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eNews - June 2007

Do You Have a Disaster Plan?

by Mike McBrideHealth Management Technology

The snail in my fish tank hasn’t moved in three days. It did this once before and I almost removed it, when, inexplicably, it started crawling and cleaning the glass. Pet shop guy says it was only sleeping for a week. Apparently, once enough gunky stuff (read, snail food) builds up, snails go about their business. It would seem that snails ...

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Rise of Consumerism
A survey of 1000 U.S. consumers finds that nearly two-thirds want more information about costs and quality of care. Read more

Health & Pension Coverage Proposal
More than 100 U.S. employers recently proposed health reform to create standardized health insurance plans for America’s insured and uninsured workers. Read more

Wisconsin Tops in Healthcare Quality
AHRQ ranks Wisconsin first in the nation in healthcare quality, with the state’s hospitals getting the highest score nationally. Read more

NHIN Report Released
A new report identifies needed services for the ongoing NHIN Trial Implementations includes common elements to be used in the next phase. Read more

Groups Lobby Congress for HIT
AARP, Business Roundtable and SEIU delivered endorsed principles for HIT to Congress as part of the group’s "Divided We Fail" campaign.
Read more

Medicare Initiative Bears Contracts processing under Medicare’s Enterprise Data Center Initiative. 
Read more

Rise of Consumerism

A PNC Financial Services-sponsored survey of 1000 U.S. consumers finds that nearly two-thirds want more information about costs and quality of care while 85 percent want those costs disclosed to the public. More than half say that those figures would influence where they seek care. The majority of those respondents with a high deductible health plan are far more conscious of healthcare costs due to the low premium/higher out-of-pocket expense aspects of the plans. The challenge is that few seem to truly understand their medical bills and the payment process. Additionally, the survey questioned 150 hospital, health system and insurance organization executives, with 72 percent saying that HDHPs add yet another layer of complexity to the claims, billing and payment process. Fully two-thirds of those executives, as well as the same percentage of the consumers surveyed, agreed that making the claims process more efficient would slow rising healthcare costs. Additional survey findings revealed 33 percent of consumer respondents contacted their health plan once in the last year to resolve a claim while 25 percent called two or three times. Fully six in ten did not even know there is a time limit within which to dispute a claim. The PNC e-Health Study was conducted by the Boston-based independent research firm of Chadwick Martin Bailey with executive survey questions asked by phone and the consumer questions asked online.

Click here for more survey highlights and background materials.

Health & Pension Coverage Proposal

A collaboration of more than 100 of the United States’ biggest employers recently produced a health reform proposal. The Employee Retirement Income Security Act Industry Committee (ERIC) proposes to create several standardized health insurance plans for benefits administrators to offer to both America’s insured and uninsured workers. This would effectively result in workers shopping for their health and retirement benefits via regional benefit administrators rather than the current employer-based system. While ERICs proposal would give employers the choice of providing worker health insurance via the current model or take an arms length approach via the standardized health insurance benefits administrator model, many consumer advocate groups see it as employers opting out of employer-based healthcare. A key point of the proposal is the requirement for workers to contribute to their own retirement accounts, which enables the self-employed and unemployed to create subsidies to supplement their incomes via coverage purchased through the administrators. The proposal would need congressional approval for some of the elements and currently does not provide any cost estimates.

Click here to read the full proposal.

Wisconsin Tops in Healthcare Quality

The Federal Agency for Healthcare Research and Quality (AHRQ) has ranked Wisconsin first in the nation in healthcare quality, with the state’s hospitals getting the highest score nationally as well. The state also was among the top five in ambulatory care and in the top 25 percent for nursing home care. Home healthcare was the state’s major statistical anomaly with an overall score of just 25, while the top performing states in that category (Michigan and Pennsylvania) pulled scores of 95. No states did well in all areas with even Wisconsin ranking worse than average in suicide deaths and avoidable hospitalization for influenza. The AHRQ “State Snapshot” ranking, which is in its fourth year, is based on 129 quality measures in four different care settings across all 50 states. The ranking is just one more indicator of the drive towards transparency and improved healthcare quality. “What gets measured and reported publicly tends to get improved faster,” says Wisconsin Collaborative for Healthcare Quality President and CEO Christopher Queram.

Click here for more on the ranking.

NHIN Report Released

The Office of the National Coordinator for Health Information Technology released the summary report of the Nationwide Health Information Network (NHIN) Prototype Architectures recently. The new report identifies and describes primary technical needs and services for ongoing NHIN development and includes common elements that will be used in the next phase in the NHIN Trial Implementations. The report also catalogs the first year’s work on the project, during which four prototype architectures were developed, tested and successfully demonstrated. Completion of this work was done by collaboration of a consortia led by IBM Corp., Northrop Grumman Corp., Accenture Ltd. and Computer Sciences Corp. The purpose of the trial implementations is to demonstrate the critical role of state-level and regional health information exchanges and to address many issues central to the NHIN “network of networks.”

Click here to visit the Federal Business Opportunities Web site.

Groups Lobby Congress for HIT

Seeking a firm timeline for widespread adoption of Health Information Technology (HIT) for achieving a reduction of medical errors, AARP, Business Roundtable and SEIU delivered a set of endorsed principles for HIT to Congress as part of the group’s “Divided We Fail” campaign. Together the three groups, which represent more than 50 million people in the United States, implored Congress to help to increase safety and efficiency in the country’s healthcare system by immediately addressing HIT issues. The nonprofit AARP, Business Roundtable—an association of chief executive officers of leading U.S. companies, and SEIU, the largest healthcare union, collectively believe that HIT will be a critical building block for large-scale reform of the American healthcare system. A study released in 2005 from the non-profit think-tank, RAND Corporation estimated that an average of more than $77 billion per year could be saved for both inpatient and outpatient care if most hospitals and doctors’ offices adopted HIT. Reduced hospital stays, reduced nurses’ administrative time, and more efficient drug utilization would account for the largest savings. Widespread adoption of HIT would raise the potential efficiency savings to $165 billion annually, according to the study. The five endorsed principles of HIT that Divided We Fail delivered to Congress are:

  1. All Americans should have access to a secure, uniform and interoperable healthcare system that provides administrative and confidential medical information.
  2. Adoption of a uniform health information system can improve the patient experience, increase positive health outcomes and realize significant savings.
  3. We urge Congress to pass legislation providing standards for secure, uniform and interoperable healthcare information technology.
  4. This legislation should include grants, loans or tax credits for providers to assist in the purchase of interoperable HIT systems.
  5. The legislation should also ensure adoption of interoperable systems by all payers and providers as early as possible.

To maintain momentum of the issue, Divided We Fail will be scheduling meetings with bipartisan leaders of both chambers of Congress and the presidential administration to discuss the need for HIT legislation in the weeks to come.

Click here for more information on the Divided We Fail lobbying campaign.

Medicare Initiative Bears Contracts

Companion Data Services (CDS), IT services provider to the Centers for Medicare & Medicaid Services (CMS), has launched data center operations to support Medicare claims processing under Medicare’s Enterprise Data Center Initiative. The initiative is the driving force behind a series of reforms aimed at modernizing and improving the efficiency for claims processing. CDS Columbia data center has already transitioned successfully the first Enterprise Data Center workloads and is currently hosting applications being used in six states around the country with work already underway in 17 more states. CMS is consolidating its data center operations at more than 20 facilities into four high-tech enterprise data centers. CMS awarded a 10-year contract in 2006 to CDS, EDS and IBM to operate the new data centers. The contract award also qualifies these companies to compete for task orders that have a combined value of $1.9 billion. Medicare expects these new data centers to accommodate their growing volume of claims, standardize operations and expanded electronic services, as well as bolster security and lower costs by millions of dollars over the next 10 years. CDS has already been awarded two task orders with a combined value of more than $228 million from CMS. To support the project, CDS has expanded the staffs at its Columbia, South Carolina and Dallas offices. In further support of the new project and their partnership with CMS, CDS also has opened a field office in Baltimore. By September, 2008, CMS plans to transfer operations for all fee-for-service Medicare claims to the Enterprise Data Centers in staggered workloads. At which point, CDS will support the processing of approximately 650 million claims submitted annually by hospitals, physicians and other providers across 30 states, Washington D.C. and Puerto Rico. Currently, CDS represents about 54 percent of the nation’s fee-for-service claims.

Click here for more on the CMS Enterprise Data Center Initiative.

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