November 27, 2001
BEGINNING TO MOVE? THE MEDICARE CHRONIC CARE IMPROVEMENT ACT OF
One of the greatest barriers to
delivering coordinated chronic care -- perhaps THE greatest barrier
-- has been the lack of appropriate reimbursement.
With support from the National Chronic Care Consortium (NCCC) and
the Chronic Care Coalition, Congressman Pete Stark and Senator Jay
Rockefeller have introduced
Medicare Chronic Care Improvement Act of 2001. This legislation
is designed to update and improve the Medicare health delivery
system to meet better the needs of people with chronic health
The Institute of Medicine's (IOM)
"Crossing the Quality Chasm", pointed out the centrality of
reforming medical reimbursement payment policies:
"...to achieve the aims of the 21st
century health care system...it is critical that payment policies be
aligned to encourage and support quality improvement.... Even among
health professionals motivated to provide the best care possible,
the structure of payment incentives may not facilitate the actions
needed to systematically improve the quality of care, and may even
prevent such actions. For example redesigning care processes to
improve follow-up for chronically ill patients through electronic
communication may reduce office visits and decrease revenues for a
medical group under some payment methods."
While the likelihood of passage for
this specific legislation is unclear, it does create a focal point
for coalition building. This legislation SHOULD draw support from a
wide constituency of health care organizations with common interests
in promoting the IOM's vision of future health care, including
e-health companies, telemedicine, pharma, medical information
technology, medical devices, provider groups, etc. Contact
Rich Bringewatt, President
and CEO of the NCCC, to express your support!
STEADY PROGRESS: 3
NEW REPORTS ON PHYSICIAN USE OF E-HEALTH TECHNOLOGIES
"Vital Signs Update: Doctors Say E-Health Delivers"
Harris Interactive and Boston Consulting Group; November 13, 2001
Some key findings:
...physicians use the Internet widely to increase their medical
busiest practitioners are most likely to turn to the Web to
enrich their professional knowledge. This makes the Internet a
powerful vehicle that pharmaceutical companies, managed care
organizations (MCOs), and health-care-delivery systems can use
to reach doctors who regularly see a large number of patients.
information that doctors are finding online is influencing-in
many cases significantly-the types of diagnoses they are making
and the kinds of medications they are prescribing.
small number of high-traffic medical sites are emerging as
potential vehicles for reaching a large number of doctors
online. The doctors who have used the tools find them highly
effective. They say that electronic medical records, electronic
prescribing, online communication with patients, and remote
disease monitoring have significantly boosted their efficiency
and the quality of the care they provide.
Commentary: ...it's worth reading
every word of this report...the BCG/Harris Interactive analysis is
insightful and thorough.
"Innovations in Physician Prescribing"
by Protocare Sciences for the California HealthCare Foundation,
The key to influencing prescribing behavior is to make information
or decision support available to the physician at the time a
prescription is written.
Keys to success:
Alignment of incentives
Physician commitment and involvement
Availability of financial and staffing support
Objective and consistent "counter-detailing" education
(regarding appropriate choices for medications)
"Wireless and Mobile Computing"
First Consulting Group for the California HealthCare Foundation (CHCF),
This is a great primer on mobile and wireless technologies for
health care applications. Keys for success include:
Understand the integration of workflow, information flow and
SPOTLIGHT CHRONIC CARE ISSUES
Two leading journals have recently
devoted special issues to the topic of chronic care needs:
Needs of Chronically Ill People
British Medical Journal; October 27, 2001
Chronic Illness in America
Health Affairs, November/December 2001
PROJECT POINTS TO FLAWS IN HIPAA
"Exposed Online: Why the new federal health privacy regulation
doesn't offer much protection to Internet users"
Health Privacy Project, Institute for Health Care Research and
Policy, Georgetown University
Sponsored by the Pew Internet & American Life Project, November 2001
new federal health privacy regulation does not apply to most
health Web sites.
Different rules may apply to different Web sites offering the
at Web sites that are owned or operated by organizations covered
by the privacy regulation, it is ambiguous which activities at
those sites are subject to the privacy rule.
HEALTH CARE BENEFIT COST INCREASES PROJECTED FOR 2002
It's the time of year when health
care benefit consultants project employer health care cost increases
for the upcoming year. Projections for 2002:
Andersen..............11.7 - 15.5%
Hewitt...................13 - 16%
Read the details:
A key question: Over the past 2 years, a number of initiatives have
arisen to place a renewed emphasis on health care quality. Will
these initiatives be given true support or lip service in light of
continuing double-digit health care cost increases?
NBCH ANALYSIS --
EMPLOYER SURVEY SHOWS EMPLOYEE INVOLVEMENT IN THEIR OWN CARE
MANAGEMENT AS BEST WAY TO BATTLE INCREASING HEALTH CARE COSTS
"August-September Employer Survey
Results: Cost Containment Strategies"
National Business Coalition on Health (NBCH)
Click here to read the
Press release or
Half of the employers surveyed believe employee involvement in
managing their own care will have the greatest impact on reducing
health care costs.
PAYMENT POLICIES - GOOD NEWS, BAD NEWS
Follow the Money"
Online Journal of Issues in Nursing; September 30, 2001
Dena S. Puskin, Sc.D.
This article presents a 10-year
overview of Medicare telemedicine reimbursement policies. It is
written by the foremost expert on the subject -- Dena Puskin, Sc.D.
- who since 1998 has served as the Director of the Office for the
Advancement of Telehealth (OAT) of the U.S. Health Resources and
Services Administration (HRSA). The office currently manages 80
telehealth programs in 43 states.
The bad news - the OAT is being
"abolished" by HRSA. What will happen to the tremendous strides
made to improve telemedicine payment?
AFFECTED BY 9-11 ATTACKS
"Americans' Health Priorities Revisited After September 11"
Health Affairs; November 13, 2001
both relative and absolute terms, health care is a much lower
priority than before September 11.
impact of these events has led Americans to have become more
concerned about a range of serious diseases, including cancer,
heart disease, HIV/AIDS, diabetes and others.
public is now concerned about the health effects of terrorism.
Concerns with bioterrorism will also lead to strong public
support for major initiatives to improve our public health
contrast to health problems, health care issues have become less
salient to the public. This is likely to lead to decreased
support for government action on health care issues that were
being debated by the Congress before September 11. These include
Medicare reform, a Medicare prescription drug benefit, patients'
rights legislation, and coverage for the uninsured.
CHILDREN WITH ASTHMA
Care for Children: Financing Issues"
Center for Healthcare Strategies, October 2001
Disclosure -- No clients were
mentioned this issue.
E-CareManagement News is an
e-newsletter that tracks a major change in health care and managed
care—the paradigm shift from “managing cost” to “managing care”.
This e-newsletter is brought to you by Better Health Technologies,
LLC (http://www.bhtinfo.com). BHT provides consulting and
business development services relating to disease management, demand
management, and patient health information technologies.
You may copy, reprint or forward this newsletter to friends,
colleagues or customers, as long as the use is not for resale or
profit and the following copyright notice is included intact.
Copyright © 2001, Better Health Technologies, LLC. All rights