5 Themes for Healthcare’s Future

As we wind up the HealthFlock Blog, I think it is important to leave healthcare providers and consumers with a listing of the top 5 things they should look for as healthcare reform initiatives are implemented.

1. Increase in Patient Accountability

Healthcare reimbursement is changing to remit payment based upon the patients’ outcomes instead of the number of patient visits. Specifically, state and federal healthcare programs will pay providers based upon whether or not the patient had a quality outcome and avoided unnecessary admissions, tests or visits. In order to achieve quality outcomes, providers are focused upon engaging patients to be more accountable for their health. Likewise, healthcare payors are modifying payor programs to make patients more responsible financially for out-of-pocket expenses. Many self-insured employer plans are already modifying premiums and benefits for employees who engage in a wellness program, have good nutrition practices or …

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Thank You for Three Great Years

We learned this past week that the decision has been by the AJC’s editorial staff that HealthFlock will discontinue as a blog as of Saturday, May 31.  We the bloggers are very sad to learn of the news but thankful for the opportunity to connect with you, the readers, every week over the past 3 years.

Since we launched, our blog has had 300 posts and over 3,000 comments from readers of all types, from healthcare professionals to major medical associations to large corporations to readers who simply cared about healthcare.  Our content, written by some of the top healthcare leaders in Georgia, has been reproduced in a number of prestigious outlets and news sources and saw significant page hits every month.

Thank you for being such an important part of our blog.  We greatly enjoyed writing about a topic we love and plan to continue our involvement in the field, both as professionals and thought leaders.  On behalf of the bloggers, we thank you again for your viewership and …

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Steps In The Evolution of The Health Care System

Healthcare in the 21st century is evolving on three paths: providing consumers with the incentives and tools to stay healthy, giving providers the incentives and tools to keep patients healthy, and creating and sustaining integrated health care institutions who maintain the health of the whole person. Often all three elements are necessary before there are measurable improvements in health and efficiency.

The health care delivery system is moving several fronts toward more intergraded systems of care driven in large part by changes in the way consumers and insurers choose sites of care and pay for that care. While most agree on the needed direction of change the evolution of the health care system is currently faced with a number of “chicken and egg” dilemmas: what has to happen first?

A representative example is the integration of primary care and behavioral health, specifically depression. A little under 10 percent of adults in the United States have symptoms of …

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Springtime: Hope Springs Eternal in the Policy World Too

augustaI love this time of year. In the Springtime, hope springs eternal. Azaleas, dogwoods and rhododendrons take center stage.

The Major League Baseball season is just getting started and everyone still hopes for another world series championship for the Braves. We are all optimistic in the Spring.

In the Springtime, everything is fresh and green and blooming … but there is this feeling of renewal … of hope … of promise.

And, we’re the in the middle of fresh, new election cycle. The Supreme Court added elections as a new Springtime tradition, joining the Opening Day for the Braves, the Masters at Augusta National, and Mother’s Day.

In the policy world, Spring is also a time for renewal. The Springtime is critical for building momentum for a movement … for planting the seeds for significant change. It is in the Springtime that you nurture ideas, gain insight and perspective, understand all you can about an issue.

Creating innovative policy which saves lives and save …

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Bringing Women and Technology Together

As a working mom, I have a soft spot for working women’s issues. As a woman working in the world of healthcare IT, I have developed a highly sensitive radar for dialogues and conversations taking place around women’s roles in technology and the greater STEM fields. It seems that, as of late, gender’s role in the workplace has taken a greater place in the spotlight of industry news.

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To Encrypt or Not To Encrypt

Tuesday, April 22nd , the government announced two significant HIPAA Settlement and Resolution Agreements related to breaches of unsecured patient information caused by stolen laptops. One settlement agreement addressed a healthcare provider that stored patient information on a laptop that was stolen from the facility. The laptop contained patient information that was not encrypted. Because the government believed the lack of encryption caused a critical risk, the penalty was $1,725,220. The second case involved 148 unsecured patient records located on a stolen laptop that was self-reported to the government. The government then investigated and found that the entity failed to adequately implement HIPAA Security safeguards until after the breach. In this case, the entity was fined $250,000. In both cases, the healthcare providers were required to enter into a corrective action plan in addition to the fines and penalties.

One key element of the corrective action plan …

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Did the Delay of ICD-10 Prevent a Financial Disaster in the Healthcare Market?

Recently healthcare providers were required to transition from the current healthcare coding system of ICD-9 to ICD-10. The acronym ICD stands for International Classification of Disease. Healthcare providers use these codes to classify disease conditions or procedures to support their reimbursement claims. U.S. healthcare providers have been using the ICD-9 coding system since 1979. Numerous countries have advanced from ICD-9 to ICD-10 supporting a greater level of detail classifying a patient’s disease condition and procedures performed. The U.S. has held off moving from ICD-9 to ICD-10 for a number of years due to the complexity and impact throughout every aspect of the healthcare business. The latest deadline for healthcare providers to comply with the ICD-10 coding system was October 1, 2014. A law recently passed gave healthcare providers a reprieve of adopting this new coding system for at least one year.

This reprieve of requiring healthcare providers’ adoption is …

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New Enrollment Numbers and a Silly New Controversy

Data from Georgia’s Insurance Commissioner indicates that insurers received 221,604 applications through the marketplace through the end of March. Premiums had only been received for 107,581 of those policies by March 31st, covering 149,465 lives. Given that more than twenty percent of the total enrollment occurred in the last two weeks of March it is likely that the final number of covered lives is likely to be higher. About two thirds of paid enrollees through the exchange are receiving subsidies.

When all is said and done the numbers of individuals covered through the exchange reflect about 40% of Georgia’s individual insurance market. Especially in Georgia however many of those who had coverage in the individual market continued with that coverage purchased outside of the marketplace.

What is not yet know is how many of those who purchased coverage in the marketplace were previously uninsured. The Rand Corporation’s survey completed in mid-March estimated that …

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Nothing is Certain Except Death and Taxes (and ObamaCare Ain’t Helping)

taxesIn a 1789 letter from Ben Franklin to Jean-Baptiste Leroy, Mr. Franklin said “… in this world nothing can be said to be certain, except death and taxes.”

Yes, it’s that time of year again. Tax time.

This is second year of what will likely be annual occurrence: increased taxes to pay for ObamaCare.

You see, when the President and Congress “cooked” the budgetary scoring for ObamaCare. President Obama stated in a joint session of Congress in 2009 that ObamaCare would cost $900 billion over ten years. More specifically, he said, “Now, add it all up, and the plan that I’m proposing will cost around $900 billion over 10 years.”

However, just a few weeks ago, the non-partisan Congressional Budget Office (CBO) has revised its cost projections. At $2.6 trillion, the new price tag is almost three-times more than what president promised.

So how are we going to pay for ObamaCare. You guessed it: Higher taxes. And once again, Ben Franklin was correct. Nothing is …

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It’s a Good Time to be in Healthcare Technology in Georgia

It’s a good time to be in technology in Georgia, especially healthcare IT, according to the latest State of the Industry report from the Technology Association of Georgia. Several of the reports’ takeaways highlight sentiments shared with me by Tee Green, CEO of Greenway Health. I had the opportunity to recently chat with him about what it means to lead a company in a state devoted to sustaining the title of the “Nation’s Capitol of Healthcare IT.”

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