Xerox to build health insurance marketplace in Florida

DALLAS – Florida Health Choices, a corporation established by the state to improve access to care, has selected Xerox to administer its insurance marketplace.

According to Xerox officials, the program is designed to give small business and eligible individuals more flexibility in finding affordable health insurance and other services. The nine-year contract is valued at $68 million.

With partner CHOICE Administrators Exchange Solutions, Xerox will provide a cloud-based Web portal and online plan selection tool to give consumers and employers more information when making health insurance selections. The solution preserves the benefits of employer-sponsored insurance and eases the administrative burden for small businesses, officials said.

“We’re designing and supporting programs that increase access to health coverage for consumers,” said Will Saunders, group president, Government Healthcare Solutions, Xerox. “The solution we create in Florida will serve citizens and small business owners and help position the state as a leader in establishing a competitive and voluntary health insurance marketplace for small employers.”

Xerox will also provide eligibility determination and enrollment management services for the program, and operate a customer contact center to share information on marketplace offerings. These services will help Florida Health Choices handle the massive amounts of information involved with the marketplace quickly, efficiently and securely.

“We need a partner who can get a fully functional marketplace setup that is designed to serve Floridians now and into the future – delivering on both our short and long-term goals,” said Aaron Bean, chairman, board of directors, Florida Health Choices. “We’re confident Xerox will support us in establishing our marketplace quickly, while helping us to increase healthcare access to small business employees – one of our key priorities.”

Vendor Notebook: AeroScout and Futura Mobility partner for RTLS

Futura Mobility has partnered with AeroScout to provide real-time location system (RTLS) technology to hospitals. With the partnership, officials say Futura Mobility will leverage AeroScout’s real-time asset management solutions that deliver location and status of mobile assets and equipment. Key components of the collaboration include temperature and humidity monitoring, patient flow and safety.

Allscripts announced that Summit Medical Group, the largest physician-owned multi-specialty practice in New Jersey, has signed a long-term contract for managed IT services. With Allscripts Managed Services, Summit will focus on its core mission of providing world class patient care while using IT to improve clinical, financial and operational outcomes, officials say.

HID Global announced the production release of its next generation EDGE EVO and VertX EVO controller platform that brings intelligence and decision-making to the door for advanced and highly customizable networked access control solutions. EDGE EVO and VertX EVO offer an open and scalable development platform for the deployment of a wide range of access control functionality, including remote management options, real-time monitoring, report generation and more.

triCerat unveiled the beta version of its Scanect software, a remote scanning technology for healthcare settings that speeds scanning without sacrificing quality or security.
 
SRS announced that Pittsburgh Bone & Joint Surgeons has selected the SRS EHR and PM to replace the system it originally purchased for its seven physicians. PBJS provides high-quality orthopaedic care to the Greater Pittsburgh area of Pennsylvania.

Allscripts announced that Evangelical Community Hospital, in Lewisburg, Pa., has selected its Sunrise EHR system. The hospital already uses Allscripts solutions for its outpatient electronic health record. The addition of the Allscripts Sunrise Clinical Manager solution will help the Hospital migrate its inpatient data and information to an electronic format and provide a seamless and integrated electronic information solution across the hospital, officials say.

Press Ganey Associates and the American Medical Group Association announced the launch of a survey designed to help accountable care organizations (ACOs) and high-performing health systems identify opportunities for improving both efficiency and quality. The AMGA-Press Ganey Coordinated Care Solution, assesses a patient’s entire episode of care and enables better management of population health to create positive patient outcomes and maximize shared savings.

Get Real Consulting announced the launch of the AARP Health Record. The application architected and developed by Get Real, is a secure web based solution designed to empower people over age 50 to manage and improve their own health. This application allows users to enter, store and edit their personal health information in a central location and to selectively share it with caregivers, family members, doctors and other healthcare providers.

InterSystems announced that it has entered into an agreement with Missouri Health Connection for InterSystems HealthShare to be the technology foundation for Missouri Health Connection’s (MHC) statewide health information network. MHC is the state-designated entity chartered to oversee development of Missouri’s statewide health information network.
 
Availity announced the launch of its suite of expanded clinical documentation capabilities, and that four major health plans, seven vendor partners, and multiple physician groups and hospitals are live and successfully utilizing these solutions across its network. The solution suite automates the costly, manual exchange of clinical information needed to support the revenue cycle, as well as emerging value-based payment models and quality improvement programs.

Outcomes Health Information Solutions announced the launch of MA365, a solution that actively drives quality results for Medicare Advantage plans year-round. Launched from a single data platform, MA365 is an integrated suite of solutions that identifies and resolves disparities in care for Medicare Advantage members with the goal of getting needed care for members while also impacting a Medicare Advantage health plan’s Star quality ratings.

MedeAnalytics announced the launch of its Employer Reporting Resource Center. As healthcare expenses have outpaced inflation and revenue growth, companies have struggled to understand the value of their relationships with full-service health plans. Created in response to growing interest by health plans looking to better serve their group and administrative services only (ASO) customers, this resource center has been created to serve as an educational service to the healthcare industry.

Pegasystems announced its next-generation product development and management solution that enables health plans to better meet industry and customer needs by reducing time to market for new insurance and wellness products amid growing healthcare complexity. Pega Product Composer System provides a customer-centric approach to developing and managing innovative healthcare products, supporting product design, approval, operational readiness and implementation.

Would single-payer healthcare be less vulnerable to the court than the ACA?

If the Supreme Court does decide to strike down any or all of the Affordable Health Care Act, the implications will range from the political to the medical to the economic.

For me, such a decision will take its place among the more supremely ironic of unintended consequences: a law designed to avoid greater government intrusion into health care will have been invalidated as an unconstitutional overreach of government power, while a far more intrusive approach would have clearly passed muster.

How could this be possible? Welcome to the wonderful world of constitutional interpretation.

Let�s begin by imagining that Congress and the president decided to adopt a genuinely radical health care plan�the kind in place in most of the industrialized world. They decide on a �single-payer� system, where the government raises revenue with taxes, and pays the doctor, hospital and lab bills for just about everyone.

Put aside the question of whether this is a good idea, or an economically sustainable notion. The question is: would such a law be constitutional?

The answer, unquestionably, is �yes.� In fact, it would be the simplest law in the world to enact. All the Congress would need to do is to take the Medicare law and strike out the words �over 65.� Why is it constitutional? For the same reason Medicare and Social Security are: the taxing power. Its reach is immense. During World War II, the maximum income tax rate was 91 per cent (it was paid by few, thanks to loopholes, but still). The same Congress that could abolish the estate tax could set just about whatever limit it chose; it could impose a 100 percent tax on estates over, say, $5 million. If it decided that a national sales tax was an answer to huge budget deficits, it could impose one at whatever level it chose.

(The remedy, of course, lies with the voters, who would be more than likely to send a powerful message at the next election, which is why the lack of constitutional limits on the taxing power do not lead to confiscatory rates.)

So why is Obama�s health care plan, with a far more modest use of government power, in serious jeopardy? It�s because the key element in the plan�the �mandate� to purchase health insurance or pay a penalty�was not based on the taxing power, but on Congress�s power, under Article I, Section 8, to regulate interstate commerce. And that power, while broad, has its limits…even if those limits are murky.

Up until the late 1930s, those limits were more like shackles. The Supreme Court repeatedly struck down sate and federal laws regulating wages, hours and working conditions on the grounds that the commerce power only touched the distribution of goods, not their manufacture. But once the court changed its mind�after an effort by FDR to �pack� the court with additional justices had failed�there seemed to be no limits at all. Back in 1942, the court said the government could stop a farmer from growing his own wheat for his own use, because of the potential effects on the wider market. But in 1995, for the first time in decades, the court said �no� to a federal law based on the Commerce clause�one banning firearms within school zones�because it could find no reasonable connection between the law and interstate commerce.

In the health care case, the questioning by several justices indicated strong skepticism about the mandate. If the commerce clause can compel a citizen to buy a specific product�in this case, health insurance�what couldn�t it do? Could it, as the now famous question had it, compel citizens to buy broccoli on health grounds? (Well, a defender might have pointed out, the government does compel taxpayers to �pay for� all kinds of things in the form of government subsidies, such as ethanol. It could clearly do the same with a broccoli subsidy.)

As a policy matter, it�s clear that a �mandate� is a much more modest extension of government power than a single-payer system. The citizen would choose which insurance to buy; in fact, under the law, a citizen could choose not to buy any insurance, and pay a penalty instead. The whole premise of a mandate is to spread risk as widely as possible; as Mitt Romney used to note when he was defending the Massachusetts plan he designed, the mandate to prevent �free riders� from benefitting from treatment once they are sick or injured. That�s why the genesis of the idea came from such conservative roots as the Heritage Foundation.

As a constitutional matter, however, the idea of compelling a citizen into a specific economic activity raises alarm bells. It evokes the specter of some bureaucrat inviting himself into your home, while checking the shelves to make sure you�ve purchased multigrain cereal and cage-free eggs. (It�s a specter the administration tried to avoid by arguing that the health-care market is unique, one in which we are all likely participants at some point, voluntarily or otherwise. Unlike life in a Robert Heinlien libertarian �utopia,� hospital ERs do not have the power to say to an uninsured heart attack or auto accident victim: “you chose not to buy insurance? Sorry…have a nice day.�)

So, for its effort to design a health care plan that moved in the direction of less government intrusion, the Obama administration faces the distinct prospect of having its signature domestic program shot down for exceeding the limits of the constitutional power it did choose to use.

I somehow doubt the White House will appreciate the irony.

Romney's Health Care Prescription Gives Some Conservatives Heartburn

Enlarge Charles Dharapak/AP

Mitt Romney (right), at the time the governor of Massachusetts, greets then-Health and Human Services Secretary Mike Leavitt during a National Governors Association forum in February 2006. Romney reportedly has tapped Leavitt to head his presidential transition team.

Charles Dharapak/AP

Mitt Romney (right), at the time the governor of Massachusetts, greets then-Health and Human Services Secretary Mike Leavitt during a National Governors Association forum in February 2006. Romney reportedly has tapped Leavitt to head his presidential transition team.

GOP presidential candidate Mitt Romney insists that when it comes to health care, his first priority is the full repeal of the 2010 Affordable Care Act.

But some of his actions of the past few days have conservatives scratching their heads.

First, there was the appointment of Mike Leavitt, a former Utah governor and Health and Human Services secretary, to lead a potential Romney transition team.

Since leaving office at the end of George W. Bush's term, Leavitt has been running a group that has, among other things, been working to help states implement key portions of the law Romney has vowed to eliminate.

 

Needless to say, that didn't go over well among those who worry that Romney might not really be serious about obliterating the federal health law, which bears a striking resemblance to the one he signed as governor of Massachusetts. (More on that in a moment.)

"The fact that Romney picked Leavitt suggests he really doesn't mind Obamacare that much, and that he is just saying whatever he needs to say to get what he wants," blogged Michael Cannon of the libertarian Cato Institute. Cannon, by the way, has produced this video, which directly challenges Leavitt's business model by arguing why states should notestablish health exchanges.

Which brings us back to Romney and his Massachusetts plan. The Wall Street Journal has unearthed some old emails the Romney folks didn't manage to destroy suggesting that the former governor and some of his closest aides were even more in favor of the "individual mandate" than was formerly known.

But it's not just old emails where Romney's penchant to defend the mandate sneaks out. Here's how he described the Massachusetts law during a January GOP debate in Jacksonville:

"If you don't want to buy insurance, then you have to help pay for the cost of the state picking up your bill, because under federal law if someone doesn't have insurance, then we have to care for them in the hospitals, give them free care. So we said, no more, no more free riders. We are insisting on personal responsibility."

Of course he ended his thought by vowing, once again, to repeal the federal law, because he said, unlike the Massachusetts version, it "takes over health care for the American people."

Does the Health Insurance Industry Have Congress In Its Pocket?

No one ever talks about dismantling the Fire Department, Police Department, or Postal Service because they’re models of a scary socialist project. Why should healthcare be any different? Quite simply, the health insurance industry stands in the way. And as the Real News Network reports, they’ve been lobbying hard to make sure that a for profit system of care remains the law of the land. But labor, single payer advocates, and Americans who want basic healthcare are pushing back.

“We believe the health insurance industry is trying to buy their way onto the table with health care reform,” says Carmen Balber of Consumer Watchdog at a protest against the American Health Insurance Plans’ 2009 Policy Forum. “We see this in two big points,” she goes on to explain, “one which is a mandate that would require individuals to purchase private health insurance… and secondly we know the insurance industry is trying to block any sort of public option for the American people. They don’t want the competition, so we’re here to call out the insurance industry for trying to buy Congress’ position.”

You can see more videos at The Real News Network.

This article is from GRITtv.

Congressman Ryan Hides After Trying to Attack Medicare in San Francisco

From Don Bechler of Single Payer Now –

Congressman Paul Ryan (R-WI) came to SF on May 24 to raise funds for his attacks on Medicare, Medicaid, Social Security, and Gay Marriage. He is the point person for the 1% attacks on our social investments. He was scheduled to speak at the GAP headquarters, but the GAP told him to move his fundraiser after massive outrage by the gay and healthcare communities.

He then cancelled his fundraiser at the GAP.

Activists from the California Alliance for Retired Americans, Gray Panthers, and Single Payer Now held a press conference at the GAP headquarters to denounce his attacks. We got coverage in both the San Francisco Chronicle and on KPFA radio.

Virginia-Care: Keeping Health Insurance Costs Down for a Small Businesses

Virginia Donohue and her husband started Pet Camp in 1997 with a love of their dogs and little else. Located in San Francisco, California, they provided group play, open spaces, and a pool. Cats had disco lights to play with, aquariums to watch and wide window sills for perches. When the business became sustainable in 2000, Virginia says, it was time to provide health insurance to their employees.

�To me it�s a moral issue. People need to have health care and how we get it is through work,� she says. �I have been one of the employers out there saying, �Look, offering health care is important.��

Virginia says that when she heard about the health care tax credit for small businesses available under the Affordable Care Act, �I was really excited.�

The health care law�s tax credit for small businesses is making it more affordable for Virginia�s company offer health coverage to its employees. She uses the funds from the tax credit to offset the company�s insurance costs. The health care tax credit, she says, amounted to about $7,000 in 2010 and about $8,000 for 2011.

The tax credit is also helping her company stay competitive in the marketplace for good employees.

�We offer health insurance because we want to attract and retain the best employees that are out there, and I think to do that you have to offer quality benefits. � [F]or us, that includes health insurance � that includes bring[ing] your dog to work,� Virginia says.

What is 'histrionic personality disorder'?

Few outside the psychiatric community knew about "histrionic personality disorder" until it was reported that attorneys for former Penn State assistant football coach Jerry Sandusky would bring it up in his defense on child sex abuse charges.

Today, the condition took center stage as a psychologist who evaluated Sandusky took the stand. The condition is defined in the American Psychiatric Association's diagnostic manual (called the DSM, short for Diagnostic and Statistical Manual of Mental Disorders) as "a pervasive pattern of excessive emotionality and attention seeking."

Psychiatrists familiar with such disorders aren't convinced such a claim will help Sandusky.

"That doesn't make any sense at all," says psychiatrist Carl Bell of Chicago, who has been in practice for 45 years. "He may have a histrionic personality, but I'm not sure it's going to do him very much good. I would never walk into court for a defense with a personality disorder because the courts don't recognize it. Personality disorders are rarely, if ever, a reason not to find somebody guilty of a crime."

The DSM says histrionic personality disorder is indicated by five or more of eight potential characteristics that include being "uncomfortable in situations in which he or she is not the center of attention." Among others: "interaction with others is often characterized by inappropriate sexually seductive or provocative behavior," "consistently uses physical appearance to draw attention to self," and "considers relationships to be more intimate than they actually are."

Experts who are editing the diagnostic manual, which is being revised for publication next year, propose to delete it as a separate disorder; it probably will be placed in the appendix, which suggests further study is warranted, says Renato Alarcon of Oakland, an emeritus professor of psychiatry and a consultant for the Mayo Clinic in Rochester, Minn.

Bell and Alarcon are among those on the personality disorders panel, which is recommending the revision for all such disorders, not just histrionic personality disorder.

"The whole issue of personality disorders is being reviewed," Alarcon says. "It will be considered mostly a trait or a feature and not a type and may be called something different, such as exhibitionism or grandiosity."

Psychiatric Ryan Shugarman, who teaches at Georgetown University and at Saint Elizabeths Hospital in Washington, D.C., says histrionic personality disorder has been recognized since 1968, and the percentage of people who meet criteria for it is low compared with that for mood or anxiety disorders.

"I see a few patients per year that meet that criteria," he says.

Estimates suggest that almost a quarter of Americans have some sort of psychiatric condition in their lifetime, and histrionic personality disorder affects about 10% to 15% of those who have received psychiatric care, Shugarman says. Some suggest the disorder is more common in women, but he says the research isn't clear on that point.

Stress levels increased since 1983, new analysis shows

You may have felt it, but now a scientific analysis of stress over time offers some proof that there's more stress in people's lives today than 25 years ago.

Stress increased 18% for women and 24% for men from 1983 to 2009, according to researchers at Carnegie Mellon University in Pittsburgh, who analyzed data from more than 6,300 people. It's considered the first-ever historical comparison of stress levels across the USA.

"The data suggest there's been an increase in stress over that time," says psychologist and lead author Sheldon Cohen, director of Carnegie Mellon's Laboratory for the Study of Stress, Immunity and Disease. The analysis is published online in the Journal of Applied Social Psychology.

In research done in 1983, 2006 and 2009, those with higher stress were women, people with lower incomes and those with less education. Findings also show that as people age, stress decreases.

"Thirty-year-olds have less stress than 20-year-olds, and 40-year-olds have less stress than 30-year-olds," says Cohen, who has studied the relationship between stress and disease for 35 years.

All three surveys used the Perceived Stress Scale (PSS), a measure Cohen and others created in 1983 to assess the degree to which situations in life are perceived as stressful. Each survey respondent answered a series of questions designed to evaluate their stress levels; researchers used the scale to analyze responses and calculate an overall score. Higher scores indicate greater psychological stress.

Results show increases in stress in almost every demographic category from 1983 to 2009, ranging from 10%-30%.

"Cohen is a good investigator," says psychiatrist David Spiegel, director of the Center on Stress and Health at Stanford University School of Medicine in Stanford, Calif. "He's using a measure of subjective stress."

White, middle-aged men with college degrees and full-time jobs were the group most affected by the economic downturn, the study found. Cohen says that group's increase was almost double that of any other demographic group.

Physician Paul Rosch, president of the non-profit American Institute of Stress, based in Yonkers, N.Y., says this study is more credible than most stress surveys because of its scientific methodology.

And the results make sense, experts say. When you compare the early 1980s to today, "economic pressures are greater, and it's harder to turn off information, and it's harder to buffer ourselves from the world," Spiegel says.

Stress levels increased since 1983, new analysis shows

You may have felt it, but now a scientific analysis of stress over time offers some proof that there's more stress in people's lives today than 25 years ago.

Stress increased 18% for women and 24% for men from 1983 to 2009, according to researchers at Carnegie Mellon University in Pittsburgh, who analyzed data from more than 6,300 people. It's considered the first-ever historical comparison of stress levels across the USA.

"The data suggest there's been an increase in stress over that time," says psychologist and lead author Sheldon Cohen, director of Carnegie Mellon's Laboratory for the Study of Stress, Immunity and Disease. The analysis is published online in the Journal of Applied Social Psychology.

In research done in 1983, 2006 and 2009, those with higher stress were women, people with lower incomes and those with less education. Findings also show that as people age, stress decreases.

"Thirty-year-olds have less stress than 20-year-olds, and 40-year-olds have less stress than 30-year-olds," says Cohen, who has studied the relationship between stress and disease for 35 years.

All three surveys used the Perceived Stress Scale (PSS), a measure Cohen and others created in 1983 to assess the degree to which situations in life are perceived as stressful. Each survey respondent answered a series of questions designed to evaluate their stress levels; researchers used the scale to analyze responses and calculate an overall score. Higher scores indicate greater psychological stress.

Results show increases in stress in almost every demographic category from 1983 to 2009, ranging from 10%-30%.

"Cohen is a good investigator," says psychiatrist David Spiegel, director of the Center on Stress and Health at Stanford University School of Medicine in Stanford, Calif. "He's using a measure of subjective stress."

White, middle-aged men with college degrees and full-time jobs were the group most affected by the economic downturn, the study found. Cohen says that group's increase was almost double that of any other demographic group.

Physician Paul Rosch, president of the non-profit American Institute of Stress, based in Yonkers, N.Y., says this study is more credible than most stress surveys because of its scientific methodology.

And the results make sense, experts say. When you compare the early 1980s to today, "economic pressures are greater, and it's harder to turn off information, and it's harder to buffer ourselves from the world," Spiegel says.

Vendor Notebook: MedAssurant becomes Inovalon

MedAssurant this week announced the formal launch of its new name: Inovalon, Inc. Company officials say Inovalon is a newly-coined term, created by combining innovation, value and action; within the name are also key elements of the words nova and valor.

Atrilogy Solutions Group announce that it is expanding its health care consulting practice, adding new strategic-focused consulting services and partnerships. With the move, Atrilogy will help U.S. health providers meet increasingly time-sensitive and business-critical regulatory requirements, particularly those involving ICD-10, and electronic medical records needs, officials say.

NovaSom announced the launch of AccuSom Delive, a turnkey program for Sleep Centers offering Out-of-Center Sleep Testing (OCST). AccuSom Deliver provides a complete OCST logistics solution while the participating Sleep Center maintains complete clinical control of their patients. The new offering includes a cloud-based portal for Sleep Centers to enable efficient management of uncomplicated adult OSA diagnosis via OCST.
 
GE Healthcare announced new enhancements designed to improve how radiologists view, navigate, and process big data sets with Centricity PACS 4.0. The new product release continues to ensure other departments and locations can seamlessly connect to PACS through the Centricity Enterprise Archive, cloud-enabled, vendor neutral archive technology that stores petabytes of data for thousands of GE customers worldwide.

Napatec announced the introduction of new functionality to intelligently identify fragmented IP packets. Available on the latest Napatech network adapters, it provides OEM vendors with a powerful off-load tool to increase performance in networks with many fragmented packets.
  
Siemens has announced new updates to the syngo Workflow radiology information system (RIS) as well as syngo.via1, for advanced visualization, syngo.plaza, the agile picture archiving and communications system (PACS), and syngo Dynamics, Siemens cardiovascular imaging and information system (CVIS). In particular, Siemens recently announced the availability of the syngo Workflow Cloud Solution, which can help healthcare providers reduce the ongoing capital expenditure of maintaining on-site hardware for this departmental scheduling and report delivery solution.

eClinicalWorks announced that Christie Clinic, one of the largest physician-owned, multi-specialty group medical practices in Illinois, will transition to eClinicalWorks comprehensive electronic health records (EHR) solution for 150 providers across 16 locations. Officials say integration with the practice’s laboratory, radiology, PACS, cardio diagnostics systems, among others, will extend the benefits of this technology.   

Awarepoint Corporation announced it raised $14 million in additional financing. The Heritage Healthcare Innovation Fund (HHIF),a limited partnership operated by Heritage Group, a Nashville, Tenn.-based private healthcare investment firm, invested $7.5 million. Existing investors including Kleiner Perkins Caufield & Byers, Cardinal Partners, Venrock, Jafco Ventures, Avalon Ventures, New Leaf Venture Partners and Top Tier Capital Partners invested the balance of the round.

Avantas announced major upgrades to its labor management solution, Smart Square. Originally designed to automate the entire staffing, scheduling, deployment and reporting processes for nursing departments, this Web-hosted application is now equipped with enterprise-wide labor management capabilities for departments beyond the inpatient environment. Avantas has also enhanced the business intelligence and user interface functionality of the software, officials say.

Cabinet NG announced the availability of the industry’s first fully integrated document management, cloud-based file sharing and workflow solution. CNG-SHARE is a major component in the latest version of CNG’s document management software, CNG-SAFE 8.0, which extends secure document sharing and collaboration to non-CNG users.

MRO Corp. announced the availability of integrated patient portal technology into the company’s release-of-information software, ROI Online. MRO’s patient portals are hospital-branded and designed specifically to suit the individual needs of the healthcare facilities and their patients, officials say. The portal websites allow patients to easily utilize a secure platform to access their health information.

PerfectServe announced that it moved its satellite office in Chicago, Ill., to a larger space from the Chicago Mercantile Exchange Center to 440 N. Wells St. to accommodate its expanding team. Over the last 60 days, PerfectServe’s Chicago office team has more than doubled, with seven new hires, officials say. Since January, the company, headquartered in Knoxville, Tenn., has hired 65 new employees – more than a 60 percent increase over the past six months.

SRS announced that Western Kentucky Orthopaedic & Neurosurgical Associates (WKONA) has selected the SRS EHR for its 11 physicians across 5 locations. WKONA provides quality orthopaedic and neurological care to the south-central region of Kentucky.

Congress passes stimulus package with $19B for healthcare IT

WASHINGTON – Congress passed the final version of the $787 billion economic stimulus bill Feb. 13, with $19 billion slated for healthcare IT. President Obama is slated to sign it today in Denver.

The American Recovery and Reinvestment Act (H.R. 1), is also loaded with more than $100 billion for other healthcare measures including funding to help beef up state Medicaid coffers and subsidies to help unemployed workers afford healthcare coverage through COBRA.

American Hospital Association President and CEO Richard Umbdenstock said the bill "is a step in the right direction," and AHA looks forward to working with Congress and the Administration to further refine some of the provisions.

Umbdenstock said provisions in the bill contain key items that are important to the patients and communities served by the nation's hospitals, ranging from ensuring the availability of healthcare coverage for the unemployed and providing increased support for the Medicaid program to making a down-payment on investments to improve the quality and efficiency of care through health information technology; investing in the training of more healthcare professionals, and blocking several Medicare and Medicaid regulations proposed by the previous Administration that would have created barriers to serving our most vulnerable patient populations.

Carl Buising, MD, executive director of healthcare, U.S. Public Sector Health at Microsoft said the bill, with its emphasis on key healthcare IT priorities will improve information-sharing and availability, which will in turn drive quality, efficiency, and patient-centric services for the 21st Century.

"With substantial funding for adoption and expansion of health IT at the provider, facility, regional, and national levels, we can make real progress," Buising said. "It will be important in the execution to include sufficient flexibility in the decisions and deployments undertaken such that today's various data and information formats can all be managed, as well as the forthcoming standards to be developed."

"During the execution phase, we must also maintain a continued emphasis on technical progress that connects the legacy and siloed systems of today and advances information sharing, rather than simply creating more siloes," he said. "This is an unusual and exciting opportunity to advance healthcare and healthcare IT in the nation.  The stimulus provides the opportunity to fundamentally alter the way we capture, store, use, and share information in the healthcare process, which will then enable improvements in efficiency, quality, and condition management to a degree simply not possible today."

"The economic stimulus package represents a significant step forward for the advancement of healthcare in the United States," said Harry Greenspun, chief medical officer for Perot Systems. "These funds should significantly advance patient safety and care while creating good paying jobs in the health IT sector, especially if we can achieve the goal of developing an electronic health record of every American."

The Pharmaceutical Care Management Association (PCMA) said the bill is an important first step. "Our industry is committed to working with all stakeholders to ensure broad adoption of health information technology so that patients and physicians have access to full and complete electronic medical records that include basic safety and savings tools like e-prescribing," PCMA officials said in a statement. "We are encouraged that the legislation specifically includes e-prescribing as an integral component of a fully-functional HIT system."
 
In addition to the healthcare IT provisions in the economic stimulus bill, PCMA said it supports the inclusion of comparative effectiveness research in the law, which will improve clinical decision-making, enhance quality of care, and discourage wasteful spending.

11 technologies pegged as best to tackle chronic disease

CAMBRIDGE, MA – Health policy institute NEHI has identified 11 emerging technologies that have the potential to improve care and lower costs for chronic disease patients, especially those in at-risk populations.

Each of the technologies are profiled in NEHI’s new report, “Getting to Value: Eleven Chronic Disease Technologies to Watch,” published with support from the California HealthCare Foundation. The report also identifies lessons learned about the role of technology in creating value and offers an overview of some of the barriers to adoption.

[See also: $103M in government funding targets chronic disease]

The “technologies to watch” target a range of chronic illnesses, including diabetes, asthma, stroke and heart disease, and reflect the growing emphasis on empowering patients to monitor their own care through the use of mobile platforms, social networking and home-based telehealth technologies.

“Nearly half of all American adults have at least one chronic illness,” said NEHI president Wendy Everett. “And these 11 emerging technologies hold the promise of greatly helping them manage their disease and connect with their doctors in real time.”

The 11 technologies on NEHI’s watch list include:Tele-stroke careVirtual visitsMobile asthma management toolsIn-car telehealthExtended care eVisitsMobile clinical decision supportMedication adherence toolsSocial media promoting healthMobile cardiovascular toolsHome telehealthMobile diabetes management tools

[See also: Pennsylvania hospital strengthens fight against chronic disease]

“These 11 technologies have the potential to extend care of chronic diseases beyond a doctor’s office to places where patients spend a great deal of their time - on their Smartphones, personal computers and in their cars,” said Everett. “And they are helping physicians get real-time data about their patients and, in some cases, share resources where staffing or financial constraints limit proper chronic disease management.”

Everett said the technologies address three big problems currently facing healthcare: chronic disease, quality care and patient engagement.

"More than 75 percent of the nation’s total medical costs are spent on chronic disease,” said Everett. “Patients need to be an integral part of their care if we are to increase the quality and decrease the cost of care.”

Of the 11 technologies identified, the three with the most “significant evidence attesting to their clinical and financial benefits” are extended care eVisits, home telehealth and tele-stroke care, said Everett.

“If successful policy interventions are undertaken to surmount barriers, these (three) technologies would be primed for widespread adoption,” she said, noting that the main benefits of these technologies are that they don’t have high cost barriers to use; they leverage mobile and telehealth technology and social media for monitoring patient health; and they allow for the collection of aggregate data.

AMGA, Press Ganey launch ACO tool

ALEXANDRIA, VA – The American Medical Group Association (AMGA) and Press Ganey Associates have  launched of a new survey tool designed to help accountable care organizations (ACOs) improve efficiency, quality and the patient's experience.  

The tool, called the AMGA-Press Ganey Coordinated Care Solution, assesses a patient’s entire episode of care and enables better management of population health to create positive patient outcomes and maximize shared savings.

 [See also: ACOs digging in to stay, experts say.]

The Coordinated Care Solution was built to fill critical information gaps identified by members of the AMGA ACO Collaborative and provides in-depth analysis unmatched by event-based surveys, according to AMGA officials. Those concepts not captured by event-based surveying include effective use of care team members, provider engagement, and the patient’s assessment of their own level of engagement, loyalty, and compliance.

“AMGA members are on the vanguard of delivering high-quality and high-value care," said Donald W. Fisher, president and chief executive officer of AMGA. "So we wanted to be at the forefront of developing an innovative survey to capture the critical component of patient engagement which is essential to successfully operate in an accountable care environment, especially under the various Medicare ACO programs.

 “With more than five million lives now covered by ACOs, the success of these organizations and other integrated delivery models is vital to fulfilling the Institute for Healthcare Improvement’s ‘triple aim’ and transitioning from a volume-based system to one that is value-based,” said Patrick T. Ryan, CEO of Press Ganey. “A key component of that success is having the right tools to help providers strive for seamless coordination of care by understanding the viewpoint and behaviors of the patient who is interacting with different providers."

One of the participants in the Coordinated Care Solution pilot is Geisinger Health System, an organization known for its advanced patient-centered medical home called ProvenHealth Navigator, a collaborative effort between Geisinger Clinic and Geisinger Health Plan (GHP), the not-for-profit health insurance component of the health system.

Tom Graf, MD, Geisinger’s associate chief medical officer said, taking a holistic approach to care meant changing the relationship with patients. "As a pioneer in coordinated care, we recognized the need for a more comprehensive tool to support this new relationship by collecting important information that was previously unavailable information on what our patients thought we were doing right and what we could improve as they moved from one type of provider to another during their treatment,” he said.

 

More docs questioning benefits of ACA, EHRs

WATERTOWN, MA – Physicians remain concerned over the future of U.S. healthcare, a new survey reveals. Among the survey’s findings, most physicians think EHRs and the ACA will adversely affect the quality of patient care, and nearly two-thirds anticipate that quality of healthcare will worsen over the next five years. 

The Physician Sentiment Index (PSI), conducted by Watertown, Mass.-based athenahealth and Cambridge, Mass.-based Sermo, collected responses from 500 physicians who represented a diverse range of specialties and practices sizes. 

This year's PSI tells a story of over-burdened physicians who are deeply concerned about where the healthcare industry is headed. The data suggests the leading distractions affecting physicians' ability to provide the optimum care for patients center on government intervention, increased utilization of and frustration with EHRs and administrative burdens. All told, these distractions have diminished physicians' optimism around their ability to deliver quality care and remain viable, profitable practices. 

"There is a lot of ‘stuff’ going on in healthcare that is making the noble pursuit of the MD degree a lot less attractive," said Jonathan Bush, athenahealth CEO and chairman. "Government involvement, ill-designed EHRs and administrative complexities are encroaching on the sacred relationship between the physician and the patient and the ability for that doctor to be fully present at the point of care."

"U.S. healthcare is changing rapidly, but time and again policymakers aren't listening to the physician perspective," said Jon Michaeli, VP of membership for Sermo. "As a result physicians feel disempowered to influence change, and hence they are more disenchanted with their profession and less connected to patients than ever.”

More specifics of the survey’s findings are listed below: 

Doctors skeptical of regulation

Over half (in 2012 and 2011) say that government involvement in regulation will not yield lower costs and better outcomes, with slightly more pessimism on display this year.A growing number concerned about the ACA’s impact on the quality of care:  Nearly one-third (29 percent) say they still do not understand the details and implications, compared to 22 percent in 2011.16 percent said they'd like to see the ACA remain 'as is' (versus 11 percent in 2011).53 percent report the ACA will have a detrimental effect on their ability to provide high quality care, versus 50 percent in 2011 – 43 percent more believe the ACA will be very detrimental to the delivery of quality of care (from 14 percent in 2011 to 20 percent in 2012).26 percent want to see the entire ACA repealed (versus 21 percent in 2011).Three-quarters report that the meaningful use process is at least somewhat difficult and/or cumbersome.The ACO model draws concerns: More indicated ACOs as having a negative impact on quality of care (39 percent in 2012 versus 26 percent in 2011) and profitability (63 percent in 2012 versus 48 percent in 2011).

EHRs – more purchased, more in use, but what do docs think?

73 percent said EHRs are a distraction to doctor-patient interaction, up 12 percentage points from 2011.The number who purchased an EHR jumped 10 percentage points between 2011 and 2012 (from 70 percent to 80 percent). – Yet, very favorable opinions did not move in line –18 percent fewer voiced a very favorable opinion of EHRs (from 39 percent in 2011 to 32 percent in 2012).36 percent more say they believe EHRs somewhat or significantly worsen patient care (from 11 percent in 2011 to 15 percent in 2012). The majority (44 percent) says that the EHR was not designed with physicians in mind versus 32 percent in 2011.

Administration woes

89 percent said payers have become more intrusive on the patient-physician relationship versus 87 percent in 2011.74 percent said payers inhibit the care they would like to provide their patients (76 percent in 2011).59 percent more physicians see pay-for-performance as negatively impacting quality of care; 30 percent more believe it will negatively impact their bottom line.However, 42 percent are very/somewhat confident their transition to ICD-10 will be smooth.

[See also: Docs believe EHRs safer than paper, but patients still ambivalent.]

Independent physicians – fretting about the future of medicine, their viability

81 percent do not see the future of independent practice as viable, representing 19 percent more doctors in 2012 than 2011.This year, 50 percent more view the current healthcare climate as very detrimental to quality care delivery.Unchanged from 2011, about two-thirds anticipate that the quality of medicine in the U.S. will decline over the next five years.

 

Premier makes big connect with big data

CHARLOTTE, NC – The Premier healthcare alliance will connect more than 100,000 healthcare provides in what Premier calls the world’s largest healthcare community to share knowledge, data, best practices and decision support.

The alliance’s PremierConnect technology platform will make it possible for clinicians, supply chain leaders, hospital executives and other healthcare providers nationwide to connect as one in communities of common interest, officials say.

[See also: Premier to bring meaning to disparate data]

Premier, which describes itself as a performance improvement alliance, includes more than 2,600 U.S. hospitals and 84,000-plus other healthcare sites.

PremierConnect will connect data, knowledge and people in ways that support evolving care delivery models and accelerate the pace of performance improvement, say Premier officials. The virtual community allows alliance members to instantly share knowledge, data and strategies based on thousands of patient outcomes that can be used to benefit treatment anywhere, an ability that has been a missing link in care delivery to date.

"Health systems today need an integrated look into utilization, costs, efficiency and quality," said Michael D. Connelly, president and CEO of Catholic Health Partners. "With this information we can further build out the predictive capabilities that will help us find opportunities and enact corrective actions before they affect patients. This initiative is a critical foundational piece to our mission and the mission of the Premier alliance to improve the health of our communities."

[See also: Premier comparative effectiveness program seeking applicants]

PremierConnect supports new ways to deliver care that are required by health reform, including accountable care organizations (ACOs), which emphasize more clinical integration and healthier outcomes. Individual health systems can use it to connect care across all of their sites – hospitals, physician offices, outpatient clinics and more. These population analytic capabilities provide insight into how to manage populations for improved outcomes.

"Leaders of healthcare systems will be able to easily make data-driven, evidence-based decisions that improve performance while making their communities healthier places to live,” said Premier President and CEO Susan DeVore. “They'll know which patients are driving undesirable outcomes, which physicians have the highest costs or the poorest performance, and why these scenarios are occurring.

"Patients will have confidence that their care is based on proven innovations and best practices from top-performing clinical leaders nationwide," DeVore added. "And their providers will understand everything about their care – what drugs they're taking or allergic to, what procedures they've had recently and more."

PremierConnect will integrate Premier's clinical, financial and operational comparative databases, containing one in four patient admissions and close to $43 billion in annual purchasing data. This information is updated every 30 days to ensure it is current. It will also continuously integrate real-time electronic health record data from over 325 hospitals. Premier's quality, safety, labor and supply chain applications will be easily accessible in PremierConnect, helping providers make decisions based on a combination of quality, safety and cost information – not each individually.

"What we've built mirrors what we're trying to do in healthcare – build a system that is coordinated and integrated, where communication is dramatically improved and we aren't unnecessarily repeating work," said Keith J. Figlioli, Premier's senior vice president of healthcare informatics. "It will help eliminate unnecessary care that can compromise safety and add to already expensive bills for both consumers and health systems. It's a new, better approach to care delivery, with a truly efficient way to treat patients and keep people healthy."

PremierConnect is powered by IBM information management, business analytics, enterprise content management, social business, Rational, Tivoli and WebSphere software, as well as IBM Power Systems hardware to provide insights from vast amounts of data.

[See also: Premier develops industry IT standards for ACOs]

Don't let meaningful use dictate EMR choices, IDC tells small practices

FRAMINGHAM, MA – A new report from IDC Health Insights rates the best EMR vendors for small physician practices -- and warns that the short-term incentives of meaningful use shouldn't overshadow those offices' long-term care strategies.

The study, "IDC MarketScape: U.S. Ambulatory EMR/EHR for Small Practices 2012 Vendor Assessment" assesses 11 products from nine vendors aimed at helping small physician practices qualify for meaningful use incentive money. In its report, IDC weighs in on which vendors are well-positioned today through current capabilities – and which are best positioned to gain market share over the next one to four years.

Vendors included in the report are: ADP AdvancedMD, Allscripts, athenahealth, eClinicalWorks, Greenway Medical Technologies, LSS (MEDITECH), Lumeris, Optum (OptumInsight) and Practice Fusion.

IDC experts say they expect the U.S. market to move from less than 25 percent adoption in 2009 to more than 80 percent adoption by 2016. That growth will be primarily influenced by regulatory stipulations and government incentives under the American Recovery and Reinvestment Act (ARRA).

But additional trends will include the quality of care improvements that result from using EMRs/EHRs in ambulatory practices, their growing capabilities and use of cloud computing, the use of mobile devices in ambulatory practices and the consolidation of provider vendors as market saturation increases, according to the report.

ARRA offers "an unprecedented opportunity for providers in small practices to garner federal incentives for demonstrating meaningful use of clinical applications that will help to improve the quality of care, enhance patient safety and prepare their practices for the future," said Judy Hanover, research director at IDC Health Insights.

But EMR technology – to say nothing of the many federal requirements and deadlines for achieving meaningful use and the disruptions of business, workflow and practice patterns necessitated by its adoption – can "present complex issues and challenges" for small physician practices, she said.

"If providers allow the constraints of meaningful use to dictate their technology choices and limit the goals for implementation," said Hanover, "they may only see the short-term incentives and not the long-term strategic advantage that an EHR can bring to their practices and may fail to compete under healthcare reform."

With hundreds of small practice EMR/EHR vendors participating in the market, IDC officials say the vendors included in the report were carefully selected to include the top five market leaders in the U.S., and a selection of additional vendors that offer compelling technology, strategies or services, such as advanced software-as-a-service (SaaS) offerings, innovative pricing or service options, platforms or architecture capabilities.

The report seeks to highlight the attributes and key capabilities physicians should look for when selecting an EMR/EHR, and offers a guide for using best practice-based approaches to leveraging an EMR/EHR to build competitive advantage in small practices.

Each product was evaluated against 25 criteria in two category measures for success: strategies and capabilities. Within each of these criteria, IDC Health Insights has weighted specific features of the product or the product's vendor that are particularly significant for purchasers of the software and for users. As part of its evaluation, IDC included customer references for all of the products included in the assessment.

Access the IDC Health Insights report here.

RPSGB responds to pharmacists gaining access to patient records

LONDON – UK pharmacists will gain access to patients' electronic Care Record for the first time under plans by NHS IT chiefs. Access has previously been limited to general practitionerss.

In a key step towards Government proposals for pharmacies to take on more clinical work, pilots are being considered in community pharmacies across the country.

The Royal Pharmaceutical Society of Great Britain's Director of Policy and Communications, David Pruce said: "Pharmacists are highly-trained healthcare professionals, with unique expertise in medicines use. Community pharmacists are highly accessible to the public, and well-placed to provide a range of healthcare services."

"Access to care records by pharmacists will improve patient safety because pharmacists will be able to view the patient record, and be fully aware of what care a patient is receiving elsewhere," he said.

"Access to care records will strengthen pharmacists' ability to make the best possible decisions for their patients, and will enable them to develop new health promotion and screening services, for the benefit of patients and doctors alike," Pruce said.

"Like other trusted healthcare professionals, pharmacists have a duty of confidentiality to their patients. Pharmacists already have access to care records in a variety of settings, including hospital wards and GP surgeries. Access to electronic care records in the community pharmacy will not present a risk to patient confidentiality," he added. "As the subject of their patient records, it is ultimately the patient's decision concerning which health professionals can view their records. However, we believe patients and doctors will experience a clear benefit when pharmacists are able to access their records."

VA awards $19M contract for mobility network

WASHINGTON – The Department of Veterans Affairs will create one of the world's largest wireless mobility infrastructures for healthcare, supporting 26 medical centers across the country. The network will accommodate voice, video and real-time location services.

VA has awarded a $19 million contract to Melbourne, Fla.-based Harris Corp. to get the job done.

[See also: Mobile tech touted as way to give veterans better access to healthcare]

Harris, an international communications and information technology company, has six years of experience delivering information management services to the VA.

"The wireless infrastructure designed and installed by Harris will make secure, enterprise-wide healthcare mobility at medical centers a reality for the Department of Veterans Affairs," said Jim Traficant, president, Harris Healthcare Solutions. "It will be a crucial element in ensuring those who serve our nation's veterans have access to mission-essential data where and when they need it."

The Harris team includes subcontractors Advanced Management Strategies Group, Synaptek Corporation, and TL Services, Inc. The contract was awarded under the U.S. Department of Veterans Affairs Transformation Twenty-One Total Technology contract vehicle.

[See also: VA to help veterans with diabetes with remote monitoring]

A nationally recognized leader in healthcare IT integration, Harris delivers business intelligence, image management, health information exchange, workflow management, portals, managed services and systems integration.

California's Prop 29 is Big Tobacco vs. Lance Armstrong

SAN FRANCISCO(AP)�Fabled as a mecca for the health-conscious and fitness-obsessed, California is also one of only a few states that has not hiked its cigarette taxes in the last decade, meaning it is less expensive to light up in Los Angeles and San Francisco than in many other places in the country.

The tobacco industry wants to keep it that way.

It has amassed nearly $50 million to kill an initiative before California voters that has been championed by cycling star Lance Armstrong and supported by New York Mayor Michael Bloomberg, who has donated $500,000 to its campaign.

Marlboro-maker Altria Group Inc., RJ Reynolds and other tobacco heavyweights have spent their millions on a media blitz to snuff out Proposition 29, which would slap an additional $1-per-pack tax on cigarettes and other tobacco products to fund cancer research.

If the tax passes, California would still have only the 16th highest tax rate in the nation, at $1.87 per pack. But tobacco companies and their allies say that voter approval of an extra tax in the nation's largest cigarette market would crush owners of small businesses and spark anti-smoking measures elsewhere.

They say the measure on Tuesday's primary ballot is flawed and would create a giant, unaccountable bureaucracy.

"We all know that Big Tobacco has poured tens of millions in this campaign saying, 'Don't tax us any more,'" said Armstrong, who beat testicular cancer that had spread to his brain and lungs more than a decade ago. "But the fact of the matter is the product they sell leads to about $9 billion a year in health care costs for California. I think if this passes, other states will follow."

Its passage is uncertain.

The Public Policy Institute of California found that support for the initiative dropped from 67% in March to 53% by late May, reflecting the blizzard of radio and TV ads from the tobacco industry.

A statewide Field Poll released Thursday found that 50% of likely voters said they will vote yes on the measure, with 42% voting no and 8% undecided.

As the primary approaches, Armstrong and other smoking foes, including Bloomberg and Laurene Powell Jobs, the widow of the late Apple CEO Steve Jobs, are pouring in their own money to counter the industry.

Bloomberg has banned smoking in New York City bars and parks during his decade in office.

"California is a particularly important state, and it's very visible on this issue," he said in a telephone interview. "A lot of people there will die unless we do something to stop Big Tobacco."

The $12.3 million anti-smoking groups have raised comes to about one-fourth of the $46.8 million war chest built by the major tobacco companies. The anti-tax contributions exceed those of any other federal independent expenditure committee except the "Restore Our Future" super PAC supporting Republican presidential candidate Mitt Romney, according to recent campaign finance figures.

Smoking is not as common in California, the nation's most populous state, as it is in other pockets of the country. Smoking rates are among the nation's lowest in California, at 12.1%, and highest in Kentucky, at 24.8% , the federal Centers for Disease Control and Prevention found in 2010.

Still, California represents a huge market for the tobacco industry. Smokers in the state bought about 970 million packs of cigarettes � spending approximately $5.2 billion � in fiscal year 2010, the most recent year for which national figures are available. Some of that money went to an existing tobacco tax, which sends 25 cents from each pack purchased to fund anti-smoking programs, provide health care services to the poor and fund tobacco-related research.

That helped reduce tobacco sales. In the 15 years after it went into effect in 1988, the industry lost $9.2 billion in pre-tax sales, according to a study by researchers at the University of California, San Francisco's Center for Tobacco Control Research and Education.

Then, in 2006, tobacco companies spent $66 million to defeat a previous measure that would have created an extra $2.60-per-pack tax.

So far, the opposition campaign has centered its messaging on the state's budget mess, calling the California Cancer Research Act a folly that will force taxpayers to support a group of political appointees who will send research money out of state. Opponents also have said it could end up raising millions of dollars yet produce little research that develops new cancer treatments, charges the measure's supporters say are baseless.

"The tobacco companies realize that we have a like mind in opposing both tax burdens and policies that create a business-unfriendly environment," said Joel Fox, president of the Los Angeles-based Small Business Action Committee, which he said has received hundreds of thousands of dollars from tobacco companies to support anti-tax policies in the last decade. "It's the first domino of potentially taxing all kinds of products."

The nonpartisan California Legislative Analyst's Office says Proposition 29 would generate about $735 million a year in revenue if approved.

The anti-tax campaign has been quick on the ground, launching radio and TV commercials a month and a half ago.

Armstrong and his coalition, including the American Cancer Society, American Lung Association, American Heart Association and California Medical Association, were too poor to mount an early advertising campaign, he said.

Aside from Armstrong, who visited with young patients during an event at a Los Angeles children's hospital earlier this month, the measure has not attracted much celebrity support. Laura Ziskin, a Hollywood producer celebrated for the "Spider-Man" movie franchise, was on the initiative's campaign board until she died last year of breast cancer.

Even so, in the final days before the primary, the battle over Proposition 29 is arguably the most high-profile campaign in an election season that has failed to generate much enthusiasm.

"The supporters and opponents wouldn't spend these millions of dollars if these commercials weren't persuading voters," said Daniel Newman, president of MapLight, a nonpartisan group that analyzes money's role in politics. "When one side has a specific financial interest, they are going to spend much more because they get such a high return on investment."

Join Us for an Online Women’s Health Town Hall

As part of our focus on women�s health, the White House and the U.S. Department of Health and Human Services (HHS) would like to invite you to participate online in a Women�s Health Town Hall on Thursday, June 7, 2012. The event will be streamed live from the White House from 10 a.m. to 11:30 a.m. ET.�

The event will be an interactive, open dialogue about how the health care law, the Affordable Care Act, is improving the health of women and their families.�

Do you know how the law affects you, your mother, and your daughter?

Here are some highlights:

The law requires insurance companies to cover people with pre-existing conditions, and means the end of women being denied or charged more for coverage just because they�re women.It also zeroes in on ensuring access to preventive services like mammograms and blood pressure screenings by making them available without a co-pay.It strengthens the Medicare program by cracking down on fraud, waste and abuse and closing the prescription drug gap known as the �donut hole,� which means lower prescription drug costs for all seniors.

We encourage you to send us what you want to know about the law. Submit questions using the Twitter hashtag #WomensHealth or on the HealthCare.gov Facebook page.�

Participants include:

Valerie Jarrett, Senior Advisor to the President and Chair of the White House Council on Women and GirlsKathleen Sebelius, Secretary of Health and Human ServicesTina Tchen, Executive Director of the White House Council on Women and Girls and Chief of Staff to First Lady Michelle ObamaCecilia Mu�oz, Director of the White House Domestic Policy CouncilMayra Alvarez, Director of Public Health Policy, Office of Health Reform, Health and Human ServicesCaya Lewis, Counselor to the Secretary of Health and Human ServicesJudy Waxman, Vice President of the National Women�s Law CenterMargarita Bertsos, Health Editor of REDBOOKKelly Wallace, Chief Correspondent and Executive Director of Digital Video of iVillage

Mark your calendar!

Obesity app takes first place in D.C. competition

WASHINGTON – The winners of the Washington D.C. Health Data & Innovation Week Code-a-Thon were announced Tuesday. School Fit was awarded first place for developing an application that utilizes physical fitness data to monitor the health of children in public schools.

The app will allow communities to recognize and collaboratively address obesity problems in California public schools. School Fit earned $4,000 and two passes to the Health Data Initiative Forum III and the 2012 Health 2.0 Annual Fall Conference. 

The Health 2.0 Code-a-Thon, sponsored by the Office of the National Coordinator for Health Information Technology (ONC) and Kaiser Permanente, attracted thousands of healthcare providers, policymakers and innovators from across the U.S.  

Teams comprising students, software developers and researchers participated in the two-day event, which required contestants to use publicly available data to create online tools and applications to enhance quality of care and prevent obesity.

"The judges had an especially difficult time choosing a winner and extended passes to the Health 2.0 fall conference to the second place team to encourage further development of its app," said Indu Subaiya, co-chair and CEO of Health 2.0.

Healthy Plate placed second by creating a mobile app that educates and improves nutritional literacy by displaying the nutritional information about the user's food they intend to purchase by portion, recipe or grocery list. It won $3,000 and two passes to Health 2.0's annual conference.

The LessBadd and SMS2Live teams tied for third place. Both teams received $1,000.

VA awards $19M contract for mobility network

WASHINGTON – The Department of Veterans Affairs will create one of the world's largest wireless mobility infrastructures for healthcare, supporting 26 medical centers across the country. The network will accommodate voice, video and real-time location services.

VA has awarded a $19 million contract to Melbourne, Fla.-based Harris Corp. to get the job done.

[See also: Mobile tech touted as way to give veterans better access to healthcare]

Harris, an international communications and information technology company, has six years of experience delivering information management services to the VA.

"The wireless infrastructure designed and installed by Harris will make secure, enterprise-wide healthcare mobility at medical centers a reality for the Department of Veterans Affairs," said Jim Traficant, president, Harris Healthcare Solutions. "It will be a crucial element in ensuring those who serve our nation's veterans have access to mission-essential data where and when they need it."

The Harris team includes subcontractors Advanced Management Strategies Group, Synaptek Corporation, and TL Services, Inc. The contract was awarded under the U.S. Department of Veterans Affairs Transformation Twenty-One Total Technology contract vehicle.

[See also: VA to help veterans with diabetes with remote monitoring]

A nationally recognized leader in healthcare IT integration, Harris delivers business intelligence, image management, health information exchange, workflow management, portals, managed services and systems integration.

Employers Less Likely To Drop Coverage Than You Might Think

iStockphoto.com

Employers are bruised by health costs, but most aren't thinking about dropping coverage just yet.

When it comes to businesses providing health coverage for employees, there's a mad dash for the exits, right?

Maybe not, according to a recent survey of more than 1,300 U.S. employers of varying sizes. Consultants at Oliver Wyman's health practice wondered how employers are weighing the increasing costs of providing health insurance and the potential exit strategy paths available under the federal health law (if it survives the Supreme Court).

Bottom line: only 8 percent of the employers surveyed have plans to drop coverage altogether. But half of the companies surveyed do plan to make big changes to the coverage they offer.

"The most critical points are that they by and large have a very strong desire to take care of their employees," Oliver Wyman's Mindy Kairey tells Shots. Many employers have a strong belief that healthy employees are better employees.

 

And some employers worry that they'd be less able to attract the workers they want without offering health coverage. Companies that employ more highly paid workers are less likely to be thinking about dropping coverage.

So what's changing? Health costs continue to rise, putting pressure on employers to manage insurance expenses. The folks at Oliver Wyman asked about two relatively new approaches that are starting to get some traction.

One is private insurance exchanges, essentially beefed-up menus of coverage options that feature a wider variety of options than you might already be choosing from each year. In some cases, the employer might give you a fixed amount of money to make the decision about which one to pick. About 60 percent of companies would consider this approach if it save them at least 10 percent on health costs, the survey found.

Another option gets a new buzzword: value-based networks. In this approach, providers of health care get paid based on the quality bang for the buck they provide. About half of employers are interested in this option, if it save them at least 10 percent of costs.

As it is, the erosion of employer-based health coverage is well under way, as NPR reported as part of a series on what it's like to be sick in America. "In plain language, it's becoming skimpier and skimpier and less and less comprehensive," Drew Altman, president and CEO of the Kaiser Family Foundation, told us.

Orion Health to supply electronic record to Northern Ireland

Health and Social Care Northern Ireland (HSCNI) has tapped Orion Health Limited to provide a clinical portal-based electronic care record (ECR).

Covering a population of more than 1.8 million people, the ECR will facilitate the sharing of patient data taken from multiple existing information systems across acute, community, primary health and social care, officials say. The contract follows a successful Proof of Concept pilot of the ECR in Ulster Hospitals Dundonald, the Belfast City Hospital and two general practices in 2009 and 2010.

“The Electronic Care Record will improve the quality and safety of patient care as the system makes all of the relevant existing information available to doctors, nurses and other staff at the point of care,” said Carolyn Harper, MD, HSCNI project sponsor.

The Orion Health Clinical Portal will provide streamlined, secure, Web-based access to patient data from a single browser view, according to officials. The ECR will include vital patient information, including latest lab results, medications and clinical correspondence. Audit tools and patient privacy controls have been built into the ECR for greater security.

“The ECR will play a key role in delivering a patient centered service ensuring that the right information is available to health professionals where and when it is needed,” said Roy Harper, MD, consultant endocrinologist, Ulster Hospital.

As part of a seven-year contract the ECR will be deployed in 18 acute and community hospitals, all GP practices and community, mental health and social care facilities across the five regional trusts in Northern Ireland. Planned implementation will start in late 2012 with completion of the core elements anticipated early summer 2013.

“I am confident that the electronic care record system will assist in developing a sustainable healthcare system that delivers now and will continue to deliver in the future for the good of everyone in Northern Ireland,” said Health Minister Edwin Poots.

Guaranteeing Value for Your Premium Dollars

When we pay for health insurance, we want to know that most of what we are paying for is for health care, not advertising, executive bonuses or overhead. It�s pretty simple: we want to get a good value for our premium dollars.

Thanks to a new rule (the �80/20 rule�) in the Affordable Care Act, you can be sure that insurance companies are spending generally at least 80 cents of every dollar you pay in premiums on your health care or activities that improve health care quality. If the insurance company fails to meet this standard, or the �medical loss ratio�, in any year, they have to pay you a rebate.

Insurance companies that didn�t meet the standard for coverage provided in 2011 are required to provide these rebates no later than August 1st of this year, and to make sure you know what you are owed, insurance companies that owe rebates will also send a letter telling you how much you�ll receive. You can see what that letter will look like here. �According to early estimates from the Kaiser Family Foundation, insurance companies will provide 15.8 million Americans with $1.3 billion in rebates.

Today, we�re also finalizing a notice for insurance companies to send you if they meet or exceed the standard. If your insurance company is providing fair value for your premium dollars, you should know that too. You�ll be able to see your plan�s medical loss ratio on HealthCare.gov starting this summer.�

The 80/20 rule and the rate review program are two ways the Affordable Care Act is protecting you. You can find out more about how the Affordable Care Act increases transparency and protects consumers here: http://www.healthcare.gov/news/factsheets/2012/02/increasing-transparency02162012a.html.

Health Think Tank Crunches Health Prices For The Masses

Ricardo Reitmeyer/iStockphoto.com

It turns out we may not know nearly as much about all the money spent on health care in the U.S. as we thought we did.

But there's a new group that wants to, well, remedy that.

The problem, Martin Gaynor, chairman of the Health Care Cost Institute, told Shots, is that "two-thirds of the population has private [health] insurance, but most of the information comes from Medicare."

That's because Medicare, being government run, is the only large insurer whose claims information has been available for academics to crunch. In fact, it's been the detailed analysis of Medicare data that's has allowed the Dartmouth Atlas to show the wide variations in health care across the U.S.

Still, many have worried that what happens to people age 65 and over may not necessarily reflect what's happening to everyone else.

 

So Gaynor, who's also a professor of economics and health policy at Carnegie Mellon University in Pittsburgh, along with a small group of academics, persuaded four of the nation's largest private health insurers � Aetna, Humana, UnitedHealthcare and Kaiser-Permanente � to give them access to information about what the insurers paid for care given to some 40 million people. (Personal information has been removed from the database.)

"That's 40 percent of the privately insured population in the U.S.," Gaynor said.

The group's first study, which examines spending and use trends in 2010 in the under-65 population, is already finding trends that would be hard to discern from Medicare data.

The first big take-home message, said Gaynor, is that while spending went up relatively slowly � about 3.3 percent � the biggest factor was an increase in "prices to providers." In other words, people didn't get more care, but they and their insurers paid more for the care they got. That also showed up in the fact that individuals' out-of-pocket spending grew slightly.

Prices rose for both inpatient and outpatient surgical procedures; for emergency room visits, and for brand-name prescription drugs from 2009 to 2010. Generic drugs were about the only category for which prices fell, 6.3 percent.

HCCI

Some analysts, like Aaron Carroll, are already using the new numbers to worry about potentially ominous trends in the health care system.

Another of the more provocative findings in the study is that spending rose fastest � 4.5 percent � for the 18 and under age group, something you'd never find in Medicare data. That rise compares to 3.1 percent for those aged 55-64 and 2.3 percent for those aged 19-44.

Why? Gaynor says an answer will take more research.

And HCCI says it will be happy to share what it expects to be a twice-a-year data dump with other academics and nonprofit research outfits. "Our goal is to create a data resource," he says.

U.S. vets' disability filings reach historic rate

America's newest veterans are filing for disability benefits at a historic rate, claiming to be the most medically and mentally troubled generation of former troops the nation has ever seen.

A staggering 45% of the 1.6 million veterans from the wars in Iraq and Afghanistan are now seeking compensation for injuries they say are service-related. That is more than double the estimate of 21% who filed such claims after the Gulf War in the early 1990s, top government officials told the Associated Press.

What's more, these new veterans are claiming eight to nine ailments on average, and the most recent ones over the last year are claiming 11 to 14. By comparison, Vietnam veterans are currently receiving compensation for fewer than four, on average, and those from World War II and Korea just two.

It's unclear how much worse off these new veterans are than their predecessors. Many factors are driving the dramatic increase in claims � the weak economy, more troops surviving wounds, and more awareness of problems such as concussions and post-traumatic stress disorder (PTSD). Almost one-third have been granted disability so far.

Government officials and some veterans' advocates say that veterans who might have been able to work with certain disabilities may be more inclined to seek benefits now because they lost jobs or can't find any. Aggressive outreach and advocacy efforts also have brought more veterans into the system, which must evaluate each claim to see if it is war-related. Payments range from $127 a month for a 10% disability to $2,769 for a full one.

As the U.S. commemorates the more than 6,400 troops who died in post-Sept. 11, 2001 wars, the problems of those who survived also draw attention. These new veterans are seeking a level of help the government did not anticipate, and for which there is no special fund set aside to pay.

The Department of Veterans Affairs is mired in backlogged claims, but "our mission is to take care of whatever the population is," says Allison Hickey, the VA's undersecretary for benefits. "We want them to have what their entitlement is."

The 21% who filed claims in previous wars is Hickey's estimate of an average for the 1990-91 Operation Desert Storm and Desert Shield to oust Iraqi troops from Kuwait. The VA has details only on the current disability claims being paid to veterans of each war.

The AP spent three months reviewing records and talking with doctors, government officials and former troops to take stock of the new veterans. They are different in many ways from those who fought before them.

More are from the Reserves and National Guard� 28% of those filing disability claims � rather than career military. Reserves and National Guard made up a greater percentage of troops in these wars than they did in previous ones. About 31% of Guard/Reserve new veterans have filed claims, compared with 56% of career military ones.

More of the new veterans are women, accounting for 12% of those who have sought care through the VA. Women also served in greater numbers in these wars than in the past. Some female veterans are claiming PTSD because of military sexual trauma � a new challenge from a disability rating standpoint, Hickey says.

The new veterans have different types of injuries than previous veterans did. That's partly because improvised bombs have been the main weapon and because body armor and improved battlefield care allowed many of them to survive wounds that in past wars proved fatal.

"They're being kept alive at unprecedented rates," says David Cifu, the VA's medical rehabilitation chief. More than 95% of troops wounded in Iraq and Afghanistan have survived.

Larry Bailey II of Zion, Ill., north of Chicago, is an example. The 26-year-old Marine remembers flying into the air, then fellow troops attending to him, after he tripped a rooftop bomb in Afghanistan last June. He ended up a triple amputee.

"I pretty much knew that my legs were gone. My left hand, from what I remember I still had three fingers on it," although they didn't seem right, Bailey said.

He is still transitioning from active duty and is not yet a veteran.

A look at the numbers

Of those who have sought VA care:

� More than 1,600 of them lost a limb; many others lost fingers or toes.

� At least 156 are blind, and thousands of others have impaired vision.

� More than 177,000 have hearing loss, and more than 350,000 report tinnitus � noise or ringing in the ears.

� Thousands are disfigured, as many as 200 of them so badly that they may need face transplants. One-quarter of battlefield injuries requiring evacuation included wounds to the face or jaw, one study found.

"The numbers are pretty staggering," says Bohdan Pomahac, a surgeon at Brigham and Women's Hospital in Boston who has done four face transplants on non-military patients and expects to start doing them soon on veterans.

Others have invisible wounds. More than 400,000 of these new veterans have been treated by the VA for a mental health problem, most commonly PTSD.

Tens of thousands of veterans suffered traumatic brain injury, or TBI � mostly mild concussions from bomb blasts � and doctors don't know what's in store for them long-term. Cifu, of the VA, says that roughly 20% of active-duty troops suffered concussions, but only one-third of them have symptoms lasting beyond a few months.

That's still a big number, and "it's very rare that someone has just a single concussion," says David Hovda, director of the UCLA Brain Injury Research Center. Suffering multiple concussions, or one soon after another, raises the risk of long-term problems. A brain injury also makes the brain more susceptible to PTSD, he says.

Body armor takes a toll, too

On a more mundane level, many new veterans have back, shoulder and knee problems, aggravated by carrying heavy packs and wearing the body armor that helped keep them alive. One recent study found that 19% required orthopedic surgery consultations and 4% needed surgery after returning from combat.

All of this adds up to more disability claims, which for years have been coming in faster than the government can handle them. The average wait to get a new one processed grows longer each month and is now about eight months � time that a frustrated, injured veteran might spend with no income.

More than 560,000 veterans from all wars currently have claims that are backlogged � older than 125 days. The VA's benefits chief, Hickey, says the backlog is the result of sheer volume, the high number of ailments per claim, and a new mandate to do oldest cases first.

With any war, the cost of caring for veterans rises for several decades and peaks 30 to 40 years later, when diseases of aging are more common, says Harvard economist Linda Bilmes. She estimates the health care and disability costs of the recent wars at $600 billion to $900 billion.

"This is a huge number, and there's no money set aside," she says. "Unless we take steps now into some kind of fund that will grow over time, it's very plausible many people will feel we can't afford these benefits we overpromised."