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  • 25 Jun 2015 11:13 AM | Denny Brennan (Administrator)

    The Supreme Court ruled today that President Obama’s health care law may provide nationwide tax subsidies to help poor and middle-class people buy health insurance.


  • 24 Jun 2015 2:35 PM | Denny Brennan (Administrator)
    Eight people, including an individual from the Bronx, N.Y.-based Montefiore Medical Center, have been indicted for stealing and using patients’ personal identifying information to make thousands of dollars in purchases at department stores and retailers in Manhattan.

    Read story...

  • 24 Jun 2015 11:15 AM | Denny Brennan (Administrator)

    Information security professionals are moving toward practices that secure the data itself rather than securing the device. What are these practices and what are their strengths and pitfalls?

    Learn more...

  • 24 Jun 2015 11:08 AM | Denny Brennan (Administrator)

    By adopting opioid guidelines, tracking data on performance, educating the clinical care team, and communicating with patients, Atrius Health is changing its culture to effectively manage chronic pain and opioid prescriptions for their patients in order to prevent unnecessary addiction.

    Learn more...

  • 16 Jun 2015 5:23 PM | Deleted user

    From   |   June 16, 2015  
    Denny Brennan, Executive Director of the Massachusetts Health Data Consortium and David Delano, Project Director for the Mass eHealth Collaborative

    Many healthcare providers and payers – large and small – are advancing toward ICD-10 readiness after two to three years of planning, assessment, design, implementation, testing and contingency planning. These organizations have substantially reduced their exposure to ICD-10 financial, technical and operating risks.

    Many other organizations, however, have delayed their ICD-10 preparation; for these organizations, the risks posed by opting to hold off on implementation are much greater. The limited time remaining reduces their tolerance for errors and delays in executing this transformation successfully.

    Agile methodologies streamline and simplify complex technical projects where complexity is high, requirements are fluid and time is short. By incorporating agile elements in their ICD-10 implementation, health care organizations can speed attaining the essential levels of training, documentation and coding required to survive October 1st and build an effective program for enhancing these competencies in the months that follow.

    For two years, ending March 31 of this year, the Massachusetts Health Data Consortium (MHDC) convened 88 of the Commonwealth’s payers and providers to meet the challenge of achieving ICD-10 compliance well in advance of this October’s deadline. With the program management support of the Massachusetts eHealth Collaborative (MAeHC), the ICD-10 Project spanned all facets of ICD-10 preparation (e.g., assessment, design, testing, and implementation).

    Among the many strategies, tactics, methods and insights produced by the ICD-10 Project were seven agile approaches that could substantially reduce wasted effort and improve the productivity of ICD-10 implementations for organizations who have delayed their conversion to the new standard, specifically:

    1. Know the time, not how the watch is built. When time is tight and success is measured in achieving rapid and increasing ICD-10 effectiveness, traditional project management tools and methods will slow progress to a halt. Replace project management software, presentations and progress reports with more and briefer daily project status meetings to accelerate progress and keep the team on track.

    2. Aim, fire, ready. If you were relocating to France on October 1st, and did not yet speak any French, you would not adopt a traditional French curriculum today to meet your communications needs four months from now. Chances are you would learn the basic French words and sentences necessary to meet your basic needs when you arrive and build your knowledge of syntax, case and conjugation over time. Traditional ICD-10 programs are not unlike traditional French curricula. They place a greater emphasis on comprehensiveness — assessment, governance, process documentation and project management — than on utility. While this level of structure is useful to support long-term transformation, it will impede the rapid, iterative methods that build essential competence more efficiently. Dedicate some of your ICD-10 program “infrastructure” to “rapid action” initiatives that will enable your organization to acquire a basic level of ICD-10 competence as quickly as possible.

    3. Get real. For many organizations, ICD-10 remains the imposition of an uncertain, complex future rather than new codes to describe the same work. While both perspectives are true, only the latter is actionable. The more organizations incorporate ICD-10 into daily operations, the more staff and physicians will consider it something useful and worth caring about. Start coding, if only as notes, an increasing number of patient encounters. Create ICD-10 flash cards and “cheat sheets” that users can affix to their workstations. Conduct weekly team briefings to review the new codes, their documentation requirements and other relevant information.

    4. Get help. Organizations just starting their ICD-10 transitions will have very limited, if any, access to external validation and testing with commercial and government health plans, given the testing deadlines and long lead times. Numerous online resources enable the rapid look-up, verification and validation of ICD-10 codes. Check with your clearinghouse or billing service to determine what on-line ICD-10 resources they provide. Knowing that you have validated your coding and that your clearinghouse or billing service is ready to, and can, receive and process your ICD-10 codes will reduce your technical risks substantially.

    5. If you stopped today, what would you have accomplished? No organization can risk being “almost ready” on October 1st. Conventional ICD-10 implementations are long on gradual and systemic improvement and short on frequent and closer-to-real-time deliverables. Rapid, repeated small-scale successes trump gradual systemic improvement when time is short. If during your weekly team meeting, you hear many gerunds (e.g., proceeding, studying, evaluating, determining) used to describe progress, you need to fix the cause of delay or shrink the scope of work to ensure more tangible progress and results reporting.

    6. Team up. Co-located and collaborating teams produce results superior to those based on working in largely segregated processes with unique goals. Assemble a multidisciplinary team with clinical, financial, technical and operational smarts. Have the team work in the same room (or very close), ensuring frequent interactions and face-to-face meetings over delegation of responsibilities and email communications.

    7. Just in case. No matter where organizations are at this point in their conversion efforts, they should have a contingency plan for October 1st in place before then. Work through failure scenarios, e.g., documentation shortfalls, system failures and coding inaccuracies, to determine how the organization will manage these situations should they arise on, or after, the deadline.

    Agile approaches to achieve ICD-10 readiness speed new programs and enhance existing programs that are at risk of failing to meet the Oct. 1 ICD-10 deadline. The increase in organizational focus and speed will support achieving necessary ICD-10 readiness and support working beyond the October 1st deadline as productively as possible.

    Denny Brennan is the Executive Director of the Massachusetts Health Data Consortium. David Delano is Project Director for the Mass eHealth Collaborative.

  • 15 Jun 2015 4:19 PM | Deleted user

    retrieved from   |   Jun 15, 2015                                                       

    Those health IT investments have accelerated as providers seek to mine data to meet quality and cost targets under new value-based payment models such as accountable care contracts. This has heightened demand for professionals capable of leading sophisticated data-analysis programs that identify waste and find opportunities to improve the health of enrolled populations.

    Skilled, experienced IT managers hold the upper hand in the job hunt, said Dr. Nicholas Marko, Geisinger’s chief data officer. “Microsoft wants people who are generally bright and good at math. Google wants those people. Amazon wants those people,” he said.

    Another factor driving staffing needs is consumers’ expectation for easy-to-use interfaces based on their experiences with online retail, banking, travel and other goods and services. They want that from healthcare providers as well. “We think our electronic health record is, and should be, as accessible as our financial data,” said Patricia Dombrowski, executive director of the Health eWorkforce Consortium at the Bellevue (Wash.) College Life Science Informatics Center near Seattle. “That is so far from the case in healthcare,” she said.

    In addition, data-security breaches have intensified competition for experts in health IT security. Health insurers Anthem, CareFirst Blue Cross and Blue Shield and Premera Blue Cross, and health systems including Partners HealthCare, Community Health Systems and Advocate Health Care all have reported stolen data and cyberattacks.

    Allina Hospitals and Clinics in Minneapolis is considering creating a new chief information-security officer position, said Susan Heichert, chief information officer for the system. But the competition for qualified candidates is intense. “With all the breaches in the news, starting with Target, that makes the job market heat up,” she said.

    Health IT jobs are projected to increase 15% to 37% by 2020—far faster than employment growth for other types of jobs. Computer information-security analyst jobs are projected to increase “much faster than average” through 2020, growing by more than one-third, according to the U.S. Bureau of Labor Statistics.

    n 2013, executive-level IT professionals averaged $189,435 in salary, up 6.1% from the prior year, according to the Healthcare Information and Management Systems Society.

    Not-for-profit hospitals, which account for most U.S. hospital operators, typically cannot compete on salary.

    An analysis by of an annual salary survey conducted by Computerworld and IDG Enterprise found the healthcare sector paid less to IT directors and IT managers than the manufacturing, legal, insurance, computer and consulting sectors. For IT directors, the gap between those industries and healthcare was $12,000 to $31,000. For IT managers, the gap ranged from $3,000 to $22,000.

    Smaller healthcare organizations particularly struggle to compete, offering lower average salaries than larger organizations, HIMSS data show. The average IT salary in 2013 at healthcare organizations with less than $5 million in revenue was $106,216, compared with $143,715 at organizations with $1 billion or more in revenue.

    “Healthcare’s not going to win a bidding war with anybody,” said Marko, who has recruited a half-dozen mathematicians and programmers and two computational biologists for not-for-profit Geisinger’s ambitious big- data division.

  • 15 Jun 2015 4:07 PM | Deleted user

    Retrieved June 15, 2015 from

    The Bethesda, Md.-based Aledade, a healthcare technology company started by Farzad Mostashari, M.D., the former National Coordinator for Health IT, has raised $30 million in venture capital funding with the aim to fuel accountable care organization (ACO) growth.

    Mostashari launched Aledade last June with $4.5 million in seed funding from New York City-based venture capital firm, Venrock. This round of funding was led by the Chicago-based ARCH Venture Partners, and includes an additional investment from Venrock.

    Aledade will put the funding to work in support of physicians transitioning to outcome-based care across the country. Specifically, according to officials, Aledade will establish new ACOs and expand existing ones; continue building prevention-focused applications and practice-centered software platforms for partner practices; initiate value-based arrangements with commercial health plans; and hire additional team members to help primary care practices deliver better care and better health for patients at lower cost.

    One year after the company’s launch, Aledade has expanded initially from New York, Maryland, Delaware, and Arkansas to include West Virginia, Louisiana, Kansas, Mississippi, and Florida. The company is on course to triple the number of covered Medicare beneficiaries in Aledade ACOs from approximately 25,000 last year, to more than 75,000 in over 100 physician practices by the end of 2015, it says.

    “There is a revolution happening in healthcare, and we are finding that doctors across the country are ready to embrace this change, but need a partner to help them get there. Aledade is that partner,” Mostashari said in a statement. “We’re helping independent physicians achieve better outcomes for their patients—and be compensated for it. The demand for our services has been overwhelming. This funding will help us reach more doctors, and continue to provide them an expanding array of services to better run their business and care for their patients,” he said.

  • 08 Jun 2015 3:27 PM | Deleted user

    Aims for one file per person, fewer errors

    By Priyanka Dayal McCluskey GLOBE STAFF  JUNE 01, 2015

    After two years as an intensive care nurse at Brigham and Women’s Hospital, Aqua Bang will no longer need to carry a pen and binder to record the vital signs of her patients. Instead, that information will instantly flow from bedside monitors to each patient’s computerized health record, part of a massive information technology system launched over the weekend by Partners HealthCare.

    The new system will eventually house millions of patient records across a network of 10 hospitals and 6,000 doctors. It comes with a $1.2 billion price tag, the single biggest investment Partners has ever made — nearly twice what it cost to build the massive Lunder Building at Massachusetts General Hospital in 2011.

    While it’s a big shift for employees, the new system will initially change little about what patients experience at the hospital. Eventually, however, it will allow patients better online access to their medical information. And it has the potential to reduce medical errors. Instead of a separate record at every Partners facility, a patient will have one record throughout the Partners system, so information is more readily shared among doctors.

    The investment is part of a gamble by Partners and the US health care system that spending vast amounts on information technology will pay off in better health care at lower costs. Hospitals across the country are investing billions of dollars in electronic medical records systems, pushed by the Obama administration and insurers, which are adopting payment systems that require careful coordination of medical services.

    The costs of the technology upgrades will eventually get passed on to consumers through health insurance premiums, and to taxpayers, who subsidize Medicare and Medicaid, the government health care programs for the elderly and poor, said Dr. Paul Hattis, a professor at Tufts University School of Medicine and member of the state’s Health Policy Commission, which monitors medical costs.

    “We will ultimately all pay for it,” Hattis said. “Will we get dividends back in terms of better care and greater efficiencies? We don’t know yet.”

    Eventually, the new system will allow patients better online access to their own medical information.

    Other Massachusetts hospitals have recently adopted similar systems, although Partners’ is far bigger, given the network’s greater size.

    Partners’ new technology will replace a patchwork of dozens of software programs used by different hospitals, departments, and clinics in the Partners network. The potpourri of software has made it difficult for doctors in one Partners facility to consult information about their patients’ visits to other Partners facilities. Even critical information like allergies to medications can be easy to miss.

    Partners officials promise the new system will give doctors, nurses, and clinical staff anywhere in the network easy access to the most up-to-date information about patients.

    Partners also is building a Web portal to allow patients to check their medical information, schedule appointments, and interact with caregivers in ways, such as through questionnaires, that weren’t possible with older systems.

    “It’s right for people to think, ‘Is this the way we should spend our health care dollars?’?” said Dr. Gregg S. Meyer, chief clinical officer at Partners.

    The launch this weekend, which hospital officials dubbed “the big bang,” included the Brigham, Partners’ Faulkner Hospital campus, its clinical partner, Dana-Farber Cancer Institute, and Partners’ home care division. The new technology will be rolled out to the rest of the Partners network, the state’s largest, through 2017. It is scheduled to be launched at Massachusetts General Hospital next April.

    The system, developed by Epic Systems Corp. of Verona, Wis., has been three years in the making. It has grown in scope to cost double the initial estimate of $600 million. Partners hired 600 new employees and hundreds of consultants to work with Epic to build the system and then train thousands of doctors, nurses, physician assistants, and other workers to use it.

    “At the core of all of this is patient safety,” said Dr. Ron M. Walls, the Brigham’s chief operating officer.

    The system, which has been dubbed Partners eCare, will send doctors alerts when a patient needs an immunization, a colonoscopy, or a test. It also will allow doctors to more easily analyze patient data.

    Dana-Farber, for example, can start monitoring how patients respond to a certain chemotherapy drug to help determine who should receive that drug in the future.

    Developing the system also included building firewalls and other security features to protect data from cybercriminals hunting for private information, Partners officials said.

    Dana-Farber and the Brigham beefed up staff over the weekend to help clinicians navigating the system for the first time. More than 1,500 extra staff were on hand, including doctors, nurses, technology specialists, and a variety of temporary workers.

    About 450 software specialists spent the weekend at computer screens in a sprawling makeshift command center at Dana-Farber, fielding a steady stream of calls from employees running into problems. Most of the issues were minor and expected, including problems logging into workstations and printing documents, hospital officials said.

    Bang struggled a bit to find her way through the system as she grappled with the small issues of learning new software, such as finding the right buttons to click. When she got confused, she flagged down one of the support staff patrolling her unit.

    “This morning I felt a little disconnected,” she said, “but I think when I get used to it, it’ll become second nature.”

    The Brigham, anticipating that staff will need time to get used to the system, reduced the number of patient appointments for the next several days, a change that will cost the hospital about $15 million in lost revenue.

    Lahey Health of Burlington is spending $160 million to install its new Epic health records system, launched in March. Boston Medical Center has also installed Epic, at a cost of $100 million, moving patients to the new system over the past year. Both BMC and Lahey are much smaller than Partners.

    Another Boston health system, Beth Israel Deaconess Medical Center, has opted not to buy a single health records management system for its network. Instead, it created a function that allows different systems to share information with the click of what the chief information officer, Dr. John D. Halamka, calls the “magic button.” That approach is far less expensive, he said, noting, “We have been able to do it with the budget we have.”

  • 08 Jun 2015 1:33 PM | Deleted user

    Retrieved from
    Bob Herman with Virgil Dickson   |   June 4, 2015

    More flexibility is coming for Medicare accountable care organizations under a final rule the CMS published Thursday (PDF). The revisions are intended to strike a balance between maintaining the program's rigor and making sure providers continue to participate. 

    The Medicare Shared Savings Program will offer a new track to take on more financial risk of patient care, and it will allow Medicare ACOs to avoid penalties beyond the initial three-year term. The CMS will also issue future guidance on benchmarking and rebasing issues that have been sources of contention for many providers.

    The Affordable Care Act catalyzed the creation of Medicare ACOs, which are networks of hospitals and physicians that aim to improve the quality and lower the cost of care for Medicare beneficiaries in a defined area. More than 400 ACOs participate in Medicare accountable care contracts, and they care for more than 7 million beneficiaries.

    The CMS received 275 comments from concerned stakeholders, and the agency expects 90% of Medicare Shared Savings ACOs will stay with the program because of the rule changes. 

    Hospitals and physicians have been able to choose between two tracks for shared savings for ACOs, and the CMS is finalizing the third option it proposed in December. The third track is “very much modeled” after the Pioneer ACO, CMS Deputy Administrator Sean Cavanaugh said. And it also shares many similarities with the Next Generation ACO model that the CMS proposed in March.

    Providers opting into track three will take on more financial risk, but could also share in potentially higher savings. The CMS said upside and downside risk for this model will be 75%—meaning an ACO's bonus or penalty would be 75% of its savings or loss— just as it proposed in December. ACOs in track three are also given a fixed population of beneficiaries to care for.

    Cavanaugh said a number of healthcare organizations around the country “will find this attractive.” But it's more important for the agency to offer a variety of options that meet a provider's tolerance for taking on financial risk and maintaining high quality, he said.

    The first track of Shared Savings ACOs, considered the safest, originally called for providers to receive rewards for hitting cost and quality targets for three years. Thereafter, they would be responsible for both rewards and penalties, called two-sided risk. However, the CMS finalized its earlier proposal, allowing ACOs to enter another three-year period in which they can avoid financial penalties. 

    Allowing no risk, “is a very strong message from CMS and the administration that they are committed to the long-term viability of the program,” said Jeffrey Spight, president of Collaborative Health Systems (CHS), a division of health insurer Universal American that operates about two dozen ACOs with Medicare shared savings contracts. Universal American previously had an even bigger presence in the program but dropped out of them in several markets. 

    The ACOs must be “in good standing with the program” and have high quality scores for beneficiaries. The CMS emphasized that two-sided risk is the future of the program despite this extension.

    “There's a reality that shifting from fee-for-service to accountable-care models takes time,” said Dr. Patrick Conway, the CMS' chief medical officer. “That is a long-term transition and can certainly take more than three years. We're really trying to meet providers where they are.”

    Later this year in a separate rule, the CMS also will readjust its methodology for what it calls benchmarking and rebasing. Several ACOs, particularly Pioneers, have said they faced significant penalties even though they had high quality scores and saved Medicare money. Regional payment differences and historically low Medicare per-beneficiary costs have not given them much room to share in savings.

    A newer methodology would account for regional trends and future savings “rather than solely ACOs' own recent spending,” the CMS said.

    The CMS made it clear in the rule that the ACO program is a separate, distinct option from traditional fee-for-service Medicare and the capitated Medicare Advantage program even though ACOs incorporate elements of both. Unlike Medicare Advantage, people enrolled in a Medicare ACO still have their full traditional Medicare benefits and can see any Medicare provider, not just those within the ACO.

    “While we frequently relied on our experience in other Medicare programs, including Medicare Advantage, to help develop program requirements and design elements for the Shared Savings Program … the intent of this program is not to recreate or replace Medicare Advantage,” the CMS said.

    HHS Secretary Sylvia Mathews Burwell set a goal in January to tie 30% of all traditional Medicare payments to alternative payment models such as ACOs and bundled payments by the end of 2016. That goal increases to 50% by the end of 2018. Adjusting ACO rules to be more accommodating to providers was viewed as necessary to the government's plan.

    “ACOs are a critical part of meeting those alternative payment model goals, and we think this rule further lays the groundwork so that we'll be able to reach those goals,” Conway said.

  • 08 Jun 2015 1:04 PM | Deleted user

    Boston Business Journal   |   Jun 4, 2015   |   Jessica Bartlett

    UMass Memorial Health Care and CareWell Urgent Care hope to integrate further beyond an affiliation, CEOs from both companies said today.

    The multi-site health system and the urgent care clinic announced their affiliation on Thursday, with plans to develop three integrated CareWell locations in Worcester and Northborough.

    But beyond Carewell using UMass staff and sharing the medical information of its patients with the health system, the two institutions hope to financially link the organizations in the future.

    “We are working on the partnership and what it look like in the long term,” said UMass Memorial CEO Dr. Eric Dickson in an interview. “The strong affiliation exists as the starting point, and will likely grow into something more concrete. I think that a tighter financial link in the future is definitely possible between us.”

    According to Shaun Ginter, president and CEO of CareWell, it’s a mutual goal. In the short-term, CareWell will pay for the expansion into three locations, two of which in Worcester are expected to open on July 15.

    The expansion is part of larger plans for both organizations. CareWell is also adding a second location in Cambridge in addition to the three through the UMass affiliation, bringing the total number of locations in the state from nine to 13.

    The organization hopes to open another two to three locations this year, and said that it is constantly talking with other health systems about affiliations. CareWell also has an affiliation with Lahey Health.

    “Proper affiliations for urgent care can help coordinate care and help integrate with the local community,” Ginter said.

    For UMass Memorial, the plan is part of a larger mission by the organization to develop a broader range of services for its patients.

    The health system has been looking for ways to offer broader access to care at lower price points, as health systems move away from getting paid for each service rendered, and more to being paid on a budgeted basis for each patient.

    In addition to allowing UMass doctors not to duplicate X-rays and other diagnostics when seeing patients for follow up care, the integration will also allow primary care doctors to refer patients to an urgent care center, rather than to an expensive emergency room.

    “We have to be thinking like we’re managing the health of the population and the total cost (of each patient),” Dickson said. “It might take some ER volume and move it to a lower cost setting. In the past, that would be financially bad. But the future of medicine, being able to do that, (is) financially good. It might not be that way today for us, but we’re looking to the future as we’ll be taking on more risk.”

    UMass is also looking to create an ambulatory surgery center to do outpatient surgeries outside of the big hospital.

    "This is one piece of a bigger extension of services that are planned, so that we can meet all of the needs of our patients," Dickson said.

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