• Need more information on these or other topics? Ask an information specialist at (312) 422-2050 or rc@aha.org

  • Enter your email address to subscribe to this blog and receive notifications of new posts by email.

    Join 330 other followers

  • Share this blog

    Share |
  • Note:

    Information posted in this blog does not necessarily represent the views of the American Hospital Association
  • Archives

  • Categories

  • Top Posts

  • Top Rated Posts

State Telehealth Laws & Reimbursement Policies

The Center for Connected Health Policy, the National Telehealth Policy Resource Center, has released its latest biannual update on state telehealth laws, regulations, and policies, with a primary focus on Medicaid fee-for-service programs. However, managed care/private payer laws are also covered when available.

Telehealth policy trends are briefly summarized from a national perspective, followed by detailed state profiles. Each state profile on telehealth reimbursement includes:

  • Key state agencies/organizations
  • State policy overview
  • Definitions
  • Live video, store-and-forward, and remote patient monitoring
  • Eligible providers, sites, geographic limits, facility/transmission fees, services/specialties
  • Consent
  • Professional regulation/health and safety, including cross-state licensing and online prescribing

States vary considerably on telehealth policies. Overall, the report noted live video Medicaid reimbursement is far more prevalent than reimbursement for store-and-forward and remote patient monitoring. Other trends noted for some states are specific documentation and/or privacy and security guidelines; the addition of home and schools as eligible originating sites; and the inclusion of teledentristy and substance abuse services as qualifying specialties.

State telehealth laws & reimbursement policies; a comprehensive scan of the 50 states & the District of Columbia. Center for Connected Health Policy, Spring 2019. https://www.cchpca.org/sites/default/files/2019-05/cchp_report_MASTER_spring_2019_FINAL.pdf

Posted by AHA Resource Center (312) 422-2050, rc@aha.org

MOBILE DEVICES: How wearable technology will change cancer care

The advances in the development of wearable and remote monitoring devices are growing exponentially.”

Monitoring symptoms of cancer patients and their participation with oncologist-recommended physical activity are two potential uses of wearable devices, according to this literature review by the authors – physicians affiliated with the MD Anderson Cancer Center, the Mayo Clinic and other institutions.  Among the challenges related to the collection of data from these devices is how to manage and store the large amounts of information involved.

Source: Liao, Y., Thompson, C., Peterson, S., Mandrola, J., and Beg, M.S. (2019, January). The future of wearable technologies and remote monitoring in health care. American Society of Clinical Oncology Educational Book, 39, 115-121.  Click here for abstract in PubMed: https://www.ncbi.nlm.nih.gov/pubmed/31099626  AHA staff members can access full text using the AHA Document Library via RightFind on Inside AHA.  Posted by AHA Resource Center (312) 422-2050, rc@aha.org

DISRUPTORS: Redesigning patient care in a ‘facilitated self-service’ model – the bot, the nurse, the PCP

Facilitated self-service means consumers can handle most of their needs without help, but some needs require a higher level of service.

How to redesign care at the physician office visit level is discussed in this brief perspective.  In the facilitated self-service model, patients might first encounter a bot for routine check-ups of chronic conditions.  The second level of care would be the nurse and the third level, the physician, if needed.  The authors maintain that this radically different approach would be better than trying to expand the numbers and availability of primary care physicians for routine care.

Source: Asch, D.A., Nicholson, S., and Berger, M.L. (2019, May 16). Toward facilitated self-service in health care.  New England Journal of Medicine, 380(20), 1891-1893.  Click here for full text (you can sign up as a visitor for 3 full text articles per month):  https://www.nejm.org/toc/nejm/medical-journal?query=main_nav_lgPosted by AHA Resource Center (312) 422-2050 rc@aha.org

ROBOTICS: Use in interventional cardiology procedures

…contemporary robot-assisted PCI systems improve operator safety by reducing ionizing radiation exposure and can improve procedural quality and outcomes by offering better accuracy accuracy in stent selection.”

The use of surgical robots for interventional cardiology procedures in the United States is discussed in this review prepared by physicians at the Mayo Clinic.  There is one manufacturer – Corindus Vascular Robotics – and two models.  The equipment is designed to help overcome a significant problem faced by interventional cardiologists, which is exposure to radiation and the need to wear leaded protective garments during procedures.  However, there are barriers which have slowed the adoption of this technology, such as a lack of randomized clinical trials and the price tag for the equipment.

Source: Maor, E., and others. (2017, July). Current and future use of robotic devices to perform percutaneous coronary interventions: A review. Journal of the American Heart Association. 6(7).  Click here: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5586317/pdf/JAH3-6-e006239.pdf  Posted by AHA Resource Center (312) 422-2050, rc@aha.org

Click to access JAH3-6-e006239.pdf

TRANSPARENCY: Should you let patients read their notes?

Advantages and disadvantages of allowing patients to read the notes that physicians and other providers write about their office visits and hospital care are explored in this short Modern Healthcare article.  The movement towards greater transparency of care is explored further on the website OpenNotes.  Here are some of the providers that are exploring this concept.

Who is doing this?

  • Geisinger Health System (Danville, PA)
  • Beth Israel Deaconess Medical Center (Boston)
  • Sutter Medical Foundation (Sacramento, CA)
  • MUSC Health (Charleston, SC)
  • Harborview Medical Center (Seattle)
  • Mayo Clinic
  • Kaiser Permanente Northwest
  • Department of Veterans Affairs
  • UCHealth (Denver)

Sources:  Livingston, S. (2017, Jan. 2). Growing number of doctors allowing patients to read their notes. Modern Healthcare, 47(1), 14-15.  Click here for publisher’s website: http://www.modernhealthcare.com/article/20161231/MAGAZINE/312319982; and, OpenNoteswww.opennotes.org   Posted by AHA Resource Center (312) 422-2050, rc@aha.org

Health Innovations State Law Database

The Health Innovations State Law Database created by the National Conference on State Legislatures is  a resource for identifying over 800 recently enacted state laws and regulations that address health policy innovations related to access, Medicaid, private and commercial insurance markets, the Accountable Care Act and social determinants of health.. The database supports searching by keyword, state, legislative status, bill number, sponsor, and/or these topics:

  • Exchanges and Health Marketplaces
  • Free Market; Challenges and Alternatives
  • Market-Cost Containment
  • Market-Coverage
  • Market-Delivery Reform [includes accountable care]
  • Market-Health Insurance Reforms
  • Market-Mandates and Essential Health Benefits
  • Market-Network Adequacy
  • Market-Other
  • Market-Payment Reforms
  • Market-Price Transparency
  • Medicaid Expansion and Waivers
  • Medicaid Payment Reform
  • Medicaid-General
  • PPACA – ACA-Health Reforms
  • State-Run Programs
  • Telehealth Programs

However, the full-text of the legislation located is restricted to NCLS members.

Source: Health innovations state law database: tracking state laws for health care transformation, 2015-2016. National Conference of State Legislatures, accessed Jan. 27, 2017. http://www.ncsl.org/research/health/health-innovations-database.aspx

Posted by AHA Resource Center, (312) 422-2050, rc@aha.org

World’s 100 Largest Medical Technology Companies

Medical Design & Outsourcing magazine annually publishes its Big 100 list of the world’s leading medical technology companies, ranked by 2014 annual revenue. For each of the ranked companies, information is also included on annual R&D spending and the number of employees.

Topping the Big 100 list are:

  1. Medtronic
  2. Johnson & Johnson
  3. Philips Healthcare
  4. GE Healthcare
  5. Fresenius Medical Care
  6. Siemens Healthcare
  7. Cardinal Health
  8. Beckton, Dickinson and Co.
  9. Baxter International
  10. Stryker Corp.

See the article for further discussion and an explanation of the methodology used to create the list.

Source: Big 100 2016: A look at the world’s 100 largest medtech companies. Medical Design & Outsourcing, Sept. 2016.  http://www.medicaldesignandoutsourcing.com/2016-big-100/

Posted by AHA Resource Center (312) 422-2050 rc@aha.org 

Largest Hospital and Ambulatory Care EHR Vendors

The Office of the National Coordinator for Healthcare Information Technology (ONC) tracks the vendors used by providers that participate in its electronic health record (EHR) incentive program. ONC has released a list of all certified health IT vendors used by providers along with how many hospitals and ambulatory care professionals are using each vendor’s technology.

There were 175 certified health IT vendors supplying technology to 4,474 non-federal acute care participating hospitals as of June 2016. These ten vendors, ranked by the number of hospitals with certified EHR technology, were the largest suppliers:

  1. Cerner Corporation (1,029 hospitals)
  2. MEDITECH (953)
  3. Epic Systems Corporation (869)
  4. Evident (636)
  5. McKesson (462)
  6. MEDHOST (359)
  7. Allscripts  (235)
  8. Sunquest Information Systems (200)
  9. FairWarning Technologies (172)
  10. Iatric Systems (161)

On the ambulatory care side, 632 vendors supplied certified health IT to 337,432 ambulatory primary care physicians, medical and surgical specialists, podiatrists, optometrists, dentists, and chiropractors also participating in the Medicare EHR Incentive Program. These were the top ambulatory care EHR vendors based on the number of participating health care professionals using each vendor’s technology:

  1. Epic Systems Corporation (83,673 professionals)
  2. Allscripts (33,127)
  3. eClinical Works LLC (25,524)
  4. Next Gen Healthcare (19,676)
  5. GE Healthcare (17,704)
  6. Cerner Corporation (15,104)
  7. athenahealth Inc (14,570)
  8. Greenway Health LLC (12,407)
  9. Practice Fusion (8,523)
  10. McKesson (7,347)

Sources:

Hospital EHR vendors: certified health IT vendors and editions reported by hospitals participating in the Medicare EHR Incentive Program. Office of the National Coordinator for Healthcare Information Technology, June 2016. http://dashboard.healthit.gov/quickstats/pages/FIG-Vendors-of-EHRs-to-Participating-Hospitals.php

Health care professional EHR vendors: certified health IT vendors and editions reported by ambulatory health care professionals participating in the Medicare EHR incentive program. Office of the National Coordinator for Healthcare Information Technology, June 2016. http://dashboard.healthit.gov/quickstats/pages/FIG-Vendors-of-EHRs-to-Participating-Professionals.php

Posted by AHA Resource Center (312) 422-2050, rc@aha.org

Top 10 Issues Facing Community Hospital CEOs

Last month the American College of Healthcare Executives released the results of its annual CEO survey on the top concerns confronting community hospitals. The most pressing concerns of the CEOs in 2015 were:

  1. Financial challenges
  2. Patient safety and quality
  3. Governmental mandates
  4. Personnel shortages
  5. Patient satisfaction
  6. Physician-hospital relations
  7. Access to care
  8. Population health management
  9. Technology
  10. Reorganization [mergers, acquisitions, restructuring, partnerships]

Financial challenges has remained the top concern when compared to 2013 and 2014 surveys. Transition from volume to value, Medicaid reimbursement, bad debt, and increasing costs were among the financial challenges most often mentioned. Engaging physicians in improving the culture of safety/quality and in reducing clinically unnecessary tests and procedures were top concerns related to patient safety and quality.

Access to care and reorganization were new to the top 10 list in 2015, and personnel shortages rose to 4th place on the list, up from the 10th spot in 2014.

Source: Top issues confronting hospitals in 2015. American College of Healthcare Executives, Feb. 2, 1016. http://ache.org/pubs/research/ceoissues.cfm [press release: http://ache.org/pubs/Releases/2016/top-issues-confronting-hospitals-2015.cfm]

Posted by AHA Resource Center (312) 422-2050, rc@aha.org

TELEHEALTH: How many telehealth claims? Not many!

In this study, researchers analyzed the claims database of the Health Care Cost Institute – which has commercial data from Aetna, Humana, Kaiser Permanente, and United Healthcare, as well as Medicare Advantage data.  The objective was to look at utilization and reimbursement trends.  The number of telehealth claims submitted by primary care physicians was miniscule – about 6500 out of a total 96 million in the 4-year period studied.  Family physicians were the specialty most likely to submit telehealth claims.

Number of Claims: Primary Care Physicians: US 2009-2013

  •            6,506 telehealth claims
  • 95,900,000 non-telehealth claims

PCPs’ Most Frequent Use of Telehealth to Diagnose (in descending order of frequency)

  • Diabetes
  • Depression
  • Acute sinusitis
  • Biopsy of the lymphatic structure
  • Obstructive sleep apnea

Source: Wilson, F.A., Trout, K., Rampa, S., and others. (2016). An examination of private payer reimbursements to primary care providers for healthcare services using telehealth, United States 2009-2013. Issue Brief [Health Care Cost Institute].  Click here for full text: http://www.healthcostinstitute.org/files/HCCI-Issue-Brief-Examination-of-Private-Payer-Reimbursements.pdf  Posted by AHA Resource Center (312) 422-2050, rc@aha.org