Record attendance at HIMSS 2015 in Chicago - over 43,000 people. Now that HIMSS15 is over, take a look at some of the trends that dominated the headlines, the social buzz and the chatter at after show cocktail parties. Of course, there were the overarching themes of interoperability, and population health, but there were some key themes that received the most attention.
When thinking about ICD-10 program governance, one of the key areas for both traditional Fee for Service (FFS) medicine and the transition to episodic (short-term) and longitudinal data for comparative effectiveness medicine in the Affordable Care Act is the Case Management process and supporting software and reports.
On October 1, 2013 Health Insurance Exchanges (aka Insurance Marketplaces or HIX) will start operating. Here is an overview of some of the things consumer can expect. Click the "play" icon to view a presentation from Kaiser Family Foundation. "Obamacare" is short for the Patient Protection and Affordable Care Act. Our firm specializes in Obamacare HIX and Accountable Care Organization (ACO) Strategies, and healthcare economics related to disruptive standards such as ICD-10, Meaningful Use of Electronic Health Records, and CORE Operating Rules.
Update August 2, 2013 - CMS published a list of 2,225 hospitals in 49 states that will lose up to 2% of their Medicare reimbursement that had too many patient readmission within 30 days of discharge because of three medical conditions: heart attack, heart failure and pneumonia. Under the PPACA, the maximum penalty will increase to 3% by 2015 and expand to include re-admissions for other medical conditions. ICD-10, a standard the describes the condition of the patient, will modify these quality measures when it goes into effect. We have published an interactive, searchable version of the penalties, by city, state, county and hospital for the healthcare industry and consumers to use to easily find the data relevant to their geography or organization.
These are important foundations that enable ubiquitous digital health data in a standard interchange, enabling in-depth analysis and increasingly, Cloud and Software as a Service methods to deploy, store and use the information to improve healthcare. These in turn are important foundations to enable Accountable Care. ICD-10 is the new data standard that will express the condition of the patient and how providers get reimbursed.
Experts to Review Electronic Health Care Innovation, Regulations and Mobile Health at Scripps, April 17th To register and for more information: http://bit.ly/SDHIS417 A group of companies will participate in a comprehensive…
If The Patient Protection and Affordable Care Act (PPACA) is repealed it will be interesting to see if it is repealed in whole or in part. The Supreme Court of the United States (SCOTUS) may excise the individual mandate requiring health insurance coverage, or it could strike it down entirely.
One of the key questions will be how the EMR provides a foundation with the Health Information Exchanges (HIEs) for comparative effectiveness data over the life span of a patient (sometimes called the continuum of care) and whether CDA standards currently proposed will accomplish that. Informatics people call this "longitudinal clinical data."
ICD-10 implementations must move forward despite Presidential campaign promises to repeal 'Omabacare' or the Affordable Care Act. As Business Week pointed out this week, repealing the Accountable Care Act is not that easy. And even if it were repealed ICD-10 is a HIPAA mandate that was enacted prior to President Omaba's election in August 2008. Hospital systems should push ahead on ICD-10 Assessments, ICD-10 Implementation Plans, and get ready for the shift to ICD-10-CM which includes many more diagnosis codes than ICD-9. ICD-10 PCS also include many more procedure codes than ICD-9.
We find that most analytics and revenue cycle companies are ignoring the future role coordinated medical coding will have, the transition to ICD-10, and the clinical documentation and processes on the revenue cycle. The ICD-10 transition will re-write the book on revenue cycle management (RCM). RAC audits and Electronic Medical Records (EMRs) will be subject to a new paradigm with ICD-10.
An Accountable Care Organization (ACO), is a physician-led entity – consisting of hospitals, primary care physicians, and specialists – responsible for managing the full continuum of care and accountable for the overall costs and quality of care for a defined population, that is partnered with their health plan. CMS mandates such as ICD-10 are separate from health care reform and were mandated before health care reform became law.