Archive for the ‘Uncategorized’ Category

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 …

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

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 …

Continue reading New Enrollment Numbers and a Silly New Controversy »

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.”

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

All Georgia Taxpayers Lose When the State Refuses to Expand Medicaid

There is legislation close to passing the Georgia legislature (it may already be passed by the time this is published) that prohibits “the state nor any department, agency, bureau, authority, office, or other unit of the state nor any political subdivision of the state shall expend or use moneys, human resources, or assets of the State of Georgia to advocate or intended to influence the citizens of this state in support of the voluntary expansion by the state of eligibility for medical assistance under” Medicaid. Its not clear what this legislation actually does, (its not clear it’s authors know what it does), but it could limit the state’s ability to actually run the existing Medicaid program, and perhaps it could prohibit public university professors from answering simple questions about the Affordable Care Act. Is it “advocating or influencing citizens” to report simple facts?

The simple fact is that expanding Medicaid under the Affordable Care Act makes every …

Continue reading All Georgia Taxpayers Lose When the State Refuses to Expand Medicaid »

Georgia’s Health Information Technology Industry: Making A Difference Everyday

health-info-techA couple of weeks ago, a group of health information technology leaders from around the state came to Atlanta to celebrate “Georgia Health Information Technology and High Tech Day at the Capitol.” Georgia State Senator Brandon Beach, Chairman of the Science & Technology Committee, welcomed over 100 Georgians to the State Capitol and talked about Georgia’s status as the nation’s “Health Information Technology Capitol.”

Georgia-based health information technology companies are a serious economic engine. The health IT industry generates more than $4 billion in revenue each year and provides over 15,000 jobs in Georgia. There are more than 186 health IT companies which call Georgia “home.”

And, the health IT industry in Georgia is growing. Georgia’s health IT businesses are growing at a phenomenal 40 percent rate, creating more jobs, more investment and more revenue for Georgia.

Georgia’s health IT industry boasts the likes of heavyweights McKesson Technology …

Continue reading Georgia’s Health Information Technology Industry: Making A Difference Everyday »

Georgia Takes Center Stage at World’s Largest Health IT Conference

HIMSS is well known for putting on the largest conference in the world dedicated to health IT. For the third year in a row, the state of Georgia – the only state to do so – has had a pavilion in the exhibit hall to showcase just a few of its many health IT companies. I had a chance on the HIMSS show floor to talk with Carol Henderson, Director of Health Sciences and Advanced Technologies at the Georgia Department of Economic Development, about the advent and growth of the pavilion, and why it sets such an example when it comes to showcasing Georgia as the nation’s capital of health IT.

Continue reading Georgia Takes Center Stage at World’s Largest Health IT Conference »

It is that Time Again

It is that time again when the Office of Inspector General (“OIG”) publishes its Work Plan for the fiscal year outlining the areas of focus that it will investigate. The Work Plan highlights the OIG’s top priority to “fight fraud, waste and abuse”. The OIG’s strategic plan for fiscal year 2014 through 2018 specifically references using data analytics and risk assessments to identify suspected fraud, waste and abuse. The OIG also utilizes enforcement resources, including, but not limited to its partnership with the Department of Justice to impose penalties and potential criminal or administrative actions against individuals or entities who have allegedly committed fraud. All healthcare providers are subject to the OIG’s enforcement actions. Accordingly, it is imperative for each healthcare provider to establish an effective compliance program. Healthcare providers should utilize this Work Plan to establish what types of audits should be conducted during the …

Continue reading It is that Time Again »

Georgia’s Students are Essential to Success of Health IT

Being immersed in – and passionate about – the world of healthcare IT has led me to the realization that education is fundamental to its implementation, utilization and realization of clinical success stories. By education, I mean introducing to students at an early age the concept of healthcare IT and its role in improving access to quality care. I have been involved in several organizations that recognize this need and are working to bring healthcare IT-related curricula into classroom and after-school activities.

For example, the Institute for Health Information Technology recently issued a workforce readiness survey that highlighted the need for greater collaboration between Georgia’s educational institutions, and healthcare vendors and providers. By working together, these stakeholders can ensure workforce needs will be met with properly educated and trained students.

In addition, the Georgia Department of Education, and the Technology Association of Georgia’s …

Continue reading Georgia’s Students are Essential to Success of Health IT »

FTC Enforces Data Security Practices

Providers beware! HIPAA is not the only law that requires adequate security safeguards for patient information. In today’s mobile environment, companies obtain and exchange patient identifiable information, including health related information constantly. Historically, the Health Insurance Portability and Accountability Act of 1996 (“HIPAA”) required healthcare providers to implement administrative, physical and technical safeguards to protect the security of patients’ identifiable information related to their healthcare needs. HIPAA has been the floor of the safeguards that must be implemented to protect patient information. When a healthcare provider fails to comply with HIPAA, the Office of Civil Rights may impose fines and penalties which recently increased to $1.5Million.

Now in 2014, the government enforcement authority for security protections expanded. On January 16, 2014, the Federal Trade Commission (“FTC”) found that it had the authority to penalize …

Continue reading FTC Enforces Data Security Practices »

Data Analytics Supporting Accountable Care Organizations Require a Different Mindset

An organization pursuing an Accountable Care model requires a different mindset of data analytics versus a healthcare delivery system. The challenge is to integrate a broad range of information across the ambulatory, acute, and post-acute healthcare settings. This integration is not at the same level as what healthcare delivery systems have been working towards for years. Healthcare delivery systems have been working towards the implementation of the longitudinal record. The goal of a longitudinal record is to measure the care path of a patient across the continuum and associated outcomes to ascertain the best practices. It also provides an extensive patient history enabling healthcare providers to assess a patient’s care, identify potential issues such as allergies or pharmaceutical contraindications, prevent unnecessary tests, and support deductive analysis to diagnose a patient’s condition. This is a critical dimension of data supporting accountable care analytics but …

Continue reading Data Analytics Supporting Accountable Care Organizations Require a Different Mindset »