and language understanding solutions make it possible to capture the complete patient story and enable unprecedented access and interaction with the data that has been captured. We believe this collaboration with EHR leader NextGen Healthcare will bring far-reaching benefits to its diverse client base.”

“With healthcare reform initiatives such as Meaningful Use and Accountable Care Organizations (ACOs) continually emerging and evolving, the ability to collect patient data in a discrete manner is perhaps now more important than ever,” noted Scott Decker, president of NextGen Healthcare. “The comprehensive reporting capabilities offered by NextGen Ambulatory EHR are best utilized when discrete data is not only accessible but also stored in the proper format. Leveraging Nuance technology will provide our clients the flexibility needed to capture patient data and effectively populate it through our powerful reporting engine. We believe that Dragon Medical will complement and enhance the breadth and depth of our EHR capability.”

About Nuance Healthcare

Nuance Healthcare, a division of Nuance Communications, is the market leader in providing clinical understanding solutions that accurately capture and transform the patient story into meaningful, actionable information. Thousands of hospitals, providers and payers worldwide trust Nuance voice-enabled clinical documentation and analytics solutions to facilitate smarter, more efficient decisions across the healthcare enterprise. These solutions are proven to increase clinician satisfaction and HIT adoption, supporting organizations to achieve Meaningful Use of EHR systems and transform to the accountable care model. Recognized as “Best-in-KLAS” 2004-2011 for Voice Recognition we invite you to learn more, http://www.nuance.com/for-healthcare/index.htm.

About NextGen Healthcare

NextGen Healthcare Information Systems, Inc., a wholly owned subsidiary of Quality Systems, Inc., provides integrated clinical, financial and connectivity solutions for ambulatory, inpatient and dental provider organizations. For more information, please visit www.nextgen.com and www.qsii.com. Follow NextGen Healthcare on Twitter at www.twitter.com/nextgen or Facebook at http://www.facebook.com/NextGenHealthcare

April 1, 2012 I Written By