While October isn’t quite over, I think it’s safe to say it’s already been a long and unusual month as far as healthcare in Georgia is concerned. Yes, the federally run health insurance exchange opened to enormous demand, and even more finger pointing. What I’d really like to highlight is the fact that Georgia’s health information exchange went live …
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
So often you hear Georgia in the headlines for being at the bottom of the list. We are in the bottom quartile as a state for public health. We have incredibly high rates of heart disease, obesity, and cancer. Twenty percent of us lack health insurance and we have significant shortages for physicians and access to healthcare (for example, we are the second worst state for providing primary care for Medicaid patients).
Frankly, I am tired of being at the bottom. I am therefore thrilled to know that we are on the other side of the coin when it comes to healthcare technology (HIT). Being an active member in the healthcare industry, I have seen the tremendous progress and success Atlanta and Georgia have achieved in the area of healthcare IT. Fellow blogger Jennifer Dennard went in detail on many of the city’s HIT successes. According to the Metro Atlanta Chamber, there are more than 225 health IT companies in the state, combining for annual revenues of $4 billion and
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.
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?
As the clock counts down to the launch of the healthcare exchanges, various groups are looking for a way to avoid participating in the Affordable Care Act. The media recently showed labor union leaders meeting with President Obama in the White House looking for tax subsidies or an exemption from the Affordable Care Act. Their argument is that the requirements and associated costs will financially ruin the unions.
Another example is Congress voted to exempt themselves from the requirements of the Affordable Care Act. As congressional members developed and promoted the Affordable Care Act, they discussed how the average citizen could have the same level of healthcare coverage as our lawmakers. It is a great talking point that appealed to everyone. The message conveyed is the benefits Congress receives should be available to the average citizen at the same cost level. Somehow, that concept got lost in the constructing of the Affordable Care Act. When lawmakers understood how the
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
As the healthcare world braces for the cost and regulatory implications of ObamaCare, there are other changes approaching on the horizon. An information technology boom is underway that could impact us all.
Healthcare is playing catch up with respect to incorporating technology into the workflow patterns of healthcare workers including physicians and nurses. Transportation, corporate America, small family businesses and even state and local governments have adopted technology solutions.
The airline industry became more efficient by using on-line reservations, on-line check-in and kiosks at airports for boarding passes. McDonald’s and most other fast food restaurants have used technology to more effectively manage workers and the workflow process resulting in better service for their customers. The banking industry embraced technology in a big way as more Americans are using on-line banking services, ATMs and mobile solutions which in turn make banks more efficient and gives
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”
GUEST COLUMNIST: Steve Cohen, MD, Internist at WellStar Cobb Medical Group
Are you willing to spend less than an hour of your time so that you or your loved ones on Medicare can save hundreds to thousands of dollars every year? If the answer is yes, you need to read about www.medicaredrugsavings.org, a website reviewed by Clark Howard, where you can learn to lower your medical costs.
The Medicare Drug Law of 2006 was a boon to the Medicare population. Before the passage of this law the US government did not pay for prescriptions. Since that time people on Medicare (those over 65 as well as people with certain disabilities) have been able to sign up for Medicare D plans (which cover outpatient medicines) or Medicare Advantage plans (essentially HMOs or PPOs which pay for medicines in addition to the hospital, physician and other outpatient bills).
Under traditional Medicare, the government directly pays the provider for rendered medical services. In contrast, private insurance