Archive for the ‘Uncategorized’ Category

Keeping Score

Is the Affordable Care Act a disaster, another step in the evolution of health care or a godsend? Well, the answer still is unclear, but that hasn’t stopped analysts of all stripes from trying to assign a score, or at least an adjective, to the law. In fact the law, three and half years after its passage, is still at least a year away from full implementation.

Information technology troubles lead to the postponement until 2015 of the requirement that employers offer affordable coverage or pay a fee and a reduction in choice in the SHOP exchange for small employers. Under the law employers with over 50 employees who did not offer coverage were subject to pay a fine for each employee (after the first 30). Employers who offered coverage that was deemed unaffordable paid a fine for any employee who received a subsidy in the exchange. The difficulty of developing the appropriate information technologies to allow that choice have forced SHOP exchanges run by the Federal …

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Five Healthcare Predictions for the Future

I attended and spoke at the Health2.0 Conference last week in Santa Clara, California. As always, it was a tremendous event with informative content, engaging speakers, and, of course, plenty of speculation on the future of our healthcare industry. Although it’s hard to select only a handful, below are five predictions I believe we will see take shape in the next year as our industry continues to evolve and progress towards a more efficient and effective operating model.

1. Patient “Engagement” & “Empowerment” is Central: This was probably the most shared theme threaded throughout the conference. Engaging and empowering patients to be active in their healthcare in order to produce better health outcomes and reduce costs. This encompasses everything from engaging with consumers on multiple platforms like mobile and digital, to providing convenient self-service tools, applications and services, to providing better education and consumer-focused participation in healthcare. …

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Why is Atlanta such a great place for healthcare IT?

The subject of Atlanta and healthcare IT is on my mind thanks to an article I read recently at ChicagoBusiness.com. The story, “Why is Chicago so bad in healthcare IT?” listed reasons mainly having to do with turmoil at Merge Healthcare and Allscripts. After reading that rather doom-and-gloom assessment, I began to reflect on our city’s claim to healthcare IT fame. How would I explain it to someone in Chicago, or Boston, or Silicon Valley, or anywhere else that believes they have a claim to the title?

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Confusion reigns

Huffington Post’s Jason Cherkis reported in August: “A middle-aged man in a red golf shirt shuffles up to a small folding table with gold trim, in a booth adorned with a flotilla of helium balloons, where government workers at the Kentucky State Fair are hawking the virtues of Kynect, the state’s health benefit exchange established by Obamacare.
The man is impressed. “This beats Obamacare I hope,” he mutters to one of the workers.”

Kynect is, of course, the health insurance exchange set up in Kentucky as part of Obamacare.

Consumers in Georgia, and nationwide are generally uninformed on the features of the Affordable Care Act. Enrollment for both individual exchanges and small group exchanges begins October 1st, yet consumers have yet to be informed about the exchanges. Kaiser Family Foundation poll conducted in August found that most Americans remain ignorant of how the new law affects them, while 44% unsure as to whether it remains the law or not.

The reasons for this …

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Community Insurance for the People

We are all probably aware of the Medicaid expansion that is occurring across the country. There is also a simultaneous expansion occurring among private insurers and employers. So goes Medicaid, so goes the rest of the insurers. The changes brought about by the American Recovery and Reinvestment act and the Patient Protection and Affordability Care Act seemed to have moved this country in another direction. This not only affects health it also will impact workforce development and economics. For better or worse, things are certainly changing.

Insurance companies are expanding their Accountable Care Organization (ACO) networks in a fast paced move to change the way physicians and other providers are paid. As these insurers move more into the Medicaid market with Health Insurance Exchanges and other products they have an opportunity to change our broken health care system to a more financially successful entity with better clinical outcomes. I remember when “health reform” …

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Healthcare Technology Empowering People Daily

Rarely do I use the venue of HealthFlock to talk about my company SoloHealth. I usually try to provide a relevant and informative perspective on the trends, individuals, companies and ideas shaping the healthcare technology landscape. But, if you’ll indulge me, I’d like to tell a SoloHealth story. During a recent Friday team meeting, an individual shared a personal experience that quite literally embodied what our company mission is all about, what we strive for here every day. And it came from an intern.

Jared Nuessen has been our marketing analytics intern at SoloHealth since May. Don’t let the title of “intern” fool you as Jared has several years of real-world experience as an engineer and researcher, including with a bio-tech startup. He came to us via the Kelley School of Business at Indiana University, where he is a graduate assistant at the Indiana Business Research Center, and is returning to that role the first of September.

Jared was scheduled to give us a …

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Less than One Month to Go and Counting

Healthcare providers, healthcare clearinghouses, health plans (“Covered Entities”) and their business associates all have less than one month to go before they are required to be in compliance with the enhanced privacy and security requirements that became final and effective on March 26, 2013. The compliance deadline for “Covered Entities” is September 23, 2013. For many, there is a lot of work to be completed before the compliance deadline arrives.

On the privacy side, Covered Entities need to update the Notice of Privacy Practices. On the Notice of Privacy Practices (“Notice”), Covered Entities need to ensure that the following notifications have been included in the Notice: (1) if a patient pays out of pocket for a visit in full and request a restriction on disclosing the PHI to the health plan the protected health information related to the services would not be disclosed; (2) most uses and disclosures of psychotherapy notes require an authorization; (3) most uses …

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Facts About Exchange Premiums

One of the most disturbing aspects of the political battle over implementation of the Affordable Care Act is the degree of misinformation being generated by officials in a number of states. Over the summer Insurance departments in Florida, Indiana, Ohio, and Georgia have selectively released information on the cost of coverage in the health insurance exchanges that are misleading at best. They have all claimed that under the ACA people purchasing individual health insurance through the exchanges will face significantly higher premiums. In fact all of their analysis either misstates actual premiums (Indiana), compares exchanges premiums to a fabricated plan that no one can actually purchase currently (Florida), or finds a rare unidentified person who faces higher premiums (Georgia).

The ACA requires that beginning in 2014 premiums in the individual market be based only on age, location with in a state, whether a person smokes, and the plan. Premiums can vary by age by no …

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Anti- Kickback Drama and Why it is bad news for all Hospitals

Two of the nation’s largest for-profit Health Systems, Tenet and HMA, got themselves sued by the Federal Government under the Anti-Kickback Statute last week. The Anti-kickback statute, in a nut shell, prohibits Providers from paying for referrals on patients covered under the Federal Medicare or Medicaid program. The allegations of the complaint center around two pregnancy clinics located in Georgia, and the steerage of illegal immigrants from those clinics to these hospitals. The State of Georgia has also joined the lawsuit to recover it’s spent Medicaid funds.
I understand both Health Systems should be given the benefit of the doubt unless and until the allegations are proven true in court. However, the whistleblower in this case is a former CFO of one of these organizations, and these allegations are very severe. How does this happen in 2013? Is it possible that people, or the corporations they represent, believe they can get away with something like this? Wasn’t there one …

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5 Ways Healthcare Marketers Can Succeed in Today’s Technology Driven World

Technology is creating massive change and disruption that has forever altered the way consumers and businesses interact. The healthcare industry is no exception as we are seeing lighting fast innovation from data digitalization, mobile applications and self-service consumer platforms. Perhaps no other time in history has technology so rapidly changed how we learn, collaborate and communicate. Consider the wave of change with mobile advancements that saw the “pager” become a dinosaur to the Blackberry, only to be followed by the iPhone and smartphones overcoming the Blackberry. By the end of the year, they’ll be more mobile devices on earth than people. And more people are online than ever before socializing, searching and shopping, helping to generate 90% of the world’s data in the last two years alone. The consumerization of technology and the digitalization of data are fundamentally changing us.

All these changes have completely upended how marketing functions. Marketing …

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