Archive for October, 2012

Recently, the Office of Inspector General (“OIG”) released a Work Plan to identify the reviews and investigations that the OIG intends to pursue in 2013. Notwithstanding the federal government’s initiatives to encourage the adoption of Electronic Health Record (“EHR”), EHR systems will be a focus of several OIG reviews. The OIG’s goal is to protect the integrity of the Medicare program and evaluate the Department of Health and Human Resources (DHHS) programs. Ultimately, the OIG Work Plan highlights areas where the government enforcement actions are historically focused and areas that providers should address through their compliance programs.

In 2009 the American Recovery and Reinvestment Act (“Stimulus Act”), created the DHHS EHR financial incentive program. This program provided financial incentives to healthcare providers, including hospitals and physicians, that adopt, implement and meaningfully use certified EHRs. Over $20 Billion was dedicated to …

Continue reading The OIG Focuses Upon Electronic Health Records in 2013 »

Healthcare providers today continue to invest and expand their information technology footprint to meet increasing demands of data. As we hear about healthcare provider financials put at risk due to RAC (Recovery Audit Contractor) audits, self-reporting appropriate use of ICDs (Implantable Cardioverter Defibrillator), pay-for-performance, Bundled Payments for episodes care, Accountable Care Organization, etc., there is an increasing expenditure of technology to meet these growing information demands.

Given the enormous amount of information presently collected at the patient, physician and procedure level, is the issue that healthcare providers are not collecting enough data to support these ever growing and changing business needs?

I would make the argument that the existing information platform for most healthcare providers collects more than sufficient information allowing organizations to measure their operational performance and address both the present and upcoming …

Continue reading Do Healthcare Providers need to invest in more information technology or focus on leveraging existing information? »

The political debate over the future of Medicare seems to be a clash of philosophies, but in fact ,  there doesn’t seem to be that much difference in the vision for the future of the health care.

The Romney/Ryan campaign argues that their plan will bring market forces to the Medicare program to reduce costs, while claiming the Obama administration would use bureaucracies to control costs. The Obama campaign claims that Romney/Ryan plan actually increases costs while saving the Medicare program money by shifting those costs to Medicare beneficiaries. The Affordable Care Act seeks to control Medicare costs through a number of provisions that alter both provider incentives and the organization of the delivery of care.

The Romney plan provides vouchers to Medicare beneficiaries and allows them to choose among several private plans and traditional Medicare. The goal is create a competitive market that gives private health insurance plans incentives to control costs and …

Continue reading Its Debatable but Not Really Different »

Editor’s Note: Today’s guest blogger Justin Hipps, MBA, is Technical Data Analyst at HealthLink Dimensions in Atlanta.

We’ve all heard the age old expression, “One bad apple spoils the bunch.” But, have you ever stopped to wonder whether this is actually true? Digging deeper, we discover this idiom is not only rooted in common sense, but also in science. When apples mature, they give off a gas called ethylene that accelerates the ripening process. However, if released too early, this gas has the ability to over-stimulate the ripening process, thus proving that one bad apple can, indeed, ruin all the others. You may be thinking, what do apples have in common with healthcare?

According to the McKinsey Center for US Health System Reform, “Healthcare is now the world’s largest industry – with a value and cost three times greater than the banking sector.” Continued growth is eminent as healthcare spending on telecommunications services alone is projected to outpace the growth …

Continue reading Dirty Data Detox: 3 Ways Poor Data Governance is Harming Healthcare »

As most people know, the Romney/Ryan ticket is proposing a Medicare “voucher” program. I use the word voucher lightly, because they have never actually used that word. The supporters of the program prefer premium assistance. If you have been watching certain news channels or negative advertisements, you may have heard this program defined a taking Medicare benefits away from the elderly.

I do not think anyone knows exactly what a voucher program would do to Medicare. The truth of the matter is that until one is put in place, we just will not know. However, it seems like a pretty decent idea to me. One thing is for sure, what we are doing currently is not working on multiple levels. It is not sustainable long term for its patients, and its rules and payment rates are not sustainable for the providers.

I like the ability to choose my insurance coverage. I do so yearly through a plan that allows me to buy up and down on certain coverage categories. The best insurance …

Continue reading Would a Medicare voucher program work? »

This past week held the first presidential debate between President Obama and hopeful Mitt Romney.  While the debate centered on domestic policy, each candidate at points spoke of the role that domestic issues have on U.S. global competitiveness, citing the US economy and unemployment as examples.  I believe that healthcare has an equal standing in this regards; a clear case can be made that our healthcare problems have a direct impact on US foreign policy.  This might be one of the few areas in the healthcare debate that both Mitt Romney and Barack Obama can agree.

Continue reading It is not all politics when talking healthcare »

The phrase from the Roman poet Virgil, ‘Sic vos non vobis’, means ‘This you do, not for yourselves’.  As patients we have an opportunity to create our own transformation resulting in improved healthcare and not just for ourselves, but also for all patients.

Essentially, we are all patients at some point in our lives and with that comes the ability to make a big impact to improve healthcare for all. Here are a few examples that represent where patients could have an impact:  clinical, general technology, and healthcare fraud and abuse.

There are numerous clinical technologies used by providers that can reduce medical errors and allow information to be shared more easily. These tools have important capabilities that help physicians know more about you as a patient but can also reduce errors.  As a patient, do you select healthcare providers that embrace technologies such as electronic medical records or electronic prescribing?

Also, how important is quality and cost …

Continue reading Sic Vos Non Vobis »

As a child, I can’t tell you how many times I heard that question. As a parent, I can’t tell you how many times I’ve asked that question.

Over the years, dentists have done a fantastic job of raising awareness of the importance of preventative dental care. They give us tooth brushes and dental floss after each and every visit. They schedule appointments with us every six months to check our teeth and reinforce the importance of preventative dental care.

It wasn’t always that way. Dentists used make a living pulling teeth … not preserving them. But over the last half century, the dental community has changed the way we view preventative dental care. Plus, those of us fortunate enough to have dental insurance often paid little to nothing out-of-pocket for preventative dental services.

So how can the health care system — more specifically, how can health care professionals — learn from the dental profession?

First, we should learn to value preventative services.

At this …

Continue reading Did You Brush Your Teeth? »

The healthcare industry has been evolving for years, led by innovations that help streamline an antiquated industry for better effectiveness and efficiencies. The administration’s healthcare reform bill is keeping the foot on the proverbial gas, fueling new thinking and technologies for better consumer access and engagement. Those business entities that can help cut costs, create awareness and prevention, and empower consumer engagement will find success among the changing landscape. It’s a prime time to be a healthcare marketer—full of new challenges and vast new opportunities.

Take, for instance, the rise of retail health clinics—both a cost savings and a convenience for consumers. A short time ago they didn’t even exist. Today they are practically mainstream and thriving. Urgent care centers are also booming, treating common injuries and illnesses and performing routine tests—and doing it all more quickly and conveniently than primary care doctors can handle. …

Continue reading Technologies, New Thinking & Consumerism Fueling Tomorrow’s Healthcare Landscape »