Consortium News

  • 26 Aug 2015 3:11 PM | Denny Brennan (Administrator)
    By Priyanka Dayal McCluskey, Boston Globe Staff,  August 25, 2015


    A federal program to reduce the cost of providing care to seniors produced sizable savings in Massachusetts over the past three years, adding momentum to efforts to change the way doctors and hospitals are paid for providing health care.

    New figures show five Massachusetts health systems saved a combined $141 million during that period as part of the program, which aims to rein in costs by better coordinating care for Medicare patients and cutting unnecessary hospital stays and medical services. Doctors manage care for these patients in pools known as Pioneer accountable care organizations.

    Nationwide, these organizations saved $304 million in three years, federal officials said Tuesday. Still, that is a tiny fraction of the more than $1 trillion spent during this period by Medicare, the government health insurance program for seniors.

    “The numbers tell me it’s working, that new payment mechanisms are getting providers to change the way they deliver care, and those changes are producing measurable results,” said Dr. Timothy G. Ferris, senior vice president of population health management for Partners HealthCare.

    Partners said it saved $40 million in providing care to the seniors in its accountable care organization from 2012 to 2014.

    Beth Israel Deaconess Care Organization, a network of health care providers including Beth Israel Deaconess Medical Center, saved $50 million over the same period, while Steward Health Care System saved $30 million.

    “It’s a great three-year story,” said Dr. Sanjay Shetty, president of Steward’s physician network. “It fits with Steward’s bigger strategy of bringing value and accountable care to as many patients as we can.”

    The physicians group affiliated with Mount Auburn Hospital saved nearly $14 million in three years, and the large physicians network Atrius Health saved $7.5 million. That was less than the other Massachusetts health systems, Atrius said, because it was already saving money by coordinating care for seniors before this federal program was launched.

    The savings are based on how much Medicare would have spent to provide care to patients under traditional payment systems, known as fee-for-service, which compensate doctors and hospitals for every visit, test, and procedure.

    Accountable care organizations give doctors and hospitals spending targets for providing care. When providers come in below budget and achieve high-quality scores, they earn more money and the federal government saves.

    Accountable care organizations are a key component of the federal Affordable Care Act, also known as Obamacare. Although they cover a small portion of Medicare patients nationwide now, federal officials have said they want to move most Medicare patients and their providers under such alternative payment programs in the next few years.

    Commercial insurers have developed similar models for patients in commercial health plans. The state’s largest insurer, Blue Cross Blue Shield of Massachusetts, in particular, is working to expand the number of members covered under such payment plans.

    Five of the 20 Pioneer accountable care organizations nationwide are in Massachusetts. Fifteen of them nationally saved money, while five had losses.

  • 25 Aug 2015 9:35 PM | Denny Brennan (Administrator)

    By Melanie Evans  | Modern Healthcare | August 25, 2015

    Three out of four Medicare accountable care organizations did not slow health spending enough to earn bonuses last year, a continuation of mixed results for an initiative that federal officials have targeted for rapid expansion.

    Medicare released 2014 results for 353 accountable care organizations, which include hospitals and physician groups that agreed to meet targets for quality and slow spending. Those that succeed can keep a share of money they save. In January the Obama administration announced plans to aggressively increase the share of Medicare spending under accountable care and other alternative payment models through 2018.

    Last year, 97 ACOs earned bonuses totaling $422 million out of $833 million in savings they produced. Savings are awarded under formulas that account for performance on quality targets after the first year in the program. (For ACOs in their first year, organizations must report quality scores but do not have to meet performance targets.)

    The CMS said results “show that ACOs with more experience in the program tend to perform better over time.”

    The results the agency published Tuesday include savings for 20 Pioneer ACOs, a small group of the most sophisticated organizations participating in a separate program administered by the CMS Innovation Center. That group began with 32 ACOs but several have dropped out, either to join Medicare's larger and less risky accountable care effort, the Shared Savings Program, or exiting entirely. One of the dropouts was included in 2014 results, though the organization did not stay the entire year.

    Eleven of the Pioneer ACOs earned savings bonuses that totaled $82 million. Another five Pioneer ACOs were required to return $9 million to Medicare. The average quality score for Medicare ACOs edged upward in 2014 from the prior year. Quality scores for 28 of the 33 measures improved.

    Some Pioneer ACOs reported significant savings. Banner Health Network, one of the remaining Pioneer ACOs, accounted for $29 million in total savings. The Montefiore ACO saved $18 million.

    Officials at both organizations said performance was boosted by attention to post-acute care costs and quality. Banner Health's ACO developed a preferred network of skilled-nursing facilities and recommends those facilities to patients.

    Other Pioneer ACOs have developed similar networks among skilled-nursing homes, where data show variation in quality and spending. Banner vetted local skilled-nursing facilities with questions on quality and culture.

    Shaun Anand, the Banner Health Network chief medical officer, said improvement in post-acute care was a significant contributor to the ACO's results.

    The Montefiore ACO worked with skilled-nursing facilities to avoid hospitalization, where possible, by finding alternatives for services that could be delivered elsewhere, such as blood transfusions.

    Ninety-two ACOs in the Medicare Shared Savings Program earned bonuses, but six did not receive payouts because they did not meet the quality requirements. Quality improved on 27 of 33 quality measure for those ACOs with more than one year of performance results.

    “These results show that accountable care organizations as a group are on the path towards transforming how care is provided," acting CMS Administrator Andy Slavitt said in a news release. “Many of these ACOs are demonstrating that they can deliver a higher level of coordinated care that leads to healthier people and smarter spending.”

    Medicare's shared savings program has struggled to push hospitals and doctors into contracts with more financial risk for hospitals and doctors. ACOs can earn bonuses but the bonuses are larger for ACOs that agree to absorb losses when patients' medical bills grow too rapidly.

    Contracts with more financial risk are a more powerful motivation for providers to achieve quality and cost-control targets. But many ACOs balked at plans to increase the financial risks after three years. Medicare conceded this summer, with new rules that allow more time without potential losses.

  • 25 Aug 2015 9:27 PM | Denny Brennan (Administrator)

    Aug 25, 2015, 4:34pm EDT

    Jessica Bartlett, Reporter, Boston Business Journal

    The Imprivata device scans patients' hands as a better way to identify them.

    Next time you walk into the hospital, you might be identified not by your social security number or birthday, but by the pattern of veins in the palm of your hand.

    Imprivata has launched a new patient identification process called “palm vein biometrics”, which takes a scan of a patient’s hand and captures the unique palm vein pattern.

    The Imprivata device scans patients' hands as a better way to identify them.

    The technology will link a patient to their medical record, and is intended to diminish duplicative electronic health records, reduce attempts at identity theft and diminish insurance fraud, without the stigma of fingerprints or the invasiveness of an eye scan.

    “It’s 100 times more accurate (than fingerprint biometrics). It’s convenient, there’s no stigma and it’s really easy to use,” said Omar Hussain, president and CEO of Imprivata. “Put your palm down and you’re easily identified. As patient ID becomes the next big issue, we thought this acquisition would position Imprivata to capitalize on great technology.”

    The technology came out of HT Systems of Tampa, a company Imprivata acquired in April for $19 million. Imprivata launched the technology through its own software system on Tuesday.

    The Lexington health IT company said it plans to market the device to hospitals, either as self-serve kiosks or at the enrollment station in hospitals. From there, the hospitals will likely deploy it to clinics where the hospital’s physicians participate.

    Hussain said Imprivata closed on the deal with HT Systems in June, and the company has spent the last several months ramping up the product and the branding.

    The technology will expand Imprivata’s offerings from data security for providers — such as a single log-in for electronic health records, to patient identification and enrollment.

    Patient identification is one of the biggest issues in health care, Hussain said. Studies have shown that approximately 10-15 percent of all medical records are duplicates. Another 6-10 percent of medical errors occur because a physician is treating the wrong patient.

    “You identify the wrong patient, you’re talking life and death. When you’re not sure of the patient, you start a new record,” Hussain said. “As health care systems start to get automated, that 10-15 percent of duplicative medical records becomes a patient safety issue and a monitoring issue. Fraud is up 22 percent in the U.S. because if one person doesn’t have insurance, they will use their brother’s information. If the hospital misidentifies the patient, the hospital gets sued.”

    Case studies in a Texas hospital showed there were 531 Maria Garcias with the same birthday enrolled in the hospital’s database. Another 70,000 patients matched up with another record that had the same first and last name and date of birth.

    “Right now, one of the biggest arguments in congress is unless you can uniquely identify a patient, all these arguments about interoperability and improving patient safety is irrelevant,” Hussain said.

    Imprivata has added dozens of employees to support the new technology, and Hussain said the 429-person company will expand to help product lines as needed.

    “We’re going to expand a successful technology and bring it to the market globally over the next year or so,” Hussain said.

  • 17 Aug 2015 10:06 AM | Denny Brennan (Administrator)

    Beth Walsh, Clinical Innovation + Technology, August 16, 2015

    The National Cybersecurity Center of Excellence (NCCoE) has released a draft for public comment of the first guide in a new series of publications that will show businesses and other organizations how to improve their cybersecurity using standards-based, commercially available or open-source tools. 

    The step-by-step guide  demonstrates how healthcare providers can make mobile devices, such as smartphones and tablets, more secure, in order to better protect patient information and still take advantage of advances in communications technology.

    The guide was developed because the use of mobile devices to store, access and transmit EHRs is outpacing the privacy and security protections on those devices, according to a release.

    Securing Electronic Records on Mobile Devices  provides IT implementers and security engineers with a detailed architecture so that they can copy, or recreate with different but similar technologies, the security characteristics of the guide. It also maps to standards and best practices from the National Institute of Standards and Technology (NIST) and others, and to HIPAA rules. The guide takes into account the need for different types of implementation for different circumstances such as when cybersecurity is handled in-house or is outsourced.

    The draft guide was developed by industry and academic cybersecurity experts, with the input of healthcare providers who first identified the challenge. The center then invited technology providers with relevant commercial products to partner with NIST through cooperative research and development agreements and collected public feedback at multiple steps along the way.

    The team at the NCCoE built a virtual environment that simulates interaction among mobile devices and an electronic health record system supported by the IT infrastructure of a medical organization. They developed a scenario in which a hypothetical primary care physician uses her mobile device to perform recurring activities such as sending a referral containing clinical information to another physician or sending an electronic prescription to a pharmacy. Then, using commercially available technologies, they built a solution to improve privacy and security protections.

  • 14 Aug 2015 5:02 PM | Denny Brennan (Administrator)
    This week, Atrius Health announced that home health care affiliates VNA Care Network & Hospice and VNA of Boston received high Quality of Patient Care Star Ratings from the Centers for Medicare & Medicaid Services (CMS). These new scores from CMS will allow consumers to compare and choose among home health agencies on the basis of quality patient care. VNA Care Network & Hospice received a 4.0 out of 5.0 star rating, one of the 20% of home health agencies nationwide that received a 4-star rating or better. VNA of Boston received a 4.5 star rating, landing within the 8% of home health agencies in the country to receive that score or better. Both ratings are higher than the national and state averages, which are 3.0 and 3.5 respectively.

    "Delivering this level of home health and hospice requires compassionate care from dedicated staff who are willing to go above and beyond for their patients. I'm proud to say that our teams exceed those standards and we look forward to continuing to improve even more our provision of high quality care to those we serve," said Mary Ann O'Connor, President & CEO of VNA Care Network Foundation. "I am thrilled to extend my utmost congratulations to VNA Care Network & Hospice and VNA of Boston for their well-deserved Medicare Star Ratings."

    This year marks the first time CMS has evaluated home health agencies in quality patient care. The ratings will appear on the CMS Home Health Compare (HHC) website in October 2015. CMS calculated these ratings through patient assessments performed by each home health agency, and evaluated each agency based on 9 of the 29 quality measures posted on Home Health Compare.

    These nine quality measures include:

    • How often the home health team began their patients' care in a timely manner.
    • How often the home health team made sure that their patients have received a flu shot for the current flu season.
    • How often the home health team taught patients (or their family caregivers) about their prescribed drugs.
    • How often home health patients got better at walking or moving around.
    • How often home health patients got better at getting in and out of bed.
    • How often home health patients had less pain when moving around.
    • How often home health patients got better at bathing.
    • How often home health patients' breathing improved.
    • How often home health patients had to be admitted to the hospital.

    To view other recent blog postings about health care or to sign up, please go to blog.atriusheath.org.

    About Atrius Health

    Atrius Health is the Northeast's largest nonprofit independent multi-specialty medical group. The Atrius Health practices-including Dedham Medical Associates, Granite Medical Group, Harvard Vanguard Medical Associates-together with VNA Care Network & Hospice serve 675,000 patients across eastern Massachusetts. A national leader in delivering high-quality, patient-centered coordinated care, the Atrius Health medical groups and home health agency & hospice work together, and in collaboration with hospital partners, community specialists and skilled nursing facilities, to develop innovative, effective and efficient ways of delivering care in the most appropriate setting, making it easier for patients to be healthy.

  • 13 Aug 2015 10:16 PM | Denny Brennan (Administrator)

    August 13, 2015, AAAS, by Rajiv Leventhal

    Researchers from Boston-based Beth Israel Deaconess Medical Center (BIDMC) have zeroed in on the potential benefits of allowing patients access to the notes their clinicians write after a visit.

    Read more...

  • 13 Aug 2015 10:57 AM | Denny Brennan (Administrator)

    Tech Crunch, Jordan Crook

    The company, launched back in 2011, provides software framework for things like payment processing, eligibility checks from insurance companies, referrals, claims submissions, online scheduling, patient identity management and provider search.

    Read more...

  • 10 Aug 2015 4:15 PM | Denny Brennan (Administrator)

    The Center for Brain Health at NorthShore University HealthSystem in the Chicago area is relying on the health system’s informatics infrastructure to help neurologists identify patients at higher risk for developing Alzheimer’s.

    Read more...

  • 07 Aug 2015 10:18 AM | Denny Brennan (Administrator)

    Life as a Healthcare CIO - John Halamka, MD - August 5, 2015

    EKG machines, IV pumps, and radiology workstations are all computers, often running un-patched old operating systems, ancient Java virtual machines, and old web servers that no one should currently have deployed in production.

    Read more...

  • 07 Aug 2015 10:09 AM | Denny Brennan (Administrator)

    Mathew J. Schwartz  • HealthcareInfoSecurity • August 6, 2015

    Based on glowing reviews and rapid adoption, the new Windows 10 operating system may give Microsoft the market "win" that it's been desperately seeking. But whether the new OS represents a win or loss for users' privacy and security remains an open question.

    Read more...

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