MedWorm provides a medical RSS filtering service. Over 6000 RSS medical sources are combined and output via different filters. This feed contains the latest medical blog items that have been tagged with 'coordination'. Sat, 03 Sep 2011 02:20:00 +0100 http://www.medworm.com/index.php?rid=5159299&cid=t_113822_113_f&fid=35744&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Fe-CareManagement%2F%7E3%2FWP26N28MUOk%2F This afternoon CMS announced the Bundled Payments for Care Improvement Initiative (BPCII). For details, start reading here. Here are six quick first impressions: 1. It’s very creative and innovative. CMS has demonstrated out-of-the-box thinking and leaves a lot of room for applicants to propose their own approaches. Expect to have to read the materials 2-3 times to wrap your thinking around it. Unlike the Medicare Shared Savings ACO rule, the BPCII is flexible.  Anticipate some innovative and non-traditional proposals from diverse applicants. Unlike the Medicare ACO Shared Savings rule, the BPCII invites flexibility in: Definition of care bundles Proposal of specific financial terms Participation by diverse care providers (see below) Risk adjustment of beneficiaries (more&#8230... e-CareManagement blogs http://www.medworm.com/rss/comments.php?id=5159299 Wed, 24 Aug 2011 00:14:11 +0100 5159299 http://www.medworm.com/index.php?rid=5158854&cid=t_113822_86_f&fid=36669&url=http%3A%2F%2Ffadelibrary.wordpress.com%2F2011%2F08%2F23%2Fthe-core-cities-health-network-report-new-horizons-and-new-challenges%2F Scan or click to download 'The Core Cities Health Network Report: New Horizons and New Challenges' Title:  The Core Cities Health Network Report: New Horizons and New Challenges The Skinny: Report from the Core Cities Health Network that identifies that understanding the commissioning task for securing healthcare for large city/urban areas will be essential for established (and yet to be established) GP commissioning consortia and new statutory Health and Wellbeing Partnership Boards. Building effective partnerships across agencies ensures that local health care strategies for city populations must be informed and driven by health improvement and the reduction of health inequalities. Publisher: DH Published: August 2011 Size: 35p. Filed under: Ooops Missed Category! Tagged: Annu... Fade Library blogs http://www.medworm.com/rss/comments.php?id=5158854 Tue, 23 Aug 2011 12:56:43 +0100 5158854 http://www.medworm.com/index.php?rid=5158856&cid=t_113822_86_f&fid=36669&url=http%3A%2F%2Ffadelibrary.wordpress.com%2F2011%2F08%2F23%2Fhow-to-guide-improving-transitions-from-the-hospital-to-the-clinical-office-practice-to-reduce-avoidable-rehospitalizations%2F Scan or click to download 'How-to Guide: Improving Transitions from the Hospital to the Clinical Office Practice to Reduce Avoidable Rehospitalizations' Title: How-to Guide Improving Transitions from the Hospital to the Clinical Office Practice to Reduce Avoidable Rehospitalizations The Skinny: Guide from Institute for Health Improvement on avoiding avoidable rehospitalisations as a result of poor co-ordination of care settings. Avoiding this is a key step toward achieving broader delivery system transformation. Based on the healthcare system of the USA this guide is of use to those looking at primary care and community settings. Publisher: Institute for Health Improvement Published: August 2011 Filed under: Ooops Missed Category! Tagged: Clinical Governance, Collaboration, Coord... Fade Library blogs http://www.medworm.com/rss/comments.php?id=5158856 Tue, 23 Aug 2011 09:53:48 +0100 5158856 http://www.medworm.com/index.php?rid=5159301&cid=t_113822_113_f&fid=35744&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Fe-CareManagement%2F%7E3%2F6e23a3ZIUP8%2F by Jaan Sidorov MD, MHSA, FACP and Vince Kuraitis JD, MBA Physicians face great uncertainty. According to a survey conducted by The Physicians Foundation, the great majority of physicians (89%) believe the traditional model of independent private practice is either “on shaky ground” or “is a dinosaur soon to go extinct.” In the face of this uncertainty, many physicians are jumping to a conclusion that “I have to sell my practice to the hospital.” In this post of our series on The 100 Year Shift, we will examine physician practice.  We’ll show that the economic and clinical environment  is changing rapidly and that selling to the hospital is one option. However, it is not the only option. (more…) Article Series - The 100 Year Shift? Strategic ... e-CareManagement blogs http://www.medworm.com/rss/comments.php?id=5159301 Mon, 22 Aug 2011 15:26:12 +0100 5159301 http://www.medworm.com/index.php?rid=5158860&cid=t_113822_86_f&fid=36669&url=http%3A%2F%2Ffadelibrary.wordpress.com%2F2011%2F08%2F22%2Fthe-future-of-cancer-networks-policy-recommendations-as-a-result-of-a-joint-seminar-held-at-the-kings-fund%2F Title: The future of cancer networks: Policy recommendations as a result of a joint seminar held at the Kings Fund Scan or click to download ‘The future of cancer networks: Policy recommendations as a result of a joint seminar held at the Kings Fund’ The Skinny: Report that recommends: Networks need to be strengthened by expanding and diversifying the mix of professionals involved, including primary care, community services, public health and social care Patients need to be involved through the creation of structures that are internal to the network A single clinical network (ie covering multiple clinical areas) is an option to meet the challenges posed by the current financial climate as it can generate efficiencies from sharing services and learning, and consistency ... Fade Library blogs http://www.medworm.com/rss/comments.php?id=5158860 Mon, 22 Aug 2011 14:52:02 +0100 5158860 http://www.medworm.com/index.php?rid=5130658&cid=t_113822_86_f&fid=36669&url=http%3A%2F%2Ffadelibrary.wordpress.com%2F2011%2F08%2F15%2Fcan-competition-and-integration-co-exist-in-a-reformed-nhs%2F Scan or Click to go to King's Fund website to download 'Can competition and integration co-exist in a reformed NHS?' Title: Can competition and integration co-exist in a reformed NHS? The Skinny: King’s Fund report that addresses the fundamental question of whether competition and integration can co-exist and considers the role that different bodies, especially the NHS Commissioning Board and Monitor, will play within a new system. The NHS Commissioning Board and Monitor must: develop bundled payment mechanisms so that commissioners can contract for packages of care from different providers allow flexibility for local innovation – regulations and guidance from both are critical access to specialist procurement support for clinical commissioning groups is vital ... Fade Library blogs http://www.medworm.com/rss/comments.php?id=5130658 Mon, 15 Aug 2011 14:00:21 +0100 5130658 http://www.medworm.com/index.php?rid=5118748&cid=t_113822_113_f&fid=34634&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FEmrAndHipaa%2F%7E3%2FjLM8hRYzQbY%2F Lynn Scheps is Vice President, Government Affairs at EHR vendor SRSsoft. In this role, Lynn has been a Voice of Physicians and SRSsoft users in Washington during the formulation of the meaningful use criteria. Lynn is currently working to assist SRSsoft users interested in showing meaningful use and receiving the EHR incentive money. Check out Lynn’s previous Meaningful Use Monday posts. At last week’s HIT Policy Committee meeting, Robert Tagalicod, (the new director of the Office of E-Health Standards & Services), presented an analysis of the attestation experience to-date [See John's previous Meaningful Use Details post for the slides and report]. The results lend themselves to some interesting observations—admittedly preliminary findings, but revealing nonetheless:  The ... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=5118748 Mon, 08 Aug 2011 18:58:10 +0100 5118748 http://www.medworm.com/index.php?rid=5050811&cid=t_113822_113_f&fid=35744&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Fe-CareManagement%2F%7E3%2FtS3SgTYmYeY%2F by Vince Kuraitis JD, MBA and Jaan Sidorov MD, MHSA, FACP In our introductory posting of this series, we noted that economic incentives previously aligning doctor-hospital interests were changing. This creates the potential for The 100 Year Shift – physicians awakening to possibilities for stronger partnerships with payers than with hospitals. In this post, we will zero in on the changing economic position of hospitals and the effect this is having on physician-hospital relationships. We will examine the trend of hospital employment of physicians and point out challenges and tensions for the future. [This is a long post...so now might be the time to refill your coffee cup.] (more…) Article Series - The 100 Year Shift? Strategic Realignment among Physicians, Hospitals and Payer... e-CareManagement blogs http://www.medworm.com/rss/comments.php?id=5050811 Tue, 19 Jul 2011 19:28:14 +0100 5050811 http://www.medworm.com/index.php?rid=5050812&cid=t_113822_113_f&fid=35744&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Fe-CareManagement%2F%7E3%2Fjm_ArodpnyU%2F I doubt it. IMHO, the recent acquisition by Highmark Blue Cross Blue Shield of West Penn Allegheny Health System (WPAHS) for $475 M is unique to local market conditions. It was done as a last resort and should not be taken as a signal that health plans are starting a hospital buying binge. Why are hospitals unattractive investments for health plans: (more…) Tags: acquisition, hospital (Source: e-CareManagement) e-CareManagement blogs http://www.medworm.com/rss/comments.php?id=5050812 Mon, 18 Jul 2011 19:00:17 +0100 5050812 http://www.medworm.com/index.php?rid=5008372&cid=t_113822_113_f&fid=35744&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Fe-CareManagement%2F%7E3%2FXIWnixTJ1Vs%2F by Jaan Sidorov MD, MHSA, FACP and Vince Kuraitis JD, MBA In our introductory posting, we suggested that a huge shift is underway in the health care industry.  Decades of hospital-physician cooperation are not only eroding, we suggest this trend could accelerate.  Instead of a natural clinical and economic affinity with hospitals, we foresee the potential for physicians forming a new dyad with insurer-buyers. In this post, we will examine what we and many other commentators view as inevitable: the demise of volume-based payment systems and how the drive for greater value will cause physicians and insurers re-examine their normally antagonistic relationship. (more…) Article Series - The 100 Year Shift? Strategic Realignment among Physicians, Hospitals and PayersThe 100 Year Shift?... e-CareManagement blogs http://www.medworm.com/rss/comments.php?id=5008372 Thu, 07 Jul 2011 20:42:41 +0100 5008372 http://www.medworm.com/index.php?rid=5008373&cid=t_113822_113_f&fid=35744&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Fe-CareManagement%2F%7E3%2FIJUiE1aXZqA%2F by Vince Kuraitis JD, MBA and Jaan Sidorov MD, MHSA, FACP Gazing at the horizon, we foresee the potential for a tectonic realignment among physicians, hospitals and payers. Here’s a quick visual representation: This essay is the first of a seven part series. In this first post we will capsulize our vision of this potential 100 Year Shift, answer initial FAQs, and lay out the structure for the rest of the series. The Lynchpin — Changing Economic Incentives In the past, physicians and hospitals have benefited from mutually supportive economic interests. (more…) Article Series - The 100 Year Shift? Strategic Realignment among Physicians, Hospitals and PayersThe 100 Year Shift? Introduction and OverviewPayment Transformation: From Volume to Value Next in series Tags: 100 Yea... e-CareManagement blogs http://www.medworm.com/rss/comments.php?id=5008373 Tue, 05 Jul 2011 17:26:33 +0100 5008373 http://www.medworm.com/index.php?rid=4975988&cid=t_113822_113_f&fid=35744&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Fe-CareManagement%2F%7E3%2FKNUpsAvSVXc%2F A study released last week by the Massachusetts Attorney General contains surprising data to challenge two commonly held ACO (accountable care organization) ”Field of Dreams” assumptions. These assumptions relate to patient ”leakage” — out-of-network patient care and referrals. 1) Hospital administrators assume that tighter physician-hospital integration (e.g., through employment of physicians) will result in ”captive referrals” by physicians back to the mother-ship hospital. 2) Medicare administrators are assuming that Medicare Shared Savings ACOs will be able to coordinate patient care even without limitations on patients’ choice to go to providers outside of the ACO provider network. Here’s the data that challenges the validity of ... e-CareManagement blogs http://www.medworm.com/rss/comments.php?id=4975988 Mon, 27 Jun 2011 18:21:41 +0100 4975988 http://www.medworm.com/index.php?rid=4813411&cid=t_113822_113_f&fid=35744&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Fe-CareManagement%2F%7E3%2F5IW3FuYsJ64%2F Why have hospitals increasingly been buying physician practices?  Are these marriages based on true love or convenience? Will these marriages survive? To address these questions, let’s take the long view (50–100 years) and revisit 7 assumptions that have driven us to today’s healthcare non-system: Healthcare payment systems have rewarded piecemeal work. Despite uneasiness, hospital-physician relationships have been cooperative. Physicians can function effectively in small/medium size practices. The healthcare mindset: built on control, not collaboration. Barriers to sharing patient info and coordinating care are high. The hospital has been the economic bedrock of the community. Health plans are the bad guys. For more details and discussion, tune in to tomorrow to Blog... e-CareManagement blogs http://www.medworm.com/rss/comments.php?id=4813411 Tue, 10 May 2011 21:48:42 +0100 4813411 http://www.medworm.com/index.php?rid=4771226&cid=t_113822_113_f&fid=35744&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Fe-CareManagement%2F%7E3%2FHV4Xl_SaRVc%2F Reprinted courtesy of MCOL. Perspectives on a Selected Key Topic |     April 2011/May 2011     |   Volume Three Issue Two Will a material number of hospitals and their core medical staffs, that are relatively independent, evolve into highly integrated delivery systems during this decade, and why? William J DeMarco MA, CMC President and CEO, Pendulum HealthCare Development Corporation The great momentum brought about by government and private payers demand for more accountability is unstoppable. Rapid consolidation of hospitals and consolidation of physicians by physician groups, hospitals and now insurers will shift referral patterns and consumer preference. 1 out of 4 hospitals will fall short of providing value and close or be absorbed within 10 years. Physicians will ... e-CareManagement blogs http://www.medworm.com/rss/comments.php?id=4771226 Sun, 01 May 2011 01:17:30 +0100 4771226 http://www.medworm.com/index.php?rid=4696719&cid=t_113822_113_f&fid=35744&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Fe-CareManagement%2F%7E3%2FC4I7Th9bops%2F My guess is you’ve probably never asked yourself this question. A quick preview: Technical barriers aren’t the limiting factors to Facebook becoming a care coordination platform. Facebook’s company DNA won’t play well in health care. Could Facebook become the care coordination platform of the future? If not Facebook, then what? 1) Technical barriers aren’t the limiting factors to Facebook as a care coordination platform. Can you imagine Facebook as a care coordination platform? I don’t think it’s much of a stretch. Facebook already has 650 million people on its network with a myriad of tools that allow for one-to-one or group interactions. What would it take to make Facebook a viable care coordination platform? More servers to handle the volume ... e-CareManagement blogs http://www.medworm.com/rss/comments.php?id=4696719 Sat, 09 Apr 2011 23:13:18 +0100 4696719 http://www.medworm.com/index.php?rid=4664298&cid=t_113822_113_f&fid=35744&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Fe-CareManagement%2F%7E3%2FsjGmiz2m08s%2F On Friday April 1st, 2011 (yes, ‘April Fools day’) at 4 PM Eastern and 1 PM Pacific ACO Watch: A Mid Week Review will host a special roundtable series on the ‘hot of the press’ Notice of Proposed Rules’ pertaining to the implementation of Accountable Care Organizations. For the published rule, click here. The roundtable team will consist of Mark Browne, MD, PYA, aka @consultdoc, Vince Kuraitis, e-Care Management blog, aka @VinceKuraitis, and David Harlow, the Harlow Group, LLC,  aka @healthblawg, with Gregg Masters, aka @2healthguru, as moderator and host. To listen live, or via archived replay, click here. During the broadcast you may also listen in via (619) 393-2836, and even participate in t... e-CareManagement blogs http://www.medworm.com/rss/comments.php?id=4664298 Thu, 31 Mar 2011 23:05:36 +0100 4664298 http://www.medworm.com/index.php?rid=4664300&cid=t_113822_113_f&fid=35744&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Fe-CareManagement%2F%7E3%2FB9uML3xGuUk%2F Let me try to get you in the right frame of mind to read one of the most remarkable white papers in a long time: Better to BEST: Value Driving Elements of the Patient Centered Medical Home and Accountable Care Organizations — released yesterday by the Commonwealth Fund, Dartmouth Institute, and PCPCC. Having been a debater in high school and then trained as a lawyer, my default mode of thinking is to be critical: “Hey, Vince, how ya doin’? Great day isn’t it?” “Well, …err…maybe, maybe not…actually, here’s 14 reasons why not.” My wife and friends kindly tell me that this personal quality can be insufferable, and if you’ve ever met a lawyer you know what I’m talking about. My internal defense mechanism against my inner-critical brain is simply to... e-CareManagement blogs http://www.medworm.com/rss/comments.php?id=4664300 Thu, 31 Mar 2011 14:48:23 +0100 4664300 http://www.medworm.com/index.php?rid=4658436&cid=t_113822_113_f&fid=35744&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Fe-CareManagement%2F%7E3%2FoVM7gUfkvy0%2F Health care lobbyists and advocates are bracing for six pages of the health care reform law to explode into more than 1,000 pages of federal regulations when the Department of Health and Human Services releases its long-delayed accountable care organization rules this week. Politico What should you be looking for as you snuggle by the fireplace this weekend reading the draft ACO regs? Rob Lazerow writes a helpful article listing 5 Things to Watch in the Medicare Shared Savings Program Proposed Rule. His list of five key design issues includes: How will patients be assigned to ACOs? To what cost benchmark will ACOs be compared? How will bonuses be calculated and paid? For which quality metrics will ACOs be responsible? What is the application process? I’d like to add a sixth  ite... e-CareManagement blogs http://www.medworm.com/rss/comments.php?id=4658436 Wed, 30 Mar 2011 07:03:33 +0100 4658436 http://www.medworm.com/index.php?rid=4610871&cid=t_113822_113_f&fid=35744&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Fe-CareManagement%2F%7E3%2FSjXt2mNST7s%2F While in Philadelphia earlier this week, my colleague Dr. David Nace presented me with a print copy of McKesson Relay Health’s newest whitepaper — Providing Accountability: Accountable Care Concepts for Providers.  I felt honored as he handed it to me and confided that it was one of only six copies in print.  I took time to read it carefully on the long flight home. The whitepaper is a great overview of accountable care and ACOs (Accountable Care Organizations). It’s a quick and easily digestible read. However, there is one key point articulated in the paper that I’d like to emphasize here: accountable care is not synonymous with ACOs. (more…) Article Series - Accountable Care Organizations: Cure-du-Jour or Real Collaborative Care?The Big Idea in U... e-CareManagement blogs http://www.medworm.com/rss/comments.php?id=4610871 Fri, 18 Mar 2011 18:25:39 +0100 4610871 http://www.medworm.com/index.php?rid=4512460&cid=t_113822_113_f&fid=35744&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Fe-CareManagement%2F%7E3%2FL1cOu3ulj6M%2F Is economic credentialing — the use of economic factors such as loyalty and utilization rates in the physician credentialing process — a potential tool for primary care physicians to lead ACOs?   and reestablish the vitality of primary care in American health care? Keith Wright and Gregory Drutchas’ incisive article Economic Credentialing: A Prescription To Secure Shared Savings Under Accountable Care provides useful history and context about economic credentialing: For many years, the use of economic factors by hospitals in making medical staff credentialing decisions has been the subject of much discussion and debate among physicians, groups such as the American Medical Association (AMA), healthcare providers, payors, and attorneys….the implementation of healthcare reform... e-CareManagement blogs http://www.medworm.com/rss/comments.php?id=4512460 Thu, 24 Feb 2011 00:31:17 +0100 4512460 http://www.medworm.com/index.php?rid=4482850&cid=t_113822_113_f&fid=35744&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Fe-CareManagement%2F%7E3%2FGmgPMF_9Ks8%2F Conclusions. Health reform policies currently envisioned to improve care and lower costs may have small effects on high-cost patients who consume most resources. Instead, developing interventions tailored to improve care and lowering cost for specific types of complex and costly patients may hold greater potential for ‘‘bending the cost curve.’’ This research uses patient-level data and a much richer set of explanatory factors than previous studies to examine key patient, physician, practice, and market characteristics associated with costs of high-cost Medicare beneficiaries, defined as the top 25 percent of beneficiaries arrayed by expected Medicare costs… we estimate determinants of Medicare expenditures (costs) at the beneficiary level….After exclusions, the analysis sampl... e-CareManagement blogs http://www.medworm.com/rss/comments.php?id=4482850 Wed, 16 Feb 2011 01:17:43 +0100 4482850 http://www.medworm.com/index.php?rid=4429079&cid=t_113822_113_f&fid=35744&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Fe-CareManagement%2F%7E3%2F32qW7qHRZ2A%2F Webinar Title: An Impending Marriage: Electronic Health Records (EHRs) and Care Management Software The presentation will be geared at practicing clinical case managers in health plans, hospitals, disease management companies, and similar organizations: Describe market forces driving integration of EHRs and care management software.  Review care management software survey data and stimulus funding for EHR adoption.  Describe a 3 stage framework for the evolution of EHRs and care management software.  Characterize benefits to patients and impacts on care manager responsibilities. The event is sponsored by HealthSciences Institute and the PartnersinImprovement Alliance. When: Friday, February 4, 2011 11:30 am Eastern Time 10:30 am Central Time 9:30 am Mountain Time 8:30 am Pacific Time... e-CareManagement blogs http://www.medworm.com/rss/comments.php?id=4429079 Wed, 02 Feb 2011 21:13:33 +0100 4429079 http://www.medworm.com/index.php?rid=4419136&cid=t_113822_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fthe-hot-spotters-is-better-care-for-the-neediest-patients-the-answer-to-lower-healthcare-costs%2F2011.01.31 Author-physician Dr. Atul Gawande has done it again with a well-written article in The New Yorker magazine entitled, “The Hot Spotters.” It deals with the fact that 5 percent of people with chronic illness make up over 50 percent of all healthcare costs. If we can zero in on providing better preventive care for those people, we can finally get our arms around runaway healthcare costs. How great that you don’t even have to have a New Yorker subscription to read it. Here are a few cliff notes until you get to it: – In Camden, New Jersey, one percent of patients account for one-third of the city’s medical costs. By just focusing attention on the social and medical outpatient needs of those people, they not only got healthier but costs were cut in half. &#8... Better Health blogs http://www.medworm.com/rss/comments.php?id=4419136 Mon, 31 Jan 2011 23:00:00 +0100 4419136 http://www.medworm.com/index.php?rid=4265923&cid=t_113822_113_f&fid=35744&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Fe-CareManagement%2F%7E3%2FMJs5VvLnXPs%2F Will ACO (accountable care organization) IT models be walled gardens or open platforms?  i.e., will ACO IT platforms focus on exchanging information within the provider network of the ACO, or will they also be able to exchange information with providers outside the ACO network? (If the question still isn’t clear, click here for a further explanation.). (more…) Article Series - Accountable Care Organizations: Cure-du-Jour or Real Collaborative Care?The Big Idea in Understanding “Accountable Care Organizations”The Achilles Heel of ACOs? Shared Savings Payment Model Unlikely to Motivate HospitalsA Dark Horse in ACO Formation: Large Physician Groups“Does This ACO Thing Really Mean We Need to be ‘Accountable’”Will ACO IT Models Be Walled Ga... e-CareManagement blogs http://www.medworm.com/rss/comments.php?id=4265923 Thu, 16 Dec 2010 00:45:16 +0100 4265923 http://www.medworm.com/index.php?rid=4249056&cid=t_113822_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fnewt-gingrichs-take-on-facebook-saving-a-womans-life%2F2010.12.10 I’ve seen at least half a dozen links to the op-ed coauthored by Newt Gingrich and neurosurgeon Kamal Thapar about how the doctor used information on Facebook to save a woman’s life. (It was published by AOL News. Really.) In brief, a woman who had been to see a number of different health care providers without getting a clear diagnosis showed up in an emergency room, went into a coma and nearly died. She was saved by a doctor’s review of the detailed notes she kept about her symptoms, etc., which she posted on Facebook. The story is vague on the details, but apparently her son facilitated getting the doc access to her Facebook page, and the details posted there allowed him to diagnose and treat her condition. She recovered fully. Newt and Dr. Thapar wax rhapsodic about... Better Health blogs http://www.medworm.com/rss/comments.php?id=4249056 Fri, 10 Dec 2010 23:00:54 +0100 4249056 http://www.medworm.com/index.php?rid=4225414&cid=t_113822_113_f&fid=35744&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Fe-CareManagement%2F%7E3%2Fuw7kIPbTkeY%2F Medicare has (finally) recently released a report showing home run results for a disease/care management demonstration project! Evaluation of Medicare Care Management for High Cost Beneficiaries (CMHCB) Demonstration: Massachusetts General Hospital and Massachusetts General Physicians Organization (MGH) Remind Me Again About the CMHCB Medicare Demo… The CMHCB started in 2005. My recollection is that the demo requirements were extremely similar to the Medicare Health Support (MHS) project, with a few exceptions: 1) Applicants had to include direct care providers (delivery systems, physicians) in their program design, 2) patient populations were significantly smaller than MHS.  Please comment on anything I’m missing. I’ve included an addendum at the bottom providing more... e-CareManagement blogs http://www.medworm.com/rss/comments.php?id=4225414 Fri, 03 Dec 2010 00:35:05 +0100 4225414 http://www.medworm.com/index.php?rid=4179379&cid=t_113822_113_f&fid=35744&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Fe-CareManagement%2F%7E3%2FJ8Pn-MgOs5s%2F A press release earlier this week announced the new CMS Center for Medicare and Medicaid Innovation. If you went to their Twitter feed today, here’s what you’d see: This struck me as a great pictorial representation of the broader challenges the CMS Innovation Center faces: They’ve kinda sorta figured out there’s a conversation going on out there — they’ve joined Twitter They haven’t figured out that they need to listen:  Following = 0 They haven’t figured out they they need to talk:  Tweets = 0 I remain hopeful, but the CMS Innovation Center has a long way to go.  Dr. Berwick, opening up this closed organization is going to be the challenge of your lifetime. Tags: CMI, CMS, health reform, Medicare (Source: e-CareManagement) e-CareManagement blogs http://www.medworm.com/rss/comments.php?id=4179379 Thu, 18 Nov 2010 18:57:32 +0100 4179379 http://www.medworm.com/index.php?rid=4133715&cid=t_113822_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fmisusing-medical-technology-and-escalating-the-cost-of-healthcare%2F2010.11.03 Guest post by Stephen C. Schimpff, M.D. We are often told that the reason for the high cost of medical care is all of our new technologies and drugs. There is an element of truth in that but when used correctly, new technologies save lives and improve the quality of patient care and often improve safety. But technologies used inappropriately increase costs while not improving quality and may adversely impact safety. A patient example An older woman had been coming to the same primary care physician (PCP) as her daughter for over twenty years. She lived in another city about 30 miles distant but she preferred to visit the doctor with her daughter. She also occasionally saw a doctor near her home if she had an immediate problem. On nearly every visit she said that she felt “tired.” Re... Better Health blogs http://www.medworm.com/rss/comments.php?id=4133715 Wed, 03 Nov 2010 16:00:08 +0100 4133715 http://www.medworm.com/index.php?rid=4125106&cid=t_113822_113_f&fid=35744&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Fe-CareManagement%2F%7E3%2FiVKcHAfiCcc%2F The American College of Physicians (ACP) just released a well-reasoned and thorough position paper, The Patient-Centered Medical Home Neighbor: The Interface of the Patient-Centered Medical Home with Specialty/Subspecialty Practices. As I’ve written before, the Big Idea behind ACOs (Accountable Care Organizations) is the notion of accountability, not the specifics of organizational structure. The purpose of the ACP position paper is to address the gaps that exist in care coordination when a physician refers a patient to a specialist. The obvious and logical answer proposed is to develop “Care Coordination Agreements” between primary care physicians and referring specialists, and the position paper takes 35 pages to explain why and how. A simplified way of thinking about Care... e-CareManagement blogs http://www.medworm.com/rss/comments.php?id=4125106 Mon, 01 Nov 2010 17:28:08 +0100 4125106 http://www.medworm.com/index.php?rid=4098122&cid=t_113822_113_f&fid=35744&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Fe-CareManagement%2F%7E3%2FPhoA0bPGIvk%2F Tuesday, Oct. 26, 1-2 p.m. Eastern Time — Presented by the Care Continuum Alliance Federally supported “Beacon Communities” are at work now defining how health information technology will support accountable, evidence-based care in communities – especially for care of chronic conditions. Backed by $235 million in federal grants, 15 communities across the country are serving as Beacon Community pilots for eventual wide-scale, performance-based use of technology to improve our health care delivery system. The goal of the webinar is to address The fundamental nature and vision of the Beacon Community Program How the Beacon Program will influence nationwide delivery system reform and be a guide-path toward developing community infrastructures Other implications for the fu... e-CareManagement blogs http://www.medworm.com/rss/comments.php?id=4098122 Fri, 22 Oct 2010 22:09:34 +0100 4098122 http://www.medworm.com/index.php?rid=4065439&cid=t_113822_113_f&fid=35744&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Fe-CareManagement%2F%7E3%2FR13qXxm3a_c%2F “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 a good idea — simple, straightforward — perhaps even obvious. The EHR (electronic health record) could be a great tool for keeping care team members in the loop and on the same page about a patient’s care. But then I thought about this for a few minutes, and the complexities started dawning. This seemingly simple recomme... e-CareManagement blogs http://www.medworm.com/rss/comments.php?id=4065439 Thu, 14 Oct 2010 02:14:40 +0100 4065439 http://www.medworm.com/index.php?rid=4036758&cid=t_113822_113_f&fid=35744&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Fe-CareManagement%2F%7E3%2FdrvBwJYXAbs%2F Last week I attended and participated in an excellent conference — the National Reducing Hospital Readmissions Forum sponsored by World Research Group. One of my main take aways is to observe a simple — yet huge — difference in mindset between hospital executives and vendors. Over the past few months I’ve heard many vendors with diverse health care offerings talking about building readmission avoidance “programs” that they want to sell to hospitals.  Their idea here is to put together a soup-to-nuts offering of technologies and services — a “program” that hospitals would mostly outsource to a 3rd  party vendor. This concept has never quite sat right with me. Having spent the first 15 years of my career in and around the hospital world, I’ve often observe... e-CareManagement blogs http://www.medworm.com/rss/comments.php?id=4036758 Wed, 06 Oct 2010 00:35:58 +0100 4036758 http://www.medworm.com/index.php?rid=4018247&cid=t_113822_113_f&fid=35744&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Fe-CareManagement%2F%7E3%2FMFllEgfzgTU%2F 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 Case Management Society of America, and the American Board of Quality Assurance and Utilization Review Physicians. The study consists of answers from 670 respondents who chose to fill out to a ... e-CareManagement blogs http://www.medworm.com/rss/comments.php?id=4018247 Thu, 30 Sep 2010 00:37:07 +0100 4018247 http://www.medworm.com/index.php?rid=4003205&cid=t_113822_83_f&fid=34856&url=http%3A%2F%2Finsidesurgery.com%2F2010%2F09%2Fplaying-video-games-improves-handeye-coordination-surgeons%2F New research published in the journal Cortex shows that the hand-eye coordination skills developed in playing video games is very similar to the skills obtained by top laparoscopic surgeons. Lead author Joshua Granek of the Vision Research Center in York, Canada shares his thoughts on his study. (Source: Inside Surgery) Inside Surgery blogs http://www.medworm.com/rss/comments.php?id=4003205 Tue, 28 Sep 2010 03:42:20 +0100 4003205 http://www.medworm.com/index.php?rid=4003292&cid=t_113822_109_f&fid=34750&url=http%3A%2F%2Fpsychcentral.com%2Fblog%2Farchives%2F2010%2F09%2F27%2Fsoldiers-dont-trust-the-military-to-help-with-suicide%2F From the “Not really surprising” file… Returning soldiers and military veterans don’t really hold much hope or trust in the military to help them with their mental health needs — especially suicidal thoughts — according to a new report. And why would they? The military is their employer. Would you feel comfortable talking to your bosses about all of your mental health issues? And not just mild stuff either, this is the serious depression, “I want to kill myself” stuff. Most of us would be extremely uncomfortable with such a conversation. We would be even more uncomfortable with such a conversation knowing it is being recorded in our work record, and will follow us around for the rest of our professional career. This is exactly what happens ... World of Psychology blogs http://www.medworm.com/rss/comments.php?id=4003292 Mon, 27 Sep 2010 16:36:28 +0100 4003292 http://www.medworm.com/index.php?rid=3965524&cid=t_113822_113_f&fid=35744&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Fe-CareManagement%2F%7E3%2FW7-Cvm8tO98%2F 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 coordination, or Both? (more…) Article Series - Stages 2 and 3 of HITECH: The Golden Era of Care Coordination or Bureaucrats Practicing Medicine?Overview: Here Come Stages 2 and 3 of HITECH!Megatrend Spotting: Health Plan Role of Having “Best Data... e-CareManagement blogs http://www.medworm.com/rss/comments.php?id=3965524 Mon, 13 Sep 2010 23:23:38 +0100 3965524 http://www.medworm.com/index.php?rid=3946560&cid=t_113822_113_f&fid=35744&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Fe-CareManagement%2F%7E3%2F5rv0xNvyUfk%2F   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 optimize population health.   This essay is the first in a new, ongoing series that will highlight: Design and metrics for Stages 2 and 3 of the HITECH act Companies and care providers developing and using applications targeting Stage 2 and 3 MU objectives This first essay wi... e-CareManagement blogs http://www.medworm.com/rss/comments.php?id=3946560 Wed, 08 Sep 2010 23:49:07 +0100 3946560 http://www.medworm.com/index.php?rid=3746740&cid=t_113822_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2F7-under-the-radar-healthcare-changes%2F2010.07.12 Kaiser Health News proves its value once again with an under-the-radar story covering some items you won’t see in many other news sources. An excerpt: “…several lesser-known provisions also take effect in coming months that could have a lasting impact on the nation’s health care system. These provisions include eliminating patients’ co-payments for certain preventive services such as mammograms, giving the government more power to review health insurers’ premium increases and allowing states to expand Medicaid coverage to low-income adults without children. While these changes might not have gotten at lot of attention, they could help build support for the law in the run-up to the contentious mid-term elections.” Their list: • Prevention For Less... Better Health blogs http://www.medworm.com/rss/comments.php?id=3746740 Mon, 12 Jul 2010 15:00:29 +0100 3746740 http://www.medworm.com/index.php?rid=3714288&cid=t_113822_113_f&fid=35744&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Fe-CareManagement%2F%7E3%2F1pHczcOEMmE%2F 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 states that are active stakeholders in multi-payer medical home initiatives, the promise of Medicare getting in the sandbox with them and playing (a.k.a. paying) is an exciting proposition. The addition of Medicare as payer to some of these state initiatives may be the critical tipping point that results in widespread primary care delivery system reform in states by involving more practices, payers and patients. (more…) Article Series - Medicare's New Direction for the Medical HomeCMS Shelves Medicare Medical Home DemonstrationMedicare’s Biggest Change in 40 Years on the Horizon?Three Years Of Medical Home Demonstrat... e-CareManagement blogs http://www.medworm.com/rss/comments.php?id=3714288 Wed, 30 Jun 2010 16:11:45 +0100 3714288 http://www.medworm.com/index.php?rid=3603595&cid=t_113822_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fhow-an-empowered-patient-finds-a-new-doctor%2F2010.05.26 What if the average patient (person) knew what healthcare insiders, providers and expert patients know? Take the process of looking for a new personal physician. Conventional wisdom tells people that when looking for a new physician they need to consider things like specialty, board certification, years in practice, and geographic proximity. Online services like Health Grades allow you to see and compare the satisfaction scores for prospective physician candidates. But industry insiders know different. Consider those patient satisfaction scores for physicians. In reality, “one can assume that the quality of care is actually worse than surveys of patient satisfaction would seem to show,” according to a 1991 lecture by Avedis Donabedian, M.D.: “Often patients are, in fact, overly pati... Better Health blogs http://www.medworm.com/rss/comments.php?id=3603595 Wed, 26 May 2010 16:00:23 +0100 3603595 http://www.medworm.com/index.php?rid=3538242&cid=t_113822_113_f&fid=35744&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Fe-CareManagement%2F%7E3%2FdIwL5RIMh8Y%2F by Vince Kuraitis JD, MBA and David C. Kibbe MD, MBA . ….or to be more specific, HITECH is synergistic with payment reform that could come from the recently passed national health care reform legislation — the Patient Protection and Affordable Care Act (PPACA). We’ll keep this post fairly short and try to avoid many of the more divisive aspects of this topic. The need for healthcare payment reform is well understood on both sides of the aisle: Realizing the full potential of health IT depends in no small measure on changing the health care system’s overall payment incentives so that providers benefit from improving the quality and efficiency of the services they provide. Only then will they be motivated to take full advantage of the power of electronic health records. Dr. David... e-CareManagement blogs http://www.medworm.com/rss/comments.php?id=3538242 Tue, 04 May 2010 23:52:12 +0100 3538242 http://www.medworm.com/index.php?rid=3524118&cid=t_113822_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fplastic-surgeon-is-the-king-of-donkey-kong%2F2010.04.30 Donkey Kong has a new recordholder — and he’s a plastic surgeon. Hank Chien, M.D., scored 1,061,700 points in 2 hours and 35 minutes, breaking the world-record score for the classic arcade game. Read the piece to learn how he did it, and more interestingly, the painstaking steps he had to take to verify his score. The feat does lend some anecdotal support linking video games and the hand-eye coordination required for surgery. There are small studies linking the laparoscopic skill of surgeons with how well they do on video games. (more…) *This blog post was originally published at KevinMD.com* (Source: Better Health) Better Health blogs http://www.medworm.com/rss/comments.php?id=3524118 Fri, 30 Apr 2010 16:00:04 +0100 3524118 http://www.medworm.com/index.php?rid=3448955&cid=t_113822_113_f&fid=35744&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Fe-CareManagement%2F%7E3%2F_fkdKFOL_90%2F 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 like to make a few simple points in this essay: The number of authorized pilots and demos in the PPACA is staggering This creates both opportunities and challenges PCMH focus will be required to navigate the ocean (more…) Article Series - Medicare's New Direction for th... e-CareManagement blogs http://www.medworm.com/rss/comments.php?id=3448955 Thu, 08 Apr 2010 15:15:31 +0100 3448955 http://www.medworm.com/index.php?rid=3416118&cid=t_113822_113_f&fid=35744&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Fe-CareManagement%2F%7E3%2F2hl9dJni6rA%2F 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 and complexity, and thought I’d share some findings from my first dive. Why are These Pilots and Demonstrations Important? (more…) No tag for this post. (Source: e-CareManagement) e-CareManagement blogs http://www.medworm.com/rss/comments.php?id=3416118 Mon, 29 Mar 2010 01:58:26 +0100 3416118 http://www.medworm.com/index.php?rid=3259061&cid=t_113822_113_f&fid=35744&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Fe-CareManagement%2F%7E3%2FVLEXdRRjotg%2F Hospitals charge on a cost basis, which places no penalty on inefficient operations. Moreover, present systems of hospital management make it very difficult to maintain effective control over hospital costs. The Commission concluded: “If the needs for health care are to be met, the health care system must be organized to employ its resources with more wisdom and effectiveness. The two areas which appear to offer the greatest potential for improvement are (1) reducing unnecessary (or unnecessarily expensive) medical care and (2) increasing efficiency in the provision of hospital care.” It will not be easy to carry out this recommendation. Who said this? …and when? (more…) No tag for this post. (Source: e-CareManagement) e-CareManagement blogs http://www.medworm.com/rss/comments.php?id=3259061 Tue, 09 Feb 2010 19:54:54 +0100 3259061 http://www.medworm.com/index.php?rid=3067156&cid=t_113822_113_f&fid=35744&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Fe-CareManagement%2F%7E3%2FmEkR3q1jQvs%2F Atul Gawande’s most recent New Yorker article “Testing, Testing” addresses the critics who lament that there is no master plan to curb delivery system costs in pending health reform legislation. Gawande retorts: “Is that a bad thing?” …and he answers his own question by describing the value of pilot programs contained in both the Senate and House versions of health reform legislation. Is Gawande correct?  Yes and no…. (more…) Article Series - Medicare's New Direction for the Medical HomeCMS Shelves Medicare Medical Home DemonstrationMedicare’s Biggest Change in 40 Years on the Horizon?Three Years Of Medical Home Demonstration Preparation Down the Drain?The Real Secret Sauce of Medicare’s Participation in Regional Collaboratives — Network EffectsIs Gawan... e-CareManagement blogs http://www.medworm.com/rss/comments.php?id=3067156 Tue, 08 Dec 2009 00:45:40 +0100 3067156 http://www.medworm.com/index.php?rid=3012474&cid=t_113822_113_f&fid=35744&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Fe-CareManagement%2F%7E3%2FmQyPb5p5cGU%2F Medicare announced today that it is extending its Personal Health Record (PHR) pilot project for residents of Utah and Arizona. This is a waste of time and taxpayer dollars. Those of you who read my blog know that I’m a big fan of PHRs, but you have to know when you’re backing the wrong approach. What’s wrong with this pilot project? A lot: (more…) Tags: business model, EHRs/PHRs, HIE, Medicare, platform (Source: e-CareManagement) e-CareManagement blogs http://www.medworm.com/rss/comments.php?id=3012474 Fri, 20 Nov 2009 05:09:35 +0100 3012474 http://www.medworm.com/index.php?rid=3003871&cid=t_113822_113_f&fid=35744&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Fe-CareManagement%2F%7E3%2FE-Jk96eOPWk%2F 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 a bit today… So, why is Medicare’s participation in MAPCI  and other regional collaboratives such a big deal? Here’s my hypothesis: Medicare’s non-participation (to-date) in regional payer/provider collaboratives has been a rate... e-CareManagement blogs http://www.medworm.com/rss/comments.php?id=3003871 Wed, 18 Nov 2009 00:53:23 +0100 3003871 http://www.medworm.com/index.php?rid=2984882&cid=t_113822_113_f&fid=35744&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Fe-CareManagement%2F%7E3%2F2NyU0BDII1g%2F Do you remember the scene in the movie Animal House where Bluto Blutarski laments “…seven years of college education down the drain?” Why aren’t primary care physicians expressing similar laments about  the shelving of the MMHD (Medicare Medical Home Demonstration) in favor of the MAPCI (Multi-Payer Advanced Primary Care Initiative). My colleague Jaan Sidorov, MD and I pick up on no signs of discontent.  Read our essay “Three Years of Medical Home Demonstration Preparation Down the Drain?” on Dr. Sidorov’s blog.     Article Series - Medicare's New Direction for the Medical HomeCMS Shelves Medicare Medical Home DemonstrationMedicare’s Biggest Change in 40 Years on the Horizon?Three Years Of Medical Home Demonstration Preparation Down the Drain? Previous in series ... e-CareManagement blogs http://www.medworm.com/rss/comments.php?id=2984882 Thu, 12 Nov 2009 15:45:50 +0100 2984882 http://www.medworm.com/index.php?rid=2943908&cid=t_113822_113_f&fid=35744&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Fe-CareManagement%2F%7E3%2Fsny5F8u6dgs%2F 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? (more…) Tags: business model, care coordination, care management, conference, EHR, health plan, health reform, HIE, hospital, meaningful use, medical home, Medicare, Medicare Medical Home Demonstration, multipayer, network effect, primary care, readmission (Source: e-C... e-CareManagement blogs http://www.medworm.com/rss/comments.php?id=2943908 Fri, 30 Oct 2009 00:35:37 +0100 2943908 http://www.medworm.com/index.php?rid=2931085&cid=t_113822_113_f&fid=35744&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Fe-CareManagement%2F%7E3%2F5FVQDknxCBw%2F I just received an email from CMS announcing the latest official word on the Medicare Medical Home Demonstration (MMHD): 10/26/2009 – In Washington, the efforts to reform health care and health insurance include proposed legislative language that would have an impact on the Medicare Medical Home Demonstration as described in section 204 of the Tax Relief and Health Care Act of 2006 and amended by section 133 of the Medicare Improvements for Patients and Providers Act of 2008. Specifically, section 1302 of House Bill 3200 contains a provision to repeal this demonstration and replace it with an independent practitioner-based medical home pilot described further in the bill. In addition, the House bill includes a second medical home pilot to evaluate community-based medical home models... e-CareManagement blogs http://www.medworm.com/rss/comments.php?id=2931085 Tue, 27 Oct 2009 15:59:21 +0100 2931085 http://www.medworm.com/index.php?rid=2904964&cid=t_113822_113_f&fid=35744&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Fe-CareManagement%2F%7E3%2F0_vhnMGH51k%2F BrightTALK is sponsoring a complimentary Electronic Health Record Summit this Tuesday, October 20, 2009. David C. Kibbe MD, MBA and I will be presenting “Introduction to Clinical Groupware and the Clinical Groupware Collaborative” Clinical groupware is a new and evolving model for the development and deployment of health information technology (HIT) platforms and applications having the following characteristics: Use of the Internet and the web for EHR technology. Explicit design for information sharing and online communication among providers and patients/consumers. A modular or component architecture upon which applications can be aggregated to meet specific clinical and workflow tasks. Patient/consumer engagement tools that facilitate ongoing health management and care coo... e-CareManagement blogs http://www.medworm.com/rss/comments.php?id=2904964 Mon, 19 Oct 2009 00:03:18 +0100 2904964 http://www.medworm.com/index.php?rid=2832251&cid=t_113822_113_f&fid=35744&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Fe-CareManagement%2F%7E3%2FtVXihMwiuC0%2F Dr. Don Storey and I spoke at the at The Forum 09 conference in San Diego earlier this week. The DMAA publication “The Continuum” had an excellent writeup of our enthusiastically received presentation.  Here’s a copy of our PowerPoint slides… HITECH Health IT Legislation: Opportunities for the DMAA Community View more presentations from vincek. and here’s DMAA’s writeup: Helping physicians and hospitals meet the “meaningful use” criteria for federal support for health information technology under recently passed legislation represents a keen opportunity for the population health management industry, presenters at this session said yesterday. Vince Kuraitis, JD, MBA, of Better Health Technologies, LLC, and Don Storey, MD, of RMD Networks, presented a look at the evolut... e-CareManagement blogs http://www.medworm.com/rss/comments.php?id=2832251 Fri, 25 Sep 2009 01:54:42 +0100 2832251 http://www.medworm.com/index.php?rid=2804026&cid=t_113822_113_f&fid=35744&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Fe-CareManagement%2F%7E3%2Fb9XSyQWm-jU%2F In my post from Monday on LifeMasters seeking Chapter 11, I dropped a BTW comment. The part that’s puzzling to me is the statement that LifeMasters owes $125 M to CMS.  That’s hard to figure…the company only participated in MHS for a few months, and to my knowledge MHS is the only Medicare demo that required guaranteed savings (i.e., payback if targets aren’t hit).   I really have to stretch my imagination to compute how CMS ran the tab to such an astronomical number. It raises questions around CMS’ good faith as a business “partner”. Let’s do the math. (more…) Article Series - CMS Bumps Off Medicare Health SupportCMS: “Rumors of Medicare Health Support’s Death Have Not Been Greatly Exaggerated”$389 M of Healthways’ Market Value Vaporiz... e-CareManagement blogs http://www.medworm.com/rss/comments.php?id=2804026 Thu, 17 Sep 2009 15:56:53 +0100 2804026 http://www.medworm.com/index.php?rid=2796539&cid=t_113822_113_f&fid=35744&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Fe-CareManagement%2F%7E3%2Fp5se2G_011g%2F 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 Healthcare Industry Group, LLC and had been working with the company and its board as a restructuring advisor prior to the filing. During the last four years, LifeMasters participated in three CMS Demonstration Projects aimed at testing ce... e-CareManagement blogs http://www.medworm.com/rss/comments.php?id=2796539 Mon, 14 Sep 2009 23:43:51 +0100 2796539 http://www.medworm.com/index.php?rid=2761973&cid=t_113822_113_f&fid=35744&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Fe-CareManagement%2F%7E3%2FcUFc7zNwVKs%2F 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 MMHD so that any patient with one or more chronic condition is eligible; this includes 86% of all Medicare patients. Physicians will be paid risk-adjusted care coordination fees for this entire population — the 86% of patients with one or more chron... e-CareManagement blogs http://www.medworm.com/rss/comments.php?id=2761973 Thu, 03 Sep 2009 17:39:20 +0100 2761973 http://www.medworm.com/index.php?rid=2699695&cid=t_113822_113_f&fid=35744&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Fe-CareManagement%2F%7E3%2Fno1LFrhNDCM%2F 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 Chronic Care Programs (e.g., Colorado, Pennsylvania, Improving Performance in Practice) Accountable Care Organizations — the n... e-CareManagement blogs http://www.medworm.com/rss/comments.php?id=2699695 Thu, 13 Aug 2009 20:41:48 +0100 2699695 http://www.medworm.com/index.php?rid=2670910&cid=t_113822_113_f&fid=35744&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Fe-CareManagement%2F%7E3%2FWgmP776-3Xk%2F by Al Lewis, Disease Management Purchasing Consortium International, Inc. Medical homes probably do save money in very controlled settings, where the entire team is literally or at least figuratively under one roof, such as Kaiser.  However, the belief that one can overlay a traditional medical home model across an entire state and save money in the process turns out to be total fiction. The poster child for that fiction, North Carolina’s Community Care program, turns out to cost state taxpayers probably $400 million a year, rather than save them $300 million, as the state’s self-serving and blatantly incorrect analysis claimed.    A more extensive analysis is available for review, and any state is welcome to the backup data as well. Here’s a press release with more detai... e-CareManagement blogs http://www.medworm.com/rss/comments.php?id=2670910 Tue, 04 Aug 2009 23:40:03 +0100 2670910 http://www.medworm.com/index.php?rid=2670911&cid=t_113822_113_f&fid=35744&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Fe-CareManagement%2F%7E3%2FvIdWeuqPmyk%2F Between the time the MMHD was authorized in 2006 and now, we’ve learned a lot about what works and what doesn’t work in Medicare care coordination programs. The MMHD is between a rock and a hard place — conflicted by two “must achieve” objectives that are diametrically opposed: As a political matter, the MMHD must save money As currently structured, the MMHD cannot save money Please read my guest post The Medicare Medical Home Demonstration (MMHD): Between a Rock and a Hard Place over at Pharos Innovations new blog: The Collaborative Forum. Is there a way out from between the rock and the hard place?  In Part II of this series, Dr. Randy Williams will discuss options. Disclosure: Pharos Innovations is a client of Better Health Technologies, LLC. Tags: care coordination, medi... e-CareManagement blogs http://www.medworm.com/rss/comments.php?id=2670911 Tue, 04 Aug 2009 13:11:57 +0100 2670911 http://www.medworm.com/index.php?rid=2580276&cid=t_113822_113_f&fid=35744&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Fe-CareManagement%2F%7E3%2F0wBiPYi-N2o%2F by Vince Kuraitis JD, MBA and David C. Kibbe MD, MBA The last article in this series — Time for EHRs to Become Plug-and-Play — used words to describe a major industry shift underway in health IT. Sometimes pictures help to make a point. Here are several diagrams that you can also download as PowerPoint slides.  Computer Industry 1983 to 2002     Source: Venkatraman, N. Winning in a Network Centric Era, 2006 Blueprint for Health IT Shift From EMR 1.0 — 2008… …to Clinical Groupware/EHR 2.0 — 2012 (more…) Article Series - The Dog Manifesto: A Disruptive Innovator's Guide to Health ITWill HITECH Lead to Innovation? The Continuing Cat/Dog DialogueDogged Optimism: Five Innovative Aspects of HITECHFeline Foot-Dragging: Three Non-Innovative Aspects of HITECHWait and S... e-CareManagement blogs http://www.medworm.com/rss/comments.php?id=2580276 Sun, 21 Jun 2009 19:18:11 +0100 2580276 http://www.medworm.com/index.php?rid=2511413&cid=t_113822_113_f&fid=35744&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Fe-CareManagement%2F%7E3%2F0wBiPYi-N2o%2F by Vince Kuraitis JD, MBA and David C. Kibbe MD, MBA The last article in this series — Time for EHRs to Become Plug-and-Play — used words to describe a major industry shift underway in health IT. Sometimes pictures help to make a point. Here are several diagrams that you can also download as PowerPoint slides.  Computer Industry 1983 to 2002     Blueprint for Health IT Shift From EMR 1.0 — 2008… …to Clinical Groupware/EHR 2.0 — 2012 (more…) Article Series - The Dog Manifesto: A Disruptive Innovator's Guide to Health ITWill HITECH Lead to Innovation? The Continuing Cat/Dog DialogueDogged Optimism: Five Innovative Aspects of HITECHFeline Foot-Dragging: Three Non-Innovative Aspects of HITECHWait and See: What’s Unclear or To-Be-Determined (TBD) ... e-CareManagement blogs http://www.medworm.com/rss/comments.php?id=2511413 Sun, 21 Jun 2009 19:18:11 +0100 2511413 http://www.medworm.com/index.php?rid=2580290&cid=t_113822_113_f&fid=35744&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Fe-CareManagement%2F%7E3%2FkBeDK-VyyFs%2F Download a copy here .  Excerpts from the Executive Summary: Effective Interventions Three types of interventions have been demonstrated to be effective in reducing hospitalizations for Medicare beneficiaries with multiple chronic conditions who in general are not cognitively impaired: Transitional care interventions in which patients are first engaged while in the hospital and then followed intensively over the 4 – 6 weeks after discharge Self-management education interventions that engage patients for 4 -7 weeks in community-based programs designed to “activate” them in the management of their chronic conditions Coordinated care interventions that identify patients with chronic conditions at high risk of hospitalization in the coming year, conduct initial assessments and care... e-CareManagement blogs http://www.medworm.com/rss/comments.php?id=2580290 Tue, 24 Mar 2009 13:00:58 +0100 2580290 http://www.medworm.com/index.php?rid=2288961&cid=t_113822_113_f&fid=35744&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Fe-CareManagement%2F%7E3%2FkBeDK-VyyFs%2F Download a copy here .  Excerpts from the Executive Summary: Effective Interventions Three types of interventions have been demonstrated to be effective in reducing hospitalizations for Medicare beneficiaries with multiple chronic conditions who in general are not cognitively impaired: Transitional care interventions in which patients are first engaged while in the hospital and then followed intensively over the 4 - 6 weeks after discharge Self-management education interventions that engage patients for 4 -7 weeks in community-based programs designed to “activate” them in the management of their chronic conditions Coordinated care interventions that identify patients with chronic conditions at high risk of hospitalization in the coming year, conduct initial assessments and care plann... e-CareManagement blogs http://www.medworm.com/rss/comments.php?id=2288961 Tue, 24 Mar 2009 13:00:58 +0100 2288961 http://www.medworm.com/index.php?rid=2211210&cid=t_113822_113_f&fid=35744&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Fe-CareManagement%2F%7E3%2F8CNlOodxzOM%2F We have learned that coordinating care of patients — particular care of Medicare patients — is complex and time consuming for physicians. A breakthrough study quantifies just how complex and challenging care coordination really is.  The study is reported in the February 17 issue of Annals of Internal Medicine and is entitled Primary Care Physicians’ Links to Other Physicians Through Medicare Patients: The Scope of Care Coordination : We found that in a single year for just fee-for-service Medicare patients, the typical primary care physician needs to coordinate care with 229 other physicians working in 117 different practices…. The number of peers was greater for physicians treating patients with higher chronic illness burden, who may benefit the most from coordination. My m... e-CareManagement blogs http://www.medworm.com/rss/comments.php?id=2211210 Thu, 19 Feb 2009 00:12:52 +0100 2211210 http://www.medworm.com/index.php?rid=2580298&cid=t_113822_113_f&fid=35744&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Fe-CareManagement%2F%7E3%2F8CNlOodxzOM%2F We have learned that coordinating care of patients — particular care of Medicare patients — is complex and time consuming for physicians. A breakthrough study quantifies just how complex and challenging care coordination really is.  The study is reported in the February 17 issue of Annals of Internal Medicine and is entitled Primary Care Physicians’ Links to Other Physicians Through Medicare Patients: The Scope of Care Coordination : We found that in a single year for just fee-for-service Medicare patients, the typical primary care physician needs to coordinate care with 229 other physicians working in 117 different practices…. The number of peers was greater for physicians treating patients with higher chronic illness burden, who may benefit the most from coordination. My m... e-CareManagement blogs http://www.medworm.com/rss/comments.php?id=2580298 Thu, 19 Feb 2009 00:06:43 +0100 2580298 http://www.medworm.com/index.php?rid=1992524&cid=t_113822_118_f&fid=36984&url=http%3A%2F%2Ffeeds.feedburner.com%2F%7Er%2FHealthManagementRx%2F%7E3%2F466505634%2Fthankful-for-life-talk-with-your-family.html Blogger's Note: Please. Talk with your family, friends, advocates, and caregivers about end of life choices. Do you have an advanced directive? A living will? This is *not* the kind of thing you want to leave til the last minute (literally). Live well. Engage with grace. From the Engage with Grace team: We make choices throughout our lives - where we want to live, what types of activities will fill our days, with whom we spend our time. These choices are often a balance between our desires and our means, but at the end of the day, they are decisions made with intent. But when it comes to how we want to be treated at the end our lives, often we don't express our intent or tell our loved ones about it.This has real consequences. 73% of Americans would prefer to die at home, but up to 50% die... Health Management Rx blogs http://www.medworm.com/rss/comments.php?id=1992524 Wed, 26 Nov 2008 18:25:00 +0100 1992524 http://www.medworm.com/index.php?rid=1982188&cid=t_113822_165_f&fid=37959&url=http%3A%2F%2Fhealthskills.wordpress.com%2F2008%2F11%2F23%2Fmaking-the-most-of-a-referral-for-pain-management%2F This is a post for people who may refer someone for pain management, or someone who is personally being referred. When I talk about pain management, I’m meaning a multidisciplinary or interdisciplinary pain management programme where participants learn about their pain, develop strategies to cope with life despite their pain, and get involved in reactivation. The contents of a cognitive behavioural pain management programme (eg INPUT, ADAPT, vary considerably - it’s essential that the approach includes these concepts: That clients can learn to accept the chronicity of their pain. That clients can change their relationship to their pain in a way that allows them to broaden their sense of identity/self beyond the pain to that of “a well person with pain”. That clients... HealthSkills Weblog blogs http://www.medworm.com/rss/comments.php?id=1982188 Sun, 23 Nov 2008 06:57:25 +0100 1982188 http://www.medworm.com/index.php?rid=1833374&cid=t_113822_113_f&fid=35744&url=http%3A%2F%2Ffeeds.feedburner.com%2F%7Er%2Fe-CareManagement%2F%7E3%2F403257588%2F Pay them to do it, take money away when they don’t — make hospitals accountable for their role in avoiding unnecessary readmissions. Mark E. Miller, Ph.D., Executive Director, Medicare Payment Advisory Commission testified recently in front of the U.S. Senate Committee on Finance. He opened his remarks by stating: The health care delivery system we see today is not a true system: care coordination is rare, specialist care is favored over primary care, quality of care is often poor, and costs are high and increasing at an unsustainable rate. About a quarter of Mr. Miller’s testimony focused on an issue that hasn’t received much attention: avoidable hospital readmissions . Here are some key excerpts: (more…) (Source: e-CareManagement) e-CareManagement blogs http://www.medworm.com/rss/comments.php?id=1833374 Thu, 25 Sep 2008 23:49:28 +0100 1833374 http://www.medworm.com/index.php?rid=1815619&cid=t_113822_113_f&fid=35744&url=http%3A%2F%2Ffeeds.feedburner.com%2F%7Er%2Fe-CareManagement%2F%7E3%2F400405909%2F “Why can’t we all just get along?”  Rodney King The Megatrend: Collaborative Care Management Networks (CCMNs) It’s been quite a while since I spotted a new Disease Management Megatrend, but here’s one that’s long overdue: Collaborative Care Management Networks will be necessary to achieve optimal care coordination. The trend in a nutshell:  payers (and others) are recognizing that optimal care coordination will require collaboration among health care stakeholders. This CANNOT be achieved with yesterday’s proprietary IT and business models. CCMNs will share many — perhaps all — of the following elements: (...)Read the rest of Megatrend Spotting: Collaborative Care Management Networks (528 words) © | Permalink | No comment | Want more on these topic... e-CareManagement blogs http://www.medworm.com/rss/comments.php?id=1815619 Tue, 23 Sep 2008 03:35:31 +0100 1815619 http://www.medworm.com/index.php?rid=1439973&cid=t_113822_113_f&fid=35744&url=http%3A%2F%2Ffeeds.feedburner.com%2F%7Er%2Fe-CareManagement%2F%7E3%2F289763443%2F This report has stirred cries of confusion and outrage. I’ll elaborate on these cries in the second posting of this series, but if you can’t wait, read here, here, here, here, here, here, here, and here. Welcome to a series of three blog postings discussing the PCMH, care management fees, and the RUC report.  I can’t claim to smooth the uproar, but I hope to frame the issues so that they can be understood and discussed constructively. The series will address numerous questions. This first post: What is the PCMH care management fee? Why is the PCMH care management fee important? Why are people confused? The second post: What is the American Medical Association/Specialty Society RVS Update Committee (RUC) ? What is the RUC’s role in the Medicare Medical Home Demonstration... e-CareManagement blogs http://www.medworm.com/rss/comments.php?id=1439973 Tue, 13 May 2008 23:00:48 +0100 1439973 http://www.medworm.com/index.php?rid=1300456&cid=t_113822_113_f&fid=35744&url=http%3A%2F%2Ffeeds.feedburner.com%2F%7Er%2Fe-CareManagement%2F%7E3%2F250829885%2F Aetna recently made another big announcement relating to their PHR.  While the concept of what they’re doing is very appealing, it strikes me that health plans in general face an uphill battle in getting consumers to adopt and use personal health records (PHRs). I’ll describe 4 factors behind my thinking: Lack of Trust Lack of Access to Clinical Data Lack of Permission Lack of Convenience in Consumer Workflow (more…) Share This Related posts (and # of comments) A First Comparison of Google Health and MS HealthVault (5) Four Misconceptions About HealthVault and the Emerging Personal Health Information Ecosystem (PHI-Ecosystem) (7) Connecting the Dots…Google Health Promises to Create AND Dominate Next Generation PHRs (44) Birth Announcement: th... e-CareManagement blogs http://www.medworm.com/rss/comments.php?id=1300456 Thu, 13 Mar 2008 16:53:02 +0100 1300456 http://www.medworm.com/index.php?rid=556192&cid=t_113822_122_f&fid=35065&url=http%3A%2F%2Feideneurolearningblog.blogspot.com%2F2007%2F04%2Frecovering-lost-literature-on-dyslexia.html In this study, Dr. Denckla tested dyslexic children (and followed them over time) on a map-walking test that involved drawing a similar pathway as one outlined in dots on a floor. "The younger dyslexic children, that is children below the age of 10 years...had the worst performance of hte three groups, as measured by walking these routes correctly. A startling "late blooming" effect, however, shone forth in the data on children over 10 years old. The teenaged dyslexic group, and in particular the familial dyslexic adolescents demonstrated superior (my italics added) performance on this test, averaging better scores than the nondsylexic, otherwise learning-disabled and normal groups. What could these results possibly mean, and what do they have to do with the history of good athletic abilit... Eide Neurolearning Blog blogs http://www.medworm.com/rss/comments.php?id=556192 Fri, 20 Apr 2007 07:03:00 +0100 556192