ObamaCare: One Step Forward, Two Steps Backward

flaD AND STETHISCOPEI have been rather vocal in my opposition to the Affordable Care Act (or ObamaCare). There have been too many problems, too many issues and too many unintended consequences.

According to a report released this week by the non-partisan Congressional Budget Office (CBO), ObamaCare will “reduce the supply of labor by the equivalent of roughly 2.3 million full-time workers through 2021.”

Just as the economy is attempting to recover, we are moving forward with the implementation of a federal healthcare disaster that will kill even more jobs.
There is some good news. There is a new, legitimate “repeal and replace” movement led by US Senators Orrin Hatch (R-Utah), Richard Burr (R-NC) and Dr. Tom Coburn (R-Oklahoma). This “repeal and replace” effort has substance and includes many thoughtful, private sector based reforms and includes some of the provisions of ObamaCare that address access to health coverage.

The new Patient CARE (Choice, Affordability, Responsibility, and …

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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 Health and …

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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 a company …

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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 it is …

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ACA Marketplace Enrollment

The Health Insurance Marketplace monthly enrollment report issued this week contained some interesting information. It is too early, and the information is too limited, to really make definitive pronouncements about the Affordable Care Act, but there some results that may be indicative of the health insurance markets of 2015 and beyond.

The big news was the rapid increase in enrollments in the health exchanges over the last month. Enrollment in the health care in Georgia grew from about 6,000 to 58,611 in the month of December. This increase reflects both the desire of consumers to have coverage by January 1, 2014 and the improved functioning of Healthcare.gov website.

Much of the coverage of the enrollment numbers centered on the age distribution trying to discern if Marketplaces were going to attract a sufficient number of younger healthier enrollees to balance out the older sicker enrollees who now have access to affordable coverage. In Georgia about 26 percent of the …

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Healthcare: The Customer Experience Imperative

We have all heard the phrase “customer experience” and the importance many organizations are placing on it. But what does that exactly mean? It’s more than just “customer service.” You might be thinking, “We don’t have a ‘customer experience’ strategy at our company.” Rest assured every organization has a customer experience … it just might be that yours currently stinks.

Forrester defines customer experience as “how customers perceive their interactions with your company.” Wikipedia defines it as, “the sum of all experiences a customer has with a supplier of goods and/or services, over the duration of their relationship with that supplier. This can include awareness, discovery, attraction, interaction, purchase, use, cultivation and advocacy.”

Of course both are correct. At its core, customer experience is how your customers feel about your brand or organization throughout every single interaction. And in today’s digital, social and mobile world, those interactions are …

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New Years’ Resolutions

NY resolutionsEach year, millions of us make so-called “New Years’ Resolutions” or a list of things that we would like to accomplish in 2014. While most of us include things like “eat less and exercise more” on our list of resolutions, this year, my New Years’ Resolutions include:

Advancing Intellectual Honesty: I work regularly in the public arena. I write and speak a great deal about the need for legitimate healthcare reform including transforming our medical malpractice litigation system. In advancing a proposal to eliminate all medical malpractice lawsuits and replace it with an administrative solution similar to workers’ compensation, there has been wholesale fabrication and outright deception involved by some of those opposed to the issue. In discussing public policy options, there needs to be transparency and those engaged in the debate should have facts versus conjecture.

Gallup, the polling people, asked Americans to rate the honesty and ethical standards of members of various …

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Healthcare Confidence Lessons from Target and PayPal

What type of healthcare facility would you rather put your personal health and financial information in the hands of? One like PayPal, who proactively reaches out to assure you its doing everything it can to protect your information, or one like Target, that alerts you to a breach several weeks after the fact? Health data breaches not only mean legal headaches and potentially very large financial penalties, but they also negatively impact a hospital’s brand, in turn causing …

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Healthcare Milestones for 2013

Now is the time of year when we look back at the highs and lows from 2013. In healthcare, there is a lot to talk about, but today we will focus on three important healthcare objectives. In 2013, the Healthcare Reform Act focused on changing reimbursement models and laid the groundwork for health insurance exchanges to commence in 2014. These changes led to three main milestones.

First, in 2013, provider integration flourished because of reimbursement changes. The bundled payment demonstration program commenced while payments to primary care providers increased. Bundled payments require providers to work together to treat a patient under a best practice protocol to reduce the costs so the providers can split one payment for the full delivery of care provided to the patients. As with most of the demonstration programs, bundled payments also require providers to report quality data to the Centers for Medicare and Medicaid Services (“CMS”). Similar to other programs this …

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What are the positive aspects of the Affordable Care Act?

The debate will continue for quite a period-of-time whether the Affordable Care Act achieved its objectives and was cost effective. While political parties and individuals posture the pro’s and con’s of the Affordable Care Act, there are some positive aspects.

Whether you loved or liked the previous healthcare insurance business model, the Affordable Care Act addressed three notable deficiencies. The following are those deficiencies and how the Affordable Care Act addressed them:

First – people with pre-existing medical conditions could not purchase insurance or it was cost prohibitive.

People with pre-existing medical conditions were not able to purchase insurance or the price was cost prohibitive. A number of individuals have pre-existing clinical conditions through no fault of their own. It could be a matter of genetics or other factors beyond their control. It is unreasonable to penalize individuals under these circumstances and put them at a financial disadvantage.

Second …

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