Subscribe if you want to be notified of new blog posts. You will receive an email confirming your subscription.
health plan
Care Coordination Metrics: One Can of Worms that NEEDS to be Opened
“Track who is on a care team — and share info with the patient.”
That’s just one of the summary recommendations coming from expert testimony given in a recent public hearing on how to improve care coordination through the use of health information technology. The Meaningful Use workgroup and Quality Measures workgroups are now wrestling with how to translate this recommendation into meaningful use criteria for HITECH Stages 2 and 3.
Seems like […]
The State-of-the-Art of Care Management Software: Disconnected
Care management software is intended to help patients make critical connections across the health care delivery system. Today it’s used primarily by 3rd party care managers who are typically either employed directed or indirectly by payers. While not surprising, the state-of-the-art of care management software is that it continues to function as disconnected islands of information.
The  2010 Health Information Technology Survey (available at no charge) provides an insightful yet sobering snapshot of care management software. The study was sponsored by TCS Healthcare Technologies, the […]
Status Report: HITPC and Workgroup Activities on HITECH Stages 2 & 3
Â
OK, let me be the first to admit that today’s “just-the-facts-ma’am” post might be a little dry…but trust me, its really important stuff to know in understanding the process of how the Health IT Policy Committee (HITPC) and its workgroups are approaching formulating recommendations for HITECH Stages 2 and 3.
At this point at least two different workgroups are involved in developing recommendations for HITECH Stages 2 and 3.
A newly formed Quality Measures Workgroup. This group will “produce initial recommendations on […]
Megatrend Spotting: Health Plan Role of Having “Best Data About YOUR Medical Conditions” is Up for Grabs
Who has the most comprehensive data about YOUR clinical conditions?
For most people, the answer today is “your health plan”, but it’s not at all clear that health plans will continue to have this role in the future.
As physicians and hospitals adopt EHRs, it’s foreseeable that clinical data about patients will be far more available and accessible.
Will patient data become:
A jockeying point for control and business advantage between health plans and care providers,
A collaborative opportunity to optimize clinical care and care […]
Overview: Here Come Stages 2 and 3 of HITECH!
Â
We’ve spent the past year creating the MU (meaningful use) requirements for Stage 1 of the HITECH act. As shown by the diagram above, Stage 1 focuses on Data Capture and Sharing. Now it’s time to begin to focus on Stage 2 (Advanced Clinical Processes) and Stage 3 (Improved Outcomes).
The current generation of EMRs (electronic medical records) were designed primarily to assist care providers with clinical documentation, billing, and maximizing revenues. They were not designed to enable care coordination and […]
Medicare MAPCP Medical Home Demo: CMS Kicks Sands in the States’ Faces
by Jaan Sidorov, MD and Vince Kuraitis
The Medicare MAPCP (Multi-Payer Advanced Primary Care Practice) demo promised to be Medicare’s Biggest Change in 40 Years…
…but the emerging reality isn’t living up to the promise.
In this post, we’ll discuss:
The Promise
An Overview of the MAPCP Demo
Our Main Takeaway: Emerging Reality Suggests Medicare Will Be a “Difficult” Partner
Conclusion: Think Twice Before Signing Up
1) The Promise
The sandbox metaphor was first used by the National Academy for State Health Policy:
For the 10 or more […]
PCMH and Healthcare Reform: Avoiding Drowning in an Ocean of Opportunity
This article appears in the April 2010 issue of Medical Home News.
First, the good news: There are a lot of pilot and demonstration projects potentially involving the Patient Centered Medical Home (PCMH) in newly enacted Federal health care reform legislation – the Patient Protection and Affordable Care Act (PPACA).
Then, the bad news: There are a lot of pilot and demonstration projects potentially involving the PCMH in the PPACA.
…so many that the PCMH risks being drowned in an ocean of opportunity.
I’d […]
Medicare’s Biggest Change in 40 Years on the Horizon?
Earlier this week CMS issued a typically cryptic Announcement indicating that they were shelving the Medicare Medical Home Demonstration (MMHD) and instead would focus on the recently announced Multi-Payer Advanced Primary Care Initiative (MAPCI). My blog post from Tuesday provides details and asks the question “What does all this mean?”
Today’s blog post will tackle:
Medicare’s biggest change in 40 years?
The rise of MAPCI
The fall of MMHD
Implications/discussion
Medicare’s Biggest Change in 40 Years?
We’re Building a REALLY BIG Health Internet!
How big a network will the Health Internet (aka National Health Information Network) be?
My BOTE (back-of-the-envelope) calculation is that this network could consist of about 301 million nodes. Here’s my math (pls. clarify or amplify):
300 million individuals in U.S.
700 K doctors
5 K hospitals
295 K — other B2B healthcare entities
Very rough…but I hope you get the point.
So let’s put into perspective press releases from Google or Microsoft announcing that they have developed new “partnerships” (i.e.nodes in the network) for Google Health or Microsoft HealthVault. As an example, […]
Medicare Health Support (MHS) Claims Another Victim: LifeMasters Files for Chapter 11
Updated 6:10 pm, September 14, 2009
One bad deal can ruin your day.
Today, LifeMasters filed for Chapter 11 bankruptcy protection. According to its press release:
“The Chapter 11 filing is the most efficient path for the company to restructure liabilities that are a result of Demonstration Projects previously performed under contracts with the Centers for Medicare and Medicaid Services (CMS), ” said George D. Pillari, President of LifeMasters. Mr. Pillari, named President of LifeMasters today, is a Managing Director of Alvarez & Marsal […]