U.S. lags behind in healthcare innovation, Sebelius says

By Jessica Zigmond 

Posted: February 27, 2014 – 3:45 pm ET

Tags: Advisory Board Co.American Recovery and Reinvestment ActCommunityHospitalsKathleen SebeliusMedicarePublic Health

http://www.modernhealthcare.com/article/20140227/NEWS/301019759/u-s-lags-behind-in-healthcare-innovation-sebelius-says?AllowView=VXQ0UnpwZTVDUGFaL1IzSkUvSHRlRU9vajAwZERlTlU=&utm_campaign=am

The federal government’s top health official Thursday gave U.S. healthcare innovation a grade of Incomplete.

“That’s really the great dichotomy of the time we’re living in,” HHS Secretary Kathleen Sebelius said. “We live in a 21st century world with a 20th century delivery system. We live in a world in which the National Cancer Institute is texting teens to convince them to quit smoking, but ask any parent how easy it is to get their kid’s immunization report from the doctor’s office.”

Although new health innovations, discoveries and technologies are allowing Americans to live longer, healthier lives, the processes of patient experience—such as how patients manage their health, how they choose a physician and how doctors work together to create a treatment plan—have not always kept pace with new medicines, vaccines and procedures, Sebelius said in addressing attendees at the Care Innovation Summit put on by the Aspen Institute and Advisory Board Co.

The answer, Sebelius suggested, is twofold: Unlock and release the information that drives innovation; and align payment for care in a way that pays for better outcomes and innovations, rather than for more operations and hospital readmissions.

And the federal government can help by unlocking some of this information. HHS has been doing that in part through the Hospital Compare website, which allows patients to compare categories such as patient experience, average wait times and whether a hospital has medical imaging capabilities, Sebelius said.

HHS for years has collected data in a wide variety of areas, such as public healthMedicare, clinical trials and spending. But often that information was either difficult or even impossible to access, either because it was hidden behind walls that would require huge sums of money to access, or because the data were published in formats that were indecipherable, she acknowledged. In other words, Sebelius said, it was “lazy” data that had potentially valuable information.

Now, HHS is working to make that “active” data. Just recently, the department had its 1,000th data set released on HealthData.gov. In the past, Sebelius said, that information would have been available only to scientists and researchers who were willing to pay for it.

“What we’re finding is if we make data open and accessible, the private and nonprofit sectors use it to start innovating,” she said.

Sebelius shared a few success stories of healthcare providers who have seen significant changes through the use of electronic health records, including one physician in the small town of Plainville, Kan., who transferred her patient records to EHRs. After she did, she was surprised to learn that only 43% of patients in her practice over the age of 50 for whom colon cancer screenings were recommended were actually getting tested. The physician created a system in which she was notified if a patient didn’t follow through. In a year and a half, that number rose to 89%, and she is working toward 100%.

“Nationally there has been tremendous progress in the last five years from quills and clipboards to computers and keyboards,” Sebelius said. “When President Obama took office in 2009, 1 in 8 hospitals were using any kind of basic electronic record. By 2012, that number had tripled,” she said, adding that the number of doctors using EHRs is now more than 50% and on the rise.

These changes are due in large part to incentives included in the American Recovery and Reinvestment Act, she said, and emphasized that with those incentives also came the national protocols to become a meaningful user.

Looking ahead, Sebelius challenged members of the health reform community to agree that from now on, “We’ll look at innovation that is something that is happening for us and with us and by us,” she said, “rather than something happening to us.”

Follow Jessica Zigmond on Twitter: @MHjzigmond

Advertisements

Obesity rates for some children nearly halved since 2003, CDC study shows

By Steven Ross Johnson 

http://www.modernhealthcare.com/article/20140225/blog/302259992?AllowView=VXQ0UnpwZTVDUGFiL1RIZ0s4WHRlRU9yalVrZEErOWY=

A glimmer of hope in the fight against childhood obesityemerged Tuesday with the release of a new government study.

The obesity rate for children between ages 2 and 5 fell to 8% in 2012 from 14% in 2003, according to the study from theCenters for Disease Control and Prevention.

Despite the improvement within that specific age group, the study, published online Tuesday in the Journal of the American Medical Association, found no significant change in the rate of obesity among American adults and youth overall. Approximately 35% of adults ages 20 and over were obese in 2012 with a body mass index at or above 30, which represented a 3 percentage point increase from the obesity rate in 2003 when it was at 32%, but a 1 percentage point decrease from the rate in 2009. A similar trend was found among young people between the ages of 2 and 19 years old, where 16.9% were found to be obese in 2012; a figure that has remained relatively unchanged compared with the rate in 2003.

“Although overall we didn’t see any signs of significant change of obesity in youth and adults, there was some good news in that we saw a decrease within young children,” said study author Cynthia Ogden, an epidemiologist at the CDC’s National Center for Health Statistics. “This is the first time since we’ve been tracking obesity that we’ve seen a decrease in any (age) group, so I think there’s a small glimmer of hope there, but we still have a long way to go.”

The study did not provide a reason for the decline. The cause was most likely the result of a comprehensive set of efforts geared toward reducing the obesity rate among young children, according to Dr. Risa Lavizzo-Mourey, president and CEO of the Robert Wood Johnson Foundation.

“I think these comprehensive approaches that provide healthier environments where kids live and learn are the ones that seem to be most promising,” Lavizzo-Mourey said.

Increases in the promotion of healthier eating and more physical activity also have played a role, Lavizzo-Mourey noted.

“We continue to see signs that, for some children in this country, the scales are tipping,” said CDC Director Dr. Tom Frieden in a written statement. “This confirms that, at least for kids, we can turn the tide and begin to reverse the obesity epidemic.”

Today’s figures come on the heels of a CDC study released last year that found that from 2008 to 2011, the obesity rate decreased slightly among low-income children between the ages of 2 and 4 years old in 19 states.

The findings drew praise from first lady Michelle Obama, who on Tuesday announced the Obama administration would propose new guidelines for school wellness policies that include prohibiting promotion of unhealthy food and beverages at public schools, and require parents and community member to get involved in those policies. Childhood obesity has been Mrs. Obama’s signature issue for the past several years. She began developing her “Let’s Move!” campaign in 2010.

“I am thrilled at the progress we’ve made over the last few years in obesity rates among our youngest Americans,” Mrs. Obama said in a written statement. “With the participation of kids, parents and communities in ‘Let’s Move!’ these last four years, healthier habits are beginning to become the new norm.”

Follow Steven Ross Johnson on Twitter: @MHSjohnson

 

Kaiser poll: Americans divided, uninformed on Obamacare

By Paul Demko

http://www.modernhealthcare.com/article/20140226/NEWS/302269951?AllowView=VDl3UXk1TzdDUEtCbkJiYkY0M3hlMEdyaVVVZEQrYz0=&utm_source=link-20140226-NEWS-302269951&utm_medium=email&utm_campaign=mpdaily&utm_name=top

Posted: February 26, 2014 – 12:01 am ET

Tags: Barack ObamaHealthcare ReformInsurance ExchangesInsuranceKaiser Family Foundation

 

Just over half of Americans would prefer to pay more for a health plan that covers a broad network of doctors and hospitals, while 37% would prefer a cheaper plan offering a narrower network, according to a survey released Wednesday by the Kaiser Family Foundation.

But the picture is very different for individuals who currently lack health coverage or who purchase coverage on the individual market, which are the groups most expected to shop for health plans through the Obamacare insurance exchanges. Of those respondents, 54% said they preferred a cheaper, narrower network, while just 35% opted for a more expensive plan with a broader provider network.

The issue of narrow networks and whether they’re a reasonable tradeoff for lower premiums has proved contentious in the implementation stage of the Patient Protection and Affordable Care Act. Moves by insurers to tighten their networks have sparked lawsuits from doctors in New York and Connecticut, and prompted legislative proposals in many states.

The Kaiser poll also found that the federal healthcare law remains broadly unpopular. Nearly half of respondents indicated that they hold an unfavorable opinion of the law, while just 35% expressed a favorable view of it. Less than one-fifth of those surveyed indicated that they had personally benefited from the ACA.

Those numbers are largely unchanged in recent months. Since Kaiser began its monthly tracking poll in April 2010, support for President Barack Obama’s signature legislative accomplishment has reached the 50% threshold only once.

Still, 56% of the Kaiser respondents in the most recent survey said they believe the law should remain in place. By contrast, less than a third said they want it to be repealed.

Americans remain largely ignorant of the legislation’s most significant provisions, according to the survey. Over half of respondents indicated that they had little or no knowledge of the state and federal exchanges established under the law. In addition, less than a quarter of respondents were aware that the deadline for individuals to acquire coverage, or potentially incur a fine, is the end of March.

The Kaiser poll surveyed 1,501 adults nationwide between Feb. 11 and 17. The survey had a margin of error of plus or minus 3 percentage points.

Follow Paul Demko on Twitter: @MHpdemko

 

Medicaid patients have longer lengths of stay for treatment of heart failure, shows study

Published on February 24, 2014 at 1:34 AM · No Comments

Source Link:  http://www.news-medical.net/news/20140224/Medicaid-patients-have-longer-lengths-of-stay-for-treatment-of-heart-failure-shows-study.aspx

Heart failure accounts for 6.5 million hospital days a year, and a new study reported in the Journal for Healthcare Quality showed that Medicaid patients and those with comorbid illnesses have longer lengths of stay for treatment of heart failure. The Journal of Healthcare Quality is the peer-reviewed publication of the National Association for Healthcare Quality (NAHQ, www.nahq.org).

Medicare and Medicaid reimbursements will be reduced under provisions of the Affordable Care Act for hospitalized conditions such as heart failure, so it is imperative for hospitals to consider how cost reductions may influence the quality of care for vulnerable populations. Researchers at Ohio State University and the University of North Carolina analyzed heart failure length of stay data from the Atherosclerosis Risk in Communities cohort from 1987 to 2005. They evaluated 1,300 patients with incident hospitalized heart failure and investigated the association of socioeconomic status with length of stay.

Results showed that patients living in lower socioeconomic areas did not have longer lengths of stay than patients with higher socioeconomic status. Instead, the study showed that Medicaid patients and individuals with comorbid illnesses had longer stays than other heart-failure patients. The authors concluded that receipt of Medicaid and presence of comorbid illnesses are associated with a greater burden of illness, which usually dictates longer hospital stays to assure patients are well enough for discharge.

Source: National Association for Healthcare Quality

As Deadline Nears, State Insurance Exchanges Still A Mixed Bag

February 21, 2014 3:35 AM

With a bit more than a month left for people to sign up for health insurance plans set up under the Affordable Care Act, the federal website known as HealthCare.gov finally seems to be working smoothly — in 36 states.

But what’s happening in the 14 states that are running their own exchanges?

Some are doing quite well, thank you. California, for example, said Wednesday that enrollment has already exceeded its projection for the entire enrollment period, which ends March 31.

Other states, however, are having trouble, some of it severe.

Oregon, for example, has only just gotten its website up and running this week, and it’s still not fully open to the public. Until now, Oregon had been using paper applications.

So what makes a state health exchange successful? Joel Ario, who helped launch the exchange program for the federal government and now consults for states and others working to implement the health law, says the states doing best are generally the ones doing the least — at least when it comes to their websites.

“The states that said, ‘This is complicated, we’re going to focus on the most essential issues,’ those were the states that tended to do better,” he says.

Among places in that category, according to Ario, are not just California, but also Kentucky, New York and Connecticut.

In contrast, Ario says, many of the states that are now struggling may simply have overreached.

“Unfortunately states that I once touted as the leaders — Maryland, Oregon, Minnesota,” are among those bringing up the rear, he acknowledges. “This is a complicated undertaking, and so people who tried to do too much in [the first year], I think, had some problems with that.”

Maryland and Minnesota haven’t had the same problems as Oregon, but their websites have both been worked only intermittently, and enrollment has lagged. Just as with the federal website, part of the problem has been on the information technology side.

“We’ve seen in some states that some vendors have not been able to deliver, and states have struggled with the IT implementation,” said Heather Howard, who advises states for the Robert Wood Johnson Foundation.

In Maryland, fixing the exchange has been complicated by the fact that two of its IT vendors are suing each other. Massachusetts and Vermont have both had issues with CGI, the vendor that was found responsible for most of the messy rollout of the federal site,HealthCare.gov.

But experts say blame for failure — and credit for success — doesn’t all belong to the outside IT contractors. It’s also due in large measure to how well those contractors worked with state officials. Audrey Haynes oversees Kentucky’s largely successful exchange, Kynect. She says one key to making it work was putting the exchange in the same department that runs Medicaid.

“Anyone knows that Medicaid has to have a pretty super IT department that supports it,” she said at a recent event sponsored by the Robert Wood Johnson Foundation. “So we have a lot of experience … at bringing up large IT structures.”

And where do state exchanges go from here? Republican members of Congress from Marylandand Oregon are asking the federal government to investigate the limping exchanges in those states. That’s because both received millions of federal dollars to set up their health insurance marketplaces.

In principle, says consultant Joel Ario, figuring out what went wrong is not a bad idea. “I certainly think we want to look carefully at what happened and learn some lessons here. I don’t think anybody’s going to find any improprieties here, because they’re going to think it was all well-intentioned activity.”

And in the long run, once the states that are lagging work out their IT problems, they will probably end up, much like California, doing better than the states being run by the federal government. Heather Howard says that’s because states running their own exchanges also have more resources for consumer outreach.

“They have consumer assistance infrastructure, grants out to community-based organizations, and they’re building and doing a lot more marketing,” Howard says. “And their consumers are hearing much more about the options.”

All of which merely underscores something important about the health law that hasn’t changed: What’s available to you depends very much on where you live.

The Affordable Care Act Ensures Former Foster Youth Receive Critical Health Coverage Until Age 26

Children Now Launches Campaign to Promote Awareness and Increase Enrollment of Former Foster Youth in Medi-Cal

February 19, 2014

Source Link:  http://www.fortmilltimes.com/2014/02/19/3297938/the-affordable-care-act-ensures.html

OAKLAND, CALIF. — Children Now today announced the launch of Coveredtil26, a statewide outreach campaign to ensure all former foster youth living in California know they are now eligible for Medi-Cal coverage until age 26. Previously, Medi-Cal coverage for former foster youth ended at age 21.

Although the Affordable Care Act provision extending health coverage to former foster youth took full effect on January 1, 2014, the majority of young adults who benefit from this new provision are not yet aware of this exciting opportunity. The Coveredtil26 campaign provides advocates, youth, and stakeholders with the necessary tools to learn about this new benefit and navigate enrollment barriers.

Each year, over 20,000 youth age out of the foster care system in the United States. In California alone, between 2,700 and 5,000 youth age out of foster care every year. These vulnerable youth too often lack adequate supports to make the transition to adulthood successfully. For example, they are much less likely than their peers to have health insurance, but tend to have more health care needs due to trauma experienced during childhood.

“The Affordable Care Act’s extension of health coverage to age 26 fills a critical need for former foster youth who do not have the same option as their peers to stay on a parent’s insurance plan,” said Ted Lempert, President of Children Now. “However, it’s imperative that state and county agencies work together to ensure the processes for enrolling in coverage are easy to navigate for this vulnerable population.”

Children Now is working closely with the Department of Health Care Services, county social service agencies, and the County Welfare Directors Association (CWDA) to simplify enrollment processes for former foster youth and educate enrollment workers about this important ACA provision.

“Making sure that former foster youth can get the health care services they need and deserve is a high priority for the state,” said Anastasia Dodson, associate director of the California Department of Health Care Services, which oversees the Medi-Cal program. “We are committed to work with our county partners, other state agencies, and advocates to ensure that these youth can promptly and easily enroll in Medi-Cal coverage.”

Currently, the best way for former foster youth to enroll in coverage is to apply directly through a county social service agency office using a simple one-page form.

“Providing Medi-Cal coverage up to age 26 is one more way we recognize that many former foster youth who are transitioning into adulthood need continued support, including access to health care,” said Frank Mecca, CWDA Executive Director. “This is a great change, and our county social service agencies are diligently working to ensure eligible youth do not miss out on this opportunity.”

Former foster youth qualify for Medi-Cal coverage until age 26 if they:

 

  • Were in foster care in any state at age 18 or older,
  • Are younger than 26 years old, and
  • Live in California now.

 

Youth are eligible for Medi-Cal coverage regardless of income. Because there is no open enrollment period for Medi-Cal, former foster youth can apply any time of the year.

For more information on the extension of Medi-Cal coverage for former foster youth and the Coveredtil26 campaign visit www.coveredtil26.org.

Children Now is the leading, nonpartisan, umbrella research, policy development, and advocacy organization dedicated to promoting children’s health and education in California and creating national media policies that support child development. The organization also leads The Children’s Movement of California.

The Coveredtil26 campaign is funded by a grant from The California Wellness Foundation (TCWF). Created in 1992 as a private independent foundation, TCWF’s mission is to improve the health of the people of California by making grants for health promotion, wellness education, and disease prevention.

California Health Insurance Enrollments Rise, but Hispanics Still Lag

By IAN LOVETT

FEB. 19, 2014

Source Link: http://www.nytimes.com/2014/02/20/us/california-health-insurance-enrollments-rise-but-hispanics-still-lag.html?partner=rss&emc=rss&_r=0

LOS ANGELES — With six weeks left in the open enrollment period for insurance under President Obama’s health care law, more than 828,000 Californians have signed up for private coverage through the state’s online health care exchange, state officials announced Wednesday.

Home to about 15 percent of the nation’s uninsured, California accounted for more than 20 percent of the 3.3 million people who enrolled in plans nationwide under the new law, the Affordable Care Act, during the first four months of open enrollment. About a quarter of the state’s enrollees have been young adults, ages 18 to 34, on par with national rates.

Still, enrollment has lagged among California’s Latinos, who make up more than half of the state’s uninsured population, according to estimates by the California Health Care Almanac. Covered California, the state-run online marketplace for health insurance, did not offer applications in Spanish until the end of December, and a Spanish-language site was dogged by translation errors — just one of a string of problems with the exchange’s website.

Through the end of January, only 21 percent of the people who had enrolled identified themselves as Latino, up slightly from 18 percent at the end of 2013, according to the data released Wednesday.

Latinos in California signed up at a slightly faster rate in January, but Peter Lee, the executive director of Covered California, said the exchange still needed to improve on Latinos’ enrollment. With six weeks left of open enrollment, Covered California has begun an aggressive campaign to beef up Latino enrollment.

“From absolutely Day 1, Latino enrollment has been probably the No. 1 priority of Covered California.” Mr. Lee said. “Have we executed perfectly? No. We’re getting better as we go, and we’re seeing results right now.”

The health care exchange plans to spend $8.2 million on Spanish-language media during the first three months of this year — more than twice what was spent from October through December. In addition, more than 4,000 Spanish-speaking enrollment counselors and insurance agents have been certified in the state.

“The key element is really promoting in-person enrollment,” Mr. Lee said, adding that the state now had “an extensive ground game in place,” referring to the enrollment counselors.

The exchange had also seen a modest uptick in sign-ups among young adults, whose enrollment is considered essential to keeping insurance premiums down because they are usually healthier and need fewer costly medical services. Mr. Lee also said he expected enrollment among young people to pick up as the March 31 deadline drew nearer.

“We are constantly doing focus groups, and a lot of guys and gals are saying they’re going to wait until the 31st to sign up,” he said. “Waiting until the last minute is certainly not preferred, but it’s not unusual.”

In addition to those who signed up for Covered California health plans, nearly 900,000 people had been deemed eligible for the state’s expandedMedicaid program, known as Medi-Cal.

More than 85 percent of enrollees in Covered California plans through January were eligible for subsidies, but Covered California did not have statistics on how many of the enrollees previously had no health coverage. About 80 percent of those who had signed up for coverage had paid their first month’s premium.

http://www.nytimes.com/2014/02/20/us/california-health-insurance-enrollments-rise-but-hispanics-still-lag.html?partner=rss&emc=rss&_r=0

Outlook 2014: Affordable Care Act changes business for area health insurers and hospitals

By Shira Schoenberg, The Republican 
Follow on Twitter
on February 09, 2014 at 5:00 AM, updated February 09, 2014 at 5:10 AM

Source link: http://www.masslive.com/politics/index.ssf/2014/02/outlook_2014_affordable_care_a.html

For Massachusetts health insurers and providers, the Affordable Care Act in 2014 is about both the big picture and the little details.

In Massachusetts, unlike in some other states, the Affordable Care Act is not fundamentally changing the way health care is provided and paid for. Massachusetts already had near-universal health insurance coverage and is moving in the direction of containing costs. But the national law still requires changes. Some are in advancing concepts such as more coordinated and integrated care, pushed by new payment models in Medicare. Others are in small regulatory details, for example laws requiring insurers to fit their plans into federal categories.

“Fundamentally, we did not have to change our business model, mostly because we had the preexisting health reform program here in Massachusetts, on which the federal law was based,” said Bruce Bullen, chief operating officer of Blue Cross Blue Shield of Massachusetts. At the same time, he said, “I think people were surprised at the extent of the change that was needed to reconcile the actual rules of the federal system and the local system.”

Several insurers said the biggest changes were technical. For example, insurers had to fit all their products into four categories, based on their actuarial value, referred to as “metallic tiers.” (The actuarial value reflects the percentage of a person’s health costs the insurer is expected to pay.) That makes it easier for shoppers to compare insurance plans since a “bronze level” plan from Blue Cross Blue Shield must be comparable to a bronze plan by Health New England.

The result, as Bullen described it, was “everybody had a new price and everybody had a new product.”

Dave Przesiek, chief sales and marketing officer for Fallon Community Health Plan, said in the long-term, the change will probably help consumers and business owners choose plans because there will be more uniformity. In the short term, the company had to rebuild its entire portfolio of products, making some more robust and some less, and had to communicate that to customers.

There are also several new fees the Affordable Care Act imposes on insurers, which will be added to the cost of plans. Jim Kessler, vice president and general counsel at Health New England, said these add less than 5 percent to the cost of a Health New England plan.

The Affordable Care Act also changes the number of “ratings factors” – things like age or participation in a wellness plan – that insurers can use to calculate the price of premiums. This will result in lower prices for some individuals and small businesses andhigher prices for others.

One change for businesses is that the Affordable Care Act will require employers to provide “affordable” coverage, meaning it costs less than 9.5 percent of their employees’ household income. So some employers are looking for cheaper plans, including plans that limit which doctors a person can see or require patients to pay a higher deductible when they go to a more expensive hospital.

“That’s one component we’re starting to get more interest in,” Przesiek said. “Employers are saying ‘I’m concerned about the 9.5 percent. Do you have a more affordable option?'”

Also in 2014, insurers will have to put the prices of procedures at different hospitals online. Currently, insurers must provide that information by phone.

Kessler said the bottom line is, “We had to do a tremendous amount of work in 2013 to make relatively small changes in a large number of areas so the details of what we do line up with the requirements of the ACA.”

Insurers and providers also had to deal with the problems plaguing the state’s Health Connector website. The problems have resulted in errors in health insurance sign-ups and in enrollment processes that should have been done online automatically instead being done by hand using spreadsheets and multiple computer systems. This affects individuals currently buying coverage through the state’s Commonwealth Care and those signing up for the first time through the exchange for subsidized or unsubsidized plans.

“It’s going to take a lot of work to get all those many thousands of people across the Commonwealth either…re-enrolled and signed up or moved to new plan or new program or new carrier and have their coverage continue without a break,” Kessler said.

On a larger scale, the Affordable Care Act is encouraging providers to change the way care is delivered. Mark Fulco, a spokesman for Mercy Medical Center, said the Affordable Care Act implementation is the culmination of “dramatic change and transformational change that we’ve actually been undertaking for several years.”

Through new Medicare rules, the law provides incentives to move away from a fee for service model of payment toward a method of payment that essentially pays per patient, rewarding doctors who provide less expensive care for equally good outcomes.

The law creates a “Medicare Shared Savings” program, for which hospitals can voluntarily sign up by creating an “accountable care organization.” What that means is a primary care doctor works with a team of doctors to care for a population of Medicare patients. The doctors are paid for that population, rather than for each procedure. If the doctors meet quality standards and provide care below a certain cost, the savings are split between the insurer and the doctors. Although the changes only apply to Medicare, some commercial insurers are moving in the same direction. For example, Blue Cross Blue Shield pays 85 percent of its doctors through a global payment system, which it has been evolving for five years.

“Ten years ago, you were simply paid for hospital admissions and procedures and office visits, and the government or managed care payers didn’t pay an awful lot of attention to the quality of the outcome,” said Dr. Mark Keroack, president and CEO of Baystate Medical Center. “Now there are clear bonuses to be had for delivering exceptional quality and penalties to be incurred if you have below average quality or complications.”

Both Baystate Medical Center and Mercy Medical Center have partnered with other area physicians to create accountable care organizations serving seniors on Medicare. Between Medicare and similar arrangements with commercial insurers, around 60 to 70 percent of primary care patients at Baystate are in a shared savings payment arrangement, Keroack said.

“Baystate has embraced this as a philosophy,” Keroack said. “If we’re going to build this infrastructure, health records, pay case managers, bill different kinds of primary care, we might as well be doing population health for all our patients rather than just a few of them.”

There is also new federal money available through the Affordable Care Act for technology such as electronic medical records. Baystate put in place new electronic medical records both within Baystate Health and connecting to several other medical practices. Mercy Medical Center created a physical hub with a new computer software system that tracks and coordinates a patient’s care as they move through the medical system. It implemented a new electronic medical record system and an online portal where patients can view their own records. Baystate, Mercy Medical Center and Holyoke Medical Center are all connecting to the state’s new health information exchange, which allows for the sharing of medical records among providers, with a patient’s consent.

“We knew that the Affordable Care Act was going to demand improvements in better coordination of care,” Fulco said. “We said we need to implement it. We need to be ahead of the curve.”

Tim Gens, executive vice president of the Massachusetts Hospital Association, said the changes in Massachusetts are not as dramatic as in other states because Massachusetts was already working on reforming its health care system, through its 2006 health care overhaul and subsequent legislation aimed at cutting health care costs.

“The Affordable Care Act in its broad outlines mimics to a great extent what Massachusetts is trying to do,” Gens said. “The Affordable Care Act is reinforcing the path we’re on about more integrated delivery of care and payment for care that’s tied more toward outcomes and taking care of populations. It’s not just about treating people on an episodic basis, but looking at taking care of patients.”

Source link: http://www.masslive.com/politics/index.ssf/2014/02/outlook_2014_affordable_care_a.html