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care management

Pilots, Demonstrations & Innovation in the PPACA Healthcare Reform Legislation

Here’s a bit of trivia that will make you the hit of the next cocktail party you attend.  How many times are the words “demonstration” and “pilot” mentioned in the newly passed Federal healthcare reform legislation — the Patient Protection and Affordable Care Act (PPACA)?

Answer:

“demonstration” — 312 mentions
“pilot” — 80 mentions

This weekend I’ve been trying to wrap my head around the question “Just what are these demos and pilots in the PPACA all about?” I have been boggled by the sheer number […]

Chilmark Needs to Chill Out on CCR/CCD Findings

John Moore of Chilmark Research and I agree on things 90+ percent of the time. He even thanked me personally for our collegial relationship in a Thanksgiving Day essay on his blog.

However…I can’t help but comment on John’s misleading story “CCD Standard Gaining Traction, CCR Fading” in The Health Care Blog. He writes:

In a number of interviews with leading HIE [Health Information Exchange] vendors, it is becoming clear that the clinical standard, Continuity of Care Document (CCD) will be the dominant standard in […]

The Real Secret Sauce of Medicare’s Participation in Regional Collaboratives — Network Effects

Last week I asked whether Medicare’s Biggest Change in 40 Years is on the horizon. That post described and discussed implications of Medicare’s new direction for the medical home — the shelving of Medicare Medical Home Demonstration (MMHD) and the refocusing on the recently announced Multi-Payer Advanced Primary Care Initiative (MAPCI).

In that post I touched briefly on the potential for MAPCI to create effective networks at multiple levels — contracting networks, health IT networks, social and collaborative care networks.  I’d like to expand […]

John Halamka’s Stunning 180: “Dogs and Cats Should Live in Harmony”

The King of the Cats has just acknowledged that indeed cats and dogs should co-exist peacefully.

Dr. John Halamka — Vice Chair of the HIT Standards Committee of the ONC and one of the most vocal and influential figures in health IT — writes a blog post this morning entitled “The Genius of AND”. Halamka reasonably summarizes the essence of the debate about standards and interoperability as being between “the healthcare informatics crowd” (cats) and the “Internet crowd” (dogs):

He notes that the debate […]

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?

Meeting Announcement: “Introduction to the Clinical Groupware Collaborative”

by Steve Adams, CEO, RMD Networks and Acting President, Clinical Groupware Collaborative  

I’m writing to extend a warm personal invitation to learn more about the Clinical Groupware Collaborative (CGC).  To-date, purely through word-of-mouth over 40 companies have expressed interest in the CGC, and we expect that you’ll be hearing a lot more about us over the coming months.

Our meeting will take place next Tuesday, September 22, 6 PM in conjunction with The Forum 09, the annual meeting of DMAA: […]

The Third Rail in HITECH Implementation: “Please Don’t Make Us All Speak Latin”

By Vince Kuraitis and Steven Waldren MD, MS.  Dr Waldren is Director of the Center for Health Information Technology at the American Academy of Family Practice (AAFP).

Two issues have rightfully surfaced front and center in the public’s understanding of HITECH Act implementation:

” definition of “Meaningful Use” of EHRs, and
” definition of “certification” process for EHRs

…and we applaud the progress of the workgroups and the HIT Policy Committee in addressing these issues constructively.

However…a THIRD issue lurks – “Data harmonization at the […]

Part II — The Medicare Medical Home Demonstration: Crawling Out From Under the Rock

In Part I of my guest post on The Collaborative Forum blog, I wrote that the Medicare Medical Home Demo is in BIG Trouble. Here’s a recap:

Political reality dictates that the MMHD must save costs.
As currently structured, the MMHD cannot achieve cost savings

In any given year, only a small percentage of patients account for the vast majority of costs
Lessons from previous Medicare disease/care management demonstrations has shown that effective care coordination interventions must be targeted at this population
Medicare has structured the […]

What’s a Network Industry? Is Healthcare One?

This post is a foundational overview of characteristics of network industries.  Much of the terminology will deserve deeper discussion, but we have to start somewhere.

In his book The Economics of Network Industries, Professor Oz Shy lists four characteristics of network industries.

The main characteristics of these markets which distinguish them from the market for grain, dairy products, apples, and treasury bonds are:

Complementarity, compatibility and standards
Consumption externalities [network effects]
Switching costs and lock-in
Significant economies of scale in production

In this essay, I’ll quote from Dr. Shy in explaining each […]

“Meaningful Use” Criteria as a Unifying Force

by Vince Kuraitis, Steve Adams, and David C. Kibbe MD, MBA

Over the past several years, many diverse initiatives have arisen offering partial solutions to systemic problems in the U.S. health care non-system. 

We see Meaningful Use Criteria recommended by the HIT Policy Committee as a unifying force for these previously disparate initiatives. These initiatives have included:

Patient Centered Medical Homes (PCMHs)
Regional Health Information Organizations (RHIOs)/Health Information Exchanges (HIEs)
Payer Disease/Care Management Programs
Personal Health Record Platforms — Google Health, Microsoft HealthVault, Dossia, health banks, more to come
State/Regional […]