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!

Carequality Seeks Community Input As It Expands Governance to FHIR

Vienna, VA – October 11, 2018 – Carequality, a national-level, interoperability trusted exchange framework, is actively seeking input from the healthcare community as it adds support for FHIR-based exchange. Member and non-member stakeholders from across the healthcare continuum are encouraged to participate in the new FHIR Implementation Guide Technical and/or Policy workgroups. The former will concentrate more on specifications and security, while the latter will focus on the “rules of the road.”

“Carequality has demonstrated the power of a nationwide governance framework in connecting health IT networks and services for clinical document exchange,” said Dave Cassel, Executive Director of Carequality.  “We believe that the FHIR exchange community will ultimately encounter some similar challenges to those that Carequality has helped to address with document exchange, and likely some new ones as well.  We’re eager to engage with stakeholders to map out the details of FHIR-based exchange under Carequality’s governance model.”

With much of the healthcare industry either starting to implement FHIR at some level, or planning to do so, the Carequality community is thinking ahead to the type of broad, nationwide deployments that Carequality governance can enable. The new policy and technical workgroups are expected to work in concert with many other organizations contributing to the maturity and development of FHIR. The workgroups will not duplicate the work that is underway on multiple fronts; including defining FHIR resource specs and associated use case workflows. Instead, the workgroups will focus on the operational and policy elements needed to support the use of these resources across an organized ecosystem.

“The overarching goal of all healthcare interoperability project is to improve outcomes, lower costs, and broadly improve overall population health,” said Cassel. “We believe that adoption of FHIR in the Carequality Interoperability Framework can advance all of these goals by improving the availability of useable clinical information, expanding the scope of exchange, and significantly lowering the costs of participating in interoperable exchange.”

Individuals interested in participating in either or both workgroups should emailadmin@carequality.org, and indicate which workgroup is of interest.

###

What is Carequality?

Carequality is a national-level, consensus-built, common interoperability framework to enable exchange between and among health data sharing networks. Carequality brings together diverse groups, including electronic health record (EHR) vendors, record locator service (RLS) providers and other types of existing networks from the private sector and government, to determine technical and policy agreements to enable data to flow between and among networks, platforms, and geographies.

The Carequality Framework provides the essential elements for trusted national exchange, such as common rules of the road (including a Trusted Exchange Framework), well-defined technical specifications and a participant directory. For more information, visit www.carequality.org and follow us at twitter.com/carequality.

October 11, 2018 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 5 blogs containing over 11,000 articles with John having written over 5500 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 18 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.

GRAChIE Using eHealth Exchange To Mobilize Connection Points for Hurricane Florence Evacuees

eHealth Exchange Network Model Ensures Secure, Interoperable Health Information Exchange

(Vienna, VA – September 14, 2018) –  As the nation braces for the force of Hurricane Florence, the Georgia Regional Academic Community Health Information Exchange (GRAChIE) is working to connect to eHealth Exchange participants in South Carolina, North Carolina, Virginia and Florida in preparation for displaced evacuees.

Major disasters such as Hurricane Florence have an effect on healthcare information needs – even before they make landfall. Hurricane Florence has already resulted in the evacuation of millions who have left the places where they normally receive care and where their healthcare records are housed.

GRAChIE has been working diligently expand its connectivity to health information exchanges (HIEs) throughout the Southeast via the eHealth Exchange as quickly as possible before Hurricane Florence hits the coast.

“We are making great strides for building bridges and exchange throughout the southeast as the storm approaches,” said Tara Cramer, CEO of GRAChIE.  “We are currently taking connections live with the approach we used last year during Hurricane Irma with great success.”

“The eHealth Exchange network provides a nationwide backbone for health information sharing that enables network participants to share information in the normal course of care and to quickly expand those connections when emergencies arise, “said Jay Nakashima, Vice President of eHealth Exchange. “This ensures a state of readiness. In disaster situations such as Hurricane Florence, physicians must have instant access to electronic patient histories to provide safe and effective care.”

Patient Unified Lookup System for Emergencies (PULSE)

When disaster strikes, and families are relocated to shelters in their community or even further afield, prescription refills and other healthcare needs become more challenging. The Sequoia Project, building upon the work incubated by HHS, is spearheading a nationwide deployment plan for the health IT disaster response platform known as the Patient Unified Lookup System for Emergencies (PULSE). The PULSE system enables authorized disaster healthcare volunteers treating patients in field hospitals, outside the normal care setting to access patient records when they have been injured or displaced by disasters and other emergencies.

“Disasters and other events are unpredictable and disruptive and place unique demands on public health, private sector healthcare, first responders and other key resources,” said Mariann Yeager, CEO of The Sequoia Project. “People need seamless healthcare, whether for emergency care or just uninterrupted prescription access, when they are displaced by a disaster.”

The PULSE platform was activated in California for the 2017 and 2018 wildfires, and many area health systems and providers rallied behind the effort. This experience will guide further efforts to deploy PULSE in other states and regions by informing governance, activities and policies on a national-level platform to enable sharing among disaster healthcare volunteers and community providers.

###

About eHealth Exchange

The eHealth Exchange is a rapidly growing health data sharing network for securely sharing clinical information over the Internet nationwide. The eHealth Exchange spans all 50 states and is the largest clinical health data sharing network in the United States. Current eHealth Exchange participants include large provider networks, hospitals, pharmacies, regional health information exchanges and many federal agencies, representing more than 75% of all U.S. hospitals, 70,000 medical groups, more than 8,300 pharmacies and 120 million patients where over 200 million clinical documents are exchanged annually. For more information about the eHealth Exchange, visit www.ehealthexchange.com. Follow the eHealth Exchange on Twitter: @eHealthExchange.

About GRAChIE

The Georgia Regional Academic Community Health Information Exchange (GRAChIE) serves healthcare organizations and providers across Georgia seamlessly bringing health information from one healthcare professional to another. GRAChIE provides health information in a secure, electronic format allowing healthcare professionals to appropriately access and securely share a patient’s health information electronically through EHR system. https://grachie.org/

About The Sequoia Project

The Sequoia Project is a non-profit, 501c3, public-private collaborative chartered to advance implementation of secure, interoperable nationwide health information exchange. The Sequoia Project supports multiple, independent health IT interoperability initiatives, most notably: the eHealth Exchange, a rapidly growing national-level health information network; and Carequality, which is a national-level, consensus-built, common interoperability framework to interconnect and enable exchange between and among existing health information networks, much like the telecommunications industry did for linking cell phone networks. For more information about The Sequoia Project and its initiatives, visit www.sequoiaproject.org. Follow The Sequoia Project on Twitter: @SequoiaProject.

September 14, 2018 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 5 blogs containing over 11,000 articles with John having written over 5500 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 18 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.

Formativ Health Partners with Lyft to Help Get Patients to Medical Appointments with Seamless Booking System

Formativ Health, a technology-enabled health services company focused on transforming the patient-provider experience, announced today it has entered into an agreement with Lyft, the fastest-growing rideshare company in the U.S.

Formativ, whose technology and services support physician practices, hospitals, and health systems, will work with Lyft to integrate Concierge into its Patient Engagement Platform (PEP). Through this integration, Formativ’s 250+ Patient Engagement Specialists can schedule non-emergency Lyft rides for patients directly through its PEP platform to provide Lyft rides in 40+ States. Lyft rides can be ordered on-demand or in advance, and patients don’t need to be a Lyft user to take advantage of the service.

The PEP, which leverages the Salesforce HealthCloud, is the core of Formativ’s technology offering, enabling improved patient-provider experiences when combined with their team of highly trained Patient Engagement Specialists. Formativ’s PEP solution includes enterprise-wide scheduling functionality that enables improved appointment inventory visibility and features automated waitlist, online self-scheduling and many other key practice management capabilities.

According to a 2017 study by the American Hospital Association, nearly four million patients per year miss out on care, due to lack of available transportation options related to cost or geographic barriers. These missed appointments make it difficult for patients to get the care they need, and this partnership is one way to make it easier for provider organizations to cut that number down.

“For many patients, access to reliable transportation can be the biggest hurdle in getting them to the doctor’s office. Formativ partnered with Lyft to enable our team of patient engagement specialists to book on-demand or scheduled rides for the patients we serve on behalf of our clients, addressing some of the negative social determinants of health, decreasing barriers to care and making life that much easier for patients,” explained David Harvey, chief technology officer at Formativ.

“We’re excited to partner with Formativ Health to integrate Lyft Concierge into their patient engagement platform – making it easier for providers to request rides for those who need them,” said Gyre Renwick, vice president of Lyft Business. “As we continue our efforts to reduce the healthcare transportation gap by introducing a reliable and efficient transportation solution to patients, partnering with organizations like Formativ – which schedules hundreds of thousands of appointments each year – is essential to having a tangible impact in this space.”

About Lyft

Lyft was founded in June 2012 by Logan Green and John Zimmer to improve people’s lives with the world’s best transportation. Lyft is the fastest growing rideshare company in the U.S. and is available to 95 percent of the US population as well as in Ontario, Canada. Lyft is preferred by drivers and passengers for its reliable and friendly experience, and its commitment to effecting positive change for the future of our cities, as the first rideshare company to offset carbon emissions from all rides globally.

About Formativ Health

New York City-based Formativ Health is a technology-enabled health services company focused on transforming the patient-provider experience. Their services help health systems, provider groups, and payors respond to the rise of consumerism by combining powerful technology with an empathetic approach to customer service. Formativ helps clients enhance their patients’ experience, adapt to evolving risk-based payment models, improve financial performance, increase practice productivity, and elevate physician satisfaction and patient loyalty. For more information, visit www.formativhealth.com or on LinkedIn, Twitter and Facebook.

September 7, 2018 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 5 blogs containing over 11,000 articles with John having written over 5500 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 18 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.

Verscend Technologies, Inc., Completes Acquisition of Cotiviti Holdings, Inc.

The combined healthcare information technology company plans to operate privately as Cotiviti, with Dr. Emad Rizk as president and chief executive officer

ATLANTA & WALTHAM, Mass. — August 27, 2018 — Verscend Technologies, Inc. (“Verscend”), a portfolio company of Veritas Capital (“Veritas”) and a leader in data-driven healthcare solutions, has completed its acquisition of Cotiviti Holdings, Inc. (“Cotiviti”), a leading provider of payment accuracy and analytics-driven solutions focused primarily on the healthcare industry. Emad Rizk, M.D., current president and chief executive officer of Verscend, will retain these titles for the combined business. The combined private company plans to operate under the Cotiviti name.

Cotiviti will operate as a healthcare information technology company able to apply multidimensional analytic insights, deep market expertise, and high-performance services to help its clients reshape the economics of healthcare. The new Cotiviti sits at the intersection of payers’ most critical programs that affect financial performance: payment accuracy; fraud, waste, and abuse management; risk adjustment; quality improvement and reimbursement; population health management; and high-value network performance. By combining some of the most robust financial and clinical data in the industry, Cotiviti will have unique insight into the healthcare system. The company’s combined intellectual capital, data assets, client base, and subject-matter expertise extend its leadership in healthcare’s rapidly changing landscape.

“Both companies are customer-driven innovators that share a similar mission: to help our clients improve healthcare affordability, reduce waste, and identify the best path to better outcomes,” said Dr. Rizk. “With our new capabilities across payment, quality, risk, and the combination of clinical and financial data, Cotiviti will be unmatched in its ability to create differentiated value for its clients.”

The acquisition of Cotiviti is the latest by Veritas Capital, which also recently acquired GE Healthcare’s Value-Based Care Division and has made previous investments in Truven Health Analytics as well as Verscend. According to chief executive officer and managing partner Ramzi Musallam, the Verscend-Cotiviti combination is a strong fit for its investment strategy.

“A core tenet of Veritas’ investment philosophy is identifying organizations that are positioned to have transformational impact in their respective domains. We see the combination of Cotiviti and Verscend as bringing much needed precision and insight to the healthcare system,” Musallam said. “We expect that the two companies’ complementary data sets, analytical capabilities, and industry expertise will accelerate forward momentum for the new Cotiviti through smarter, faster solutions that address rising costs, eliminate waste, and speed quality improvement for the healthcare industry overall.”

Under the terms of the agreement, Cotiviti shareholders will receive merger consideration in the amount of $44.75 in cash for each share of Cotiviti common stock they hold (without interest and subject to any applicable withholding taxes or other amounts required to be withheld therefrom under applicable law). American Stock Transfer & Trust Company has been appointed as paying agent in connection with the merger and will be mailing a letter of transmittal to all Cotiviti shareholders of record within two business days. The letter of transmittal will instruct shareholders on how to surrender their shares of Cotiviti common stock in exchange for the merger consideration.

The transaction was announced on June 19, 2018, and received approval from Cotiviti shareholders on August 24, 2018. As a result of the completion of the transaction, shares of Cotiviti common stock were removed from listing on the New York Stock Exchange (“NYSE”), with trading in Cotiviti shares suspended prior to the opening of business today.

About Cotiviti

Following the Verscend-Cotiviti combination, Cotiviti will be a leading information technology and analytics company that is reshaping the economics of healthcare, helping its clients uncover new opportunities to unlock value. Cotiviti’s solutions are a critical foundation for healthcare payers in their mission to lower healthcare costs and improve quality through higher-performing payment accuracy, quality improvement, risk adjustment, and network performance management programs. The company also supports retail and life/legal industries with data management and audit services that improve business outcomes. For more information, visit www.cotiviti.com.

About Veritas Capital

Veritas is a leading private equity firm that invests in companies that provide critical products and services, primarily technology and technology-enabled solutions, to government and commercial customers worldwide, including those operating in the aerospace & defense, healthcare, technology, national security, communications, energy, and education industries. Veritas seeks to create value by strategically transforming the companies in which it invests through organic and inorganic means. For more information on Veritas Capital and its current and past investments, visit www.veritascapital.com.

August 27, 2018 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 5 blogs containing over 11,000 articles with John having written over 5500 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 18 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.

AxiaMed Announces $12.4 Million Capital Investment Led By Health Enterprise Partners

Strategic Investment to Accelerate Growth Driven by Demand for Greater Patient Payment Convenience and Security

SANTA BARBARA, CA., August 14, 2018 – AxiaMed, an innovative healthcare payments technology company, announced today that it has raised $12.4 million in funding to accelerate its growth in the burgeoning market for secure, flexible patient payments. Health Enterprise Partners (HEP) led the round with participation by a number of AxiaMed’sexisting investors, including Nashville Capital Network.

Since its founding in 2015, AxiaMed has experienced triple-digit annual growth driven by the dramatic increase in patient financial responsibility for healthcare expenses. Industry analysts predict that patient payments will exceed 30% of total healthcare costs in 2019 and rise to nearly 50% within 5 years.

“We are thrilled to partner with Health Enterprise Partners and its extensive network of healthcare industry partners. This investment further validates the significance of AxiaMed’s solutions and the necessity for healthcare organizations and software solutions to provide secure patient payment technology. We look forward to significant and increased execution with the additional resources,” said Randal Clark, CEO and co-founder, AxiaMed.

AxiaMed’s Payment Fusion platform has become the healthcare industry’s preferred SaaS-based payment platform and is used by hundreds of hospitals and thousands of ambulatory providers. Payment Fusion enables healthcare software vendors to integrate secure payment technology into their applications, lessening the risks of payment data breaches, and reducing compliance burdens while improving the financial performance of providers by expanding payment options available to patients.

“While many other healthcare payment companies have focused on point solutions, AxiaMed’s innovative payment platform enables and enhances secure patient payment solutions within various healthcare software solutions,” said Ezra Mehlman, Principal at Health Enterprise Partners. “AxiaMed’s impressive growth and strong customer demand positions the company as a market leader, particularly in the healthcare payment and security categories of revenue cycle technology.”

“Health Enterprise Partners’ deep experience in the healthcare marketplace will help us accelerate the expansion of our Payment Fusion platform with healthcare organizations and software partners, greatly improving the payment experience for both providers and payers,” said Kevin Kidd, co-founder and Chief Business Development Officer, AxiaMed.

Proceeds from this funding round will enable AxiaMed to increase its product development and go-to-market strategy, strengthen its core team, and solidify its market position. Within the past year, AxiaMed became one of the first healthcare-focused PCI-validated Point-to-Point Encryption (vP2PE) solution providers. This security offering enables AxiaMed’s software partners and healthcare organizations to enhance its security infrastructure and reduce PCI compliance requirements and attendant costs.

About AxiaMed

AxiaMed is a healthcare financial technology company specializing in payment integration and security. AxiaMed’s integrated payments technology platform, Payment Fusion, improves the financial performance of healthcare providers through integration with various revenue cycle, practice management, EHRs and other software systems, enhancing interoperability and payment options across the entire ecosystem of healthcare payments between patients, providers and payers.

AxiaMed is headquartered in Santa Barbara, CA with executive offices in Nashville, TN.

For more information, visit https://www.axiamed.com/.

About Health Enterprise Partners

Health Enterprise Partners invests primarily in privately held, middle market companies in health care services and health care information technology. Central to HEP’s strategy is its unique and extensive hospital system and health plan network, 36 members of which are investors in HEP’s funds. HEP seeks to invest in companies that improve the quality of the patient experience, expand access, and reduce the cost of health care.

For more information, please visit http://www.hepfund.com .

August 15, 2018 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 5 blogs containing over 11,000 articles with John having written over 5500 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 18 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.

Proposed 2019 Physician Fee Schedule and MACRA – MIPS Changes Announced by CMS #PatientsOverPaperwork #QPP

Proposed changes to the Medicare Physician Fee Schedule and Quality Payment Program would streamline clinician billing and expand access to high-quality care

Today, the Centers for Medicare & Medicaid Services (CMS) proposed historic changes that would increase the amount of time that doctors and other clinicians can spend with their patients by reducing the burden of paperwork that clinicians face when billing Medicare. The proposed rules would fundamentally improve the nation’s healthcare system and help restore the doctor-patient relationship by empowering clinicians to use their electronic health records (EHRs) to document clinically meaningful information, instead of information that is only for billing purposes.

“Today’s reforms proposed by CMS bring us one step closer to a modern healthcare system that delivers better care for Americans at a lower cost,” said HHS Secretary Alex Azar. “Such a system requires empowering American patients by giving them price and quality transparency and control over their own interoperable health records, goals supported by CMS’s proposals. These proposals will also advance the successful Medicare Advantage program and accomplish a historic regulatory rollback to help physicians put patients over paperwork. Further, today’s proposed reforms to how CMS pays for medicine demonstrate the commitment of HHS to implementing President Trump’s blueprint for lowering drug prices. The ambitious reforms proposed by CMS under Administrator Verma will help deliver on two HHS priorities: creating a value-based healthcare system for the 21st century and making prescription drugs more affordable.”

“Today’s proposals deliver on the pledge to put patients over paperwork by enabling doctors to spend more time with their patients,” said CMS Administrator Seema Verma. “Physicians tell us they continue to struggle with excessive regulatory requirements and unnecessary paperwork that steal time from patient care. This Administration has listened and is taking action. The proposed changes to the Physician Fee Schedule and Quality Payment Program address those problems head-on, by streamlining documentation requirements to focus on patient care and by modernizing payment policies so seniors and others covered by Medicare can take advantage of the latest technologies to get the quality care they need.”

The proposals, part of the Physician Fee Schedule (PFS) and the Quality Payment Program (QPP), would also modernize Medicare payment policies to promote access to virtual care, saving Medicare beneficiaries time and money while improving their access to high-quality services no matter where they live. Such changes would establish Medicare payment for when beneficiaries connect with their doctor virtually using telecommunications technology (e.g., audio or video applications) to determine whether they need an in-person visit. Additionally, the QPP proposal would make changes to quality reporting requirements to focus on measures that most significantly impact health outcomes. The proposed changes would also encourage information sharing among health care providers electronically, so patients can see various medical professionals according to their needs while knowing that their updated medical records will follow them through the healthcare system. The QPP proposal would make important changes to the Merit-based Incentive Payment System (MIPS) “Promoting Interoperability” performance category to support greater EHR interoperability and patient access to their health information, as well as to align this clinician program with the proposed new “Promoting Interoperability” program for hospitals.

If today’s proposals were finalized, clinicians would see a significant increase in productivity – leading to substantially more and better care provided to their patients. Removing unnecessary paperwork requirements through the PFS proposal would save individual clinicians an estimated 51 hours per year if 40 percent of their patients are in Medicare. Changes in the QPP proposal would collectively save clinicians an estimated 29,305 hours and approximately $2.6 million in reduced administrative costs in CY 2019.

PROPOSED CY 2019 PHYSICIAN FEE SCHEDULE KEY CHANGES

The Physician Fee Schedule establishes payment for physicians and medical professionals treating Medicare patients. It is updated annually to make changes to payment policies, payment rates and quality-related provisions. Extensive public feedback the agency has received has highlighted a need to streamline documentation requirements for physician services known as “evaluation and management” (E&M) visits, as well as a need to support greater access to care using telecommunications technology.

The proposed changes to the Physician Fee Schedule would reinforce CMS’ Patients Over Paperwork initiative focused on reducing administrative burden while improving care coordination, health outcomes, and patients’ ability to make decisions about their own care.

Streamlining Evaluation and Management (E&M) Payment and Reducing Clinician Burden

CMS and the Office of the National Coordinator for Health Information Technology (ONC) have heard from stakeholders that CMS’s extensive documentation requirements for Evaluation and Management codes have resulted in unintended consequences. To meet these documentation requirements, providers have to create medical records that are a collection of predefined templates and boilerplate text for billing purposes, in many cases reflecting very little about the patients’ actual medical care or story.

Responding to stakeholder concerns, several provisions in the proposed CY 2019 Physician Fee Schedule would help to free EHRs to be powerful tools that would actually support efficient care while giving physicians more time to spend with their patients, especially those with complex needs, rather than on paperwork. Specifically, this proposal would:

  • Simplify, streamline and offer flexibility in documentation requirements for Evaluation and Management office visits — which make up about 20 percent of allowed charges under the Physician Fee Schedule and consume much of clinicians’ time;
  • Reduce unnecessary physician supervision of radiologist assistants for diagnostic tests; and
  • Remove burdensome and overly complex functional status reporting requirements for outpatient therapy.

Advancing Virtual Care

“CMS is committed to modernizing the Medicare program by leveraging technologies, such as audio/video applications or patient-facing health portals, that will help beneficiaries access high-quality services in a convenient manner,” said Administrator Verma.

Getting to the doctor can be a challenge for some beneficiaries, whether they live in rural or urban areas. Innovative technology that enables remote services can expand access to care and create more opportunities for patients to access personalized care management as well as connect with their physicians quickly.

Provisions in the proposed CY 2019 Physician Fee Schedule would support access to care using telecommunications technology by:

  • Paying clinicians for virtual check-ins – brief, non-face-to-face appointments via communications technology;
  • Paying clinicians for evaluation of patient-submitted photos; and
  • Expanding Medicare-covered telehealth services to include prolonged preventive services.

Lowering Drug Costs

President Trump is putting American patients first and lowering prescription drug costs, and CMS is committed to advancing this effort. CMS is today proposing changes as part of the continued rollout of the Administration’s blueprint to lower drug prices and reduce out-of-pocket costs.

The changes would affect payment under Medicare Part B. Part B covers medicines that patients receive in a doctor’s office, such as infusions. CMS is proposing a change in the payment amount for new drugs under Part B, so that the payment amount would more closely match the actual cost of the drug. This change would be effective January 1, 2019, and would reduce the amount that seniors would have to pay out-of-pocket, especially for drugs with high launch prices. This is one of many steps that CMS is taking to ensure that seniors have access to the drugs they need.

PROPOSED CY 2019 QUALITY PAYMENT PROGRAM KEY CHANGES

To implement the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), CMS established the Quality Payment Program (QPP), which consists of two participation pathways for doctors and other clinicians – the Merit-based Incentive Payment System (MIPS), which measures performance in four categories to determine an adjustment to Medicare payment, and Advanced Alternative Payment Models (Advanced APMs), in which clinicians may earn an incentive payment through sufficient participation in risk-based payment models.

The proposed changes to QPP aim to reduce clinician burden, focus on outcomes, and promote interoperability of electronic health records (EHRs), including by:

  • Removing MIPS process-based quality measures that clinicians have said are low-value or low-priority, in order to focus on meaningful measures that have a greater impact on health outcomes; and
  • Overhauling the MIPS “Promoting Interoperability” performance category to support greater EHR interoperability and patient access to their health information, as well as to align this performance category for clinicians with the proposed new Promoting Interoperability Program for hospitals.

Under the requirements of the Bipartisan Budget Act of 2018, CMS is continuing the gradual implementation of certain MIPS requirements to ease administrative burden on clinicians. The proposed changes to the Quality Payment Program reflect feedback and input from clinicians and stakeholders, and we will continue to offer free and customized support from CMS’s technical assistance networks.

MEDICARE ADVANTAGE QUALIFYING PAYMENT ARRANGEMENT INCENTIVE (MAQI) DEMONSTRATION

Aligning with the agency’s goals of improving quality of care and responding to the feedback we have received from clinicians, CMS also proposes waivers of MIPS requirements as part of testing a demonstration called the Medicare Advantage Qualifying Payment Arrangement Incentive (MAQI) demonstration. The MAQI demonstration would test waiving MIPS reporting requirements and payment adjustments for clinicians who participate sufficiently in Medicare Advantage (MA) arrangements that are similar to Advanced APMs.

Some Medicare Advantage plans are developing innovative arrangements that resemble Advanced APMs. However, without this demonstration, physicians are still subject to MIPS even if they participate extensively in Advanced APM-like arrangements under Medicare Advantage. The demonstration will look at whether waiving MIPS requirements would increase levels of participation in such MA payment arrangements and whether it would change how clinicians deliver care.

PRICE TRANSPARENCY: REQUEST FOR INFORMATION

Finally, as part of its commitment to price transparency, CMS is seeking comment through a Request for Information asking whether providers and suppliers can and should be required to inform patients about charge and payment information for healthcare services and out-of-pocket costs, what data elements would be most useful to promote price shopping, and what other changes are needed to empower healthcare consumers.

Public comments on the proposed rules are due by September 10, 2018.

For a fact sheet on the CY 2019 Physician Fee Schedule proposed rule, please visit:
https://www.cms.gov/Newsroom/MediaReleaseDatabase/Fact-sheets/2018-Fact-sheets-items/2018-07-12-2.html

To view the CY 2019 Physician Fee Schedule proposed rule, please visit: https://www.federalregister.gov/public-inspection/

For a fact sheet on the CY 2019 Quality Payment Program proposed rule, please visit: https://www.cms.gov/Medicare/Quality-Payment-Program/Resource-Library/2019-QPP-proposed-rule-fact-sheet.pdf

To view the CY 2019 Quality Payment Program proposed rule, please visit: https://www.federalregister.gov/public-inspection/

For a fact sheet on the Medicare Advantage Qualifying Payment Arrangement Incentive (MAQI) Demonstration, please visit:https://www.cms.gov/Newsroom/MediaReleaseDatabase/Fact-sheets/2018-Fact-sheets-items/2018-07-12.html

July 12, 2018 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 5 blogs containing over 11,000 articles with John having written over 5500 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 18 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.

API Integration Presents Opportunity for EMR Companies

Fullscript is an online platform that helps integrative medical practitioners dispense and e-prescribe over 20,000 professional-grade supplements, without the need for physical inventory. Its user-friendly workflow and advanced prescribing tool has made Fullscript a leader in the integrative medical e-prescribing space.

With the recent addition of a fully accessible Application Programming Interface (API), the entire Fullscript catalog is now available for integration with industry software partners.

There are currently over 1,000 vendors that offer an EMR software platform. The majority of EMR platforms offer a pharmaceutical e-prescribing solution, however, few offer a nutraceutical e-prescribing solution.

By providing the capability for EMR platforms to integrate with the Fullscript user experience, practitioners can choose the best interventions for their patients, whether that be pharmaceutical and/or nutraceutical/supplement.

“Practitioners are busy! They shouldn’t have to jump back and forth between Fullscript and their EMR to do their work. Our API allows EMR’s to take the best of Fullscript and build it into their platforms with a seamless integration. That way practitioners get the best of both worlds.”

  • Kurtis Funai, VP Engineering – Fullscript

Current Fullscript EMR partners have developed the ability for practitioners to integrate and e-prescribe nutraceuticals in as little as 4 weeks, making it a simple solution and competitive differentiator in a highly competitive EMR software market.

Three partners have launched the integration, with several more in development. The expectation by the end of 2018 is that more than 15 EMR platforms will have developed a Fullscript integration.

Are you an EMR company looking for access to the Fullscript API?

Contact our team now (email:integrations@fullscript.com.) We’d love to chat.

Interested but want to learn more? Click here.

June 25, 2018 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 5 blogs containing over 11,000 articles with John having written over 5500 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 18 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.

Inspirata Acquires Health Analytics Company, Caradigm; Plans to Use its Award-Winning Platform to Accelerate Development of its Cancer Information Data Trust

Inspirata will continue to evolve Caradigm’s population health management solutions and support existing customers, and has aggressive plans to create new customers in this space.

Redmond, WA, June 13, 2018 (GLOBE NEWSWIRE) — Cancer informatics and digital pathology workflow solution provider Inspirata®, Inc. announced today that it has acquired Redmond, WA-based Caradigm from GE Healthcare.

The company’s award-winning Caradigm Intelligence Platform (CIP) and population health management software portfolio spans data control; healthcare analytics; and care coordination and engagement across the entire healthcare enterprise, including large integrated delivery networks, accountable care organizations, clinically integrated networks, academic medical centers and community hospital networks.

“Caradigm has built a highly regarded, industry-proven big data health analytics platform,” says Inspirata CEO Satish Sanan. “Our goal is to leverage the core strengths of this platform to accelerate our Cancer Information Data Trust (CIDT) development. The CIDT will address key trends in oncology care providing important new insights for clinicians, researchers, drug discovery and cancer center operations. In addition to this, Caradigm’s strong population health product set and experienced team will have Inspirata’s specialized focus and attention to promote long-term sustainability, growth and innovation as we redouble our focus on delivering superior value to all customers.”

“We are confident that Inspirata will be able to provide the intense focus and vision needed for growth through key investments in technology, infrastructure and people to energize the Caradigm software portfolio to better enable us to serve customers’ evolving needs,” says Caradigm President and CEO Neal Singh. “The healthcare ecosystem is in dire need of change. With Inspirata, Caradigm can bring that change for providers and advance the health of the patients they serve.”

Caradigm provides an open and a flexible platform that builds a data foundation to meet the evolving demands of a dynamic healthcare environment. Caradigm Intelligence Platform aggregates data across clinical, social, operational and financial sources from disparate source systems – electronic health records, billing systems, payers, claims, pharmacy systems, labs and HIEs, coupled with the need for timely information at the point of care to address a longstanding challenge for healthcare organizations. Caradigm also provides a suite of applications for improving the patient experience of care, improving the health of populations and reducing the per capita cost of healthcare. Caradigm population health solutions enable providers to deliver the appropriate care to patients through effective coordination and patient engagement, improving outcomes and financial results.

About Inspirata, Inc.

Inspirata®, Inc. provides oncology diagnostics workflow solutions that span digital pathology; diagnostic and predictive assays; and precision medicine. It also offers cancer informatics workflows that, in combination with its natural language processing and artificial intelligence algorithms structures unstructured case files and clinician notes to provide key insights for clinical and operational activities as well as cancer reporting. Inspirata’s flagship solution is its Cancer Information Data Trust (CIDT) that generates a longitudinal view of oncology patients—from diagnosis, through treatments and therapies, to outcomes. The CIDT has extensive applications in clinical decision support, research, education, drug discovery and clinical trials enrollment. Its use will extend to physicians, patients, researchers, pharma and others. For more information, please visit www.inspirata.com or contact info@inspirata.com.

About Caradigm

Until its acquisition by Inspirata today, Caradigm was a GE Healthcare Company offering intelligent healthcare analytics and population health management solutions. Caradigm is dedicated to improving patient care, advancing the health of populations and reducing healthcare costs. Its enterprise software portfolio encompasses all capabilities critical to delivering effective population health management, including data control; healthcare analytics; and care coordination and engagement. Caradigm’s customers include large integrated delivery networks, accountable care organizations, clinically integrated networks, academic medical centers, and community hospital networks. Based in Redmond, WA, Caradigm received the Frost & Sullivan 2017 North American Health IT Value-Based Care Management Product Leadership Award. For more information, visit our website.

June 13, 2018 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 5 blogs containing over 11,000 articles with John having written over 5500 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 18 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.

healtheConnect Alaska to Improve Patient Matching and Statewide Data Exchange with NextGate

HIE network will leverage NextGate’s EMPI solution to improve patient identification and enhance care collaboration among providers throughout Alaska

PASADENA, Calif., June 12, 2017 – NextGate, a global leader in healthcare enterprise identification, announced today that healtheConnect Alaska (formerly, the Alaska eHealth Network) a leading health information exchange (HIE), has selected its Enterprise Master Patient Index (EMPI) as the foundation for enhanced care collaboration and patient identity management.

healtheConnect Alaska currently enables electronic medical records exchange and direct secure messaging services for more than 500 participants statewide, including AARP Alaska, Alaska Native Tribal Health Consortium, Premera Blue Cross Blue Shield of Alaska, Providence Health System, and the State of Alaska’s Department of Health & Social Services.

As a strategic component for population health management efforts and health information exchange activities, NextGate’s maket-leading EMPI solution will enable real-time interoperability and patient matching across health IT systems from more than 20 hospitals and 450 healthcare organizations within healtheConnect Alaska’s network, to deliver a comprehensive view of an individual’s medical record. The partnership with NextGate further strengthens the HIE’s ability to execute downstream projects including bi-directional data exchange with the Veteran’s Administration, integration with statewide behavioral health organizations, and supporting opioid and chronic illness management initiatives.

“healtheConnect Alaska is very excited to be working with NextGate to take the HIE to the next level and truly influence care quality, provider experience and, ultimately, health outcomes throughout our communities,” said Laura Young, Executive Director of healtheConnect Alaska. “Effective coordination between providers hinges on the ability to view accurate data from across the network. The EMPI Platform will play a significant role in our transformational journey toward improved care team collaboration, workflow efficiency, and the creation of a more holistic and real-time portrait of patients.”

Through NextGate’s EMPI, healtheConnect Alaska will empower participating physicians and hospitals with a longitudinal patient record at the point of care for improved coordination and clinical decision making. Patient matching algorithms in the EMPI unify and de-duplicate records from multiple sources and locations and assign each individual a unique patient identifier that serves as cross-reference for greater data exchange.

“We commend healtheConnect Alaska for prioritizing patient identity as the basis for measurable clinical and population health improvements,” said Andy Aroditis, CEO of NextGate. “Consistently connecting the right data to the right individual is a critical requirement in today’s digitized healthcare environment and NextGate is honored to support their members with a patient matching solution that reduces errors, improves patient safety, and enhances care quality, while diminishing the complexity of interoperability.”

About NextGate

With over 200 customers in four countries, NextGate is the global leader in healthcare enterprise identification. Committed to helping organizations overcome the clinical, operational and financial challenges that result from duplicate records and disparate data, our full suite of identity matching solutions connects the entire healthcare ecosystem to drive critical improvements in quality, efficiency and safety. NextGate’s market-leading EMPI currently manages 300 million lives and is deployed by the nation’s most successful healthcare systems and health information exchanges. For more information, visit NextGate.com.

About healtheConnect Alaska

healtheConnect Alaska (formerly Alaska ehealth Network) is a 501(c)(3) non-profit corporation, established by Alaska statute, and organized and managed by Alaskans. healtheconnect Alaska has been tasked by the State of Alaska’s Department of Health and Social Services to provide safe, secure transport for health information in order to improve quality and safety of patient care and increase efficiencies for hospitals and medical practices. healtheconnect Alaska provides health information exchange and direct secure messaging services to more than 20 hospitals and 450 healthcare organizations across Alaska. Benefits to these organizations include: confidential and timely access to patient’s medical history no matter where a patient receives care; rapid medical record search for historical patient data, augmenting diagnosis and treatment; public health reporting assistance to meet meaningful use requirements; reduced interface costs due to a single entry point; referrals and referral documents transmitted automatically; and notifications of selected events including admission, discharge, and abnormal lab results. For more information, visit www.ak-ehealth.org

June 12, 2018 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 5 blogs containing over 11,000 articles with John having written over 5500 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 18 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.

ResMed to Acquire HEALTHCAREfirst, a Cloud-based Software and Services Provider for Home Health and Hospice Agencies

The acquisition strengthens ResMed’s software-as-a-service (SaaS) solutions for homecare providers

SAN DIEGO – May 29, 2018 – ResMed (NYSE: RMD, ASX: RMD), a global leader in connected healthcare solutions, today announced it has entered into a definitive agreement to acquire privately held HEALTHCAREfirst, a provider of software solutions and services for home health and hospice agencies.

HEALTHCAREfirst offers electronic health record (EHR) software, billing and coding services, and advanced analytics that enable home health and hospice agencies to optimize their clinical, financial and administrative processes. HEALTHCAREfirst will complement ResMed’s existing software solutions offered by Brightree, a wholly owned subsidiary ranked as one of the top 100 healthcare IT companies in the United States.

“The home health and hospice segments are large and growing fast, due to the rising prevalence of chronic conditions and an aging population shifting to homecare and other lower-cost care settings,” said Raj Sodhi, president of ResMed’s SaaS business. “HEALTHCAREfirst’s solutions suite enables ResMed to help efficiently and effectively manage this growing population, benefiting patients, their families, agencies and payers.

“Joining ResMed, with their purpose of changing lives with every breath, is an exciting opportunity for our HEALTHCAREfirst team, as our joint mission is linked to improving quality of life for patients in out-of-hospital healthcare,” said J. Kevin Porter, HEALTHCAREfirst’s president and CEO. “We believe our combined resources and investment capabilities will make an even more impactful improvement on the patient experience and our customers’ business outcomes at a time when they’re under increased reimbursement and regulatory pressures.”

The transaction’s financial terms were not disclosed, but the transaction will not be material to ResMed’s consolidated financial results. The transaction is expected to be finalized before the end of the first quarter of ResMed’s fiscal year 2019 (September 30, 2018), subject to customary closing conditions, including regulatory approvals.

About ResMed

ResMed (NYSE: RMD, ASX: RMD), a world-leading connected health company with more than 5 million cloud-connected devices for daily remote patient monitoring, changes lives with every breath. Its award-winning devices and software solutions help treat and manage sleep apnea, chronic obstructive pulmonary disease and other respiratory conditions. Its 6,000-member team strives to improve patients’ quality of life, reduce the impact of chronic disease and save healthcare costs in more than 120 countries. ResMed.com

About HEALTHCAREfirst 

HEALTHCAREfirst provides cloud-based technologies and services to improve business and clinical operations for thousands home health and hospice providers across the United States. Based in Springfield, MO, and one of the fastest growing providers of its kind, the company provides agency and clinical management software, outsourced revenue cycle management services (billing, coding and OASIS Review), CAHPS surveys, and advanced analytics, in any combination. HEALTHCAREfirst’s breadth of solutions offers agencies a single source to improve patient care, create operational efficiencies, increase profitability and simplify CMS compliance. With HEALTHCAREfirst, agencies can focus on patients instead of paperwork. For more information call 800.841.6095 or visit healthcarefirst.com.

May 29, 2018 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 5 blogs containing over 11,000 articles with John having written over 5500 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 18 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.