News 1/12/17

Top News

Pensacola Beach, FL-based Green Circle Health will open a new facility in Indiana via a $1 million economic development investment that will help it add 125 jobs over the next five years. Launched in 2013, the healthcare management and wellness company will house its remote healthcare and coaching services at the initially 1,000 square-foot service center. The expansion news comes on the heels of its second-place finish in ONC’s Consumer Health Data Aggregator Challenge. The company developed an app that uses FHIR to import patient data into a family health dashboard that receives and serves up personal and medical device data, remote monitoring, and reminders. The full list of ONC winners, including those of the Provider User Experience Challenge, can be found here.

Webinars

January 18 (Wednesday) 1:00 ET. “Modernizing Quality Improvement Through Clinical Process Measurement.” Sponsored by LogicStream Health. Presenters: Peter Chang, MD, CMIO, Tampa General Hospital; Brita Hansen, MD, CHIO, Hennepin County Medical Center. The presenters will describe how they implemented successful quality governance programs, engaged with their health system stakeholders, and delivered actionable information to clinical leadership and front-line clinicians. Q&A will follow.

January 26 (Thursday) 1:00 ET. “Jump Start Your Care Coordination Program: 6 Strategies for Delivering Efficient, Effective Care.” Sponsored by Healthwise. Presenters: Jim Rogers, RN, RPSGT, director of healthcare solutions, Persistent Systems; Jason Burum, chief client officer, Healthwise. This webinar will explain how to implement a patient-centered care coordination program that will increase quality as well as margins. It will provide real-world examples of how organizations used care coordination to decrease readmission rates, ED visits, and costs.

Announcements and Implementations

MyMedLeads updates its CRM software to include text and voice appointment reminders, patient recall campaigns, and improved targeting and segmentation.

Florida Radiology Leasing renews its RCM agreement with Zotec Partners.

Modernizing Medicine releases the latest version of its EHR for ophthalmologists, which includes the ability to interface with the FlexSys optical inventory and point-of-sale system.

Acquisitions, Funding, Business, and Stock

Walgreens stores will serve as FedEx drop-off and pick-up locations beginning this spring. The companies will expand roll-out of the service to nearly 8,000 stores by the fall of 2018. Walgreens no doubts hopes to garner a few extra purchases from customers stopping by to take care of shipping –  a move similar in nature to its decision to get into the retail clinic business. FedEx cites internal research that shows that “customers rank pharmacies as a preferred location for accessing their e-commerce shipments” (which is news to me) as impetus for its role in the agreement.

This article hints at Nokia’s plans to enter the digital health space. The company, which quit making phones when it sold that part of its business to Microsoft in 2013, will base its digital health business on the Withing assets it acquired last year. Nokia/Withings will undergo an official rebranding at some later date, with the Nokia name taking top spot on Withings devices. “Digital health is one of the biggest IoT verticals that has emerged and is very consistent with Nokia’s vision and assets,” explains Nokia VP of Digital Health (and former Withings CEO) Cedric Hutchings. “[I]t’s about being able to scale with mass-market potential, the capacity to partner with large-scale strategic partnerships.”

People

Shawn Crawford (Central Virginia Family Physicians & MD Resource) joins Privia Medical Group – Southwest Virginia as president.

Telemedicine

TriageLogic launches a direct-to-employer telemedicine service that offers nurse-first consulting. The new Continuwell business, which will be led by CEO Charu Raheja, aims to cut down on the costs associated with initially consulting a physician during virtual encounters. If necessary, the service will connect patients to its licensed physicians, or pass them along to the employer’s preferred telemedicine vendor.

SnapMD adds administrative patient queue management tools to its telemedicine platform.

Government and Politics

In case you were wondering: HHS releases a tip sheet (including advice on dressing for cold temperatures) for those looking to join in the inauguration festivities on January 20. The city will operate 20 medical stations along the parade route. Smithsonian buildings will offer warming stations to the hundreds of thousands of people expected to attend. Fun (but sad) inauguration day fact: President William Henry Harrison delivered the longest inaugural address. The nearly two-hour speech was delivered on a cold and rainy day, likely causing the pneumonia that killed him a month later.

Other

A tip of the hat to HIStalk Practice reader Chip Hart, who turned me on to EY Entrepreneur of the Year – Healthcare winner KidsPlusPediatrics. Pittsburgh-based physicians Todd Wolynn, MD and Albert Wolf, MD entered the contest a total of three times, truly making the third time the charm. They seem genuinely humble in describing their awards-show experience, which took them from a regional to national stage with the likes of Mailchimp and Fitbit. “We’re innovating in a very slow, conservative world of healthcare,” says Wolf. “I didn’t know if they would understand how different we are from other doctors.” I’m hoping to interview them soon about their healthcare technology experiences.

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Jenn, Mr. H, Lorre

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HIStalk Practice Interviews Caraline Coats, Vice President, Provider Engagement, Humana

Caraline Coats is vice president of provider engagement at Humana.

Tell me about yourself and the company.

I am the vice president of Humana’s Development Center of Excellence department. We are largely a team that supports Humana’s enterprise goals around our value-based journey, supporting our physicians and their overall experience as they move from volume to value. My team supports our network and our market leaders on choosing the right physicians – those who make good partners. We want to develop a long-term understanding of what their needs and capabilities are and meet them along the way on our continuum. Humana doesn’t really have a one-size-fits-all. We have different options to meet physician needs depending on their infrastructure, capabilities, and appetite to launch from volume to value. My team serves as the internal operations support for our value-based goals.

My background is historically more of what you call your traditional managed-care contracting and more transactional oriented. I’ve worked both with physicians and in the hospital space in doing contracting and negotiations, and have also served in leadership roles with Humana in our network organization. It’s been within the last four to five years that I’ve transitioned myself from what I’d call the volume to the value world. I feel like I’ve been making that journey in parallel with our physician community. As the industry is evolving that way, Humana is growing its own capability to support physicians in that space.

When did Humana launch its provider quality rewards program? How have you seen provider interest in that grow?

Humana has actually been in the value-based space for over 20 years. We have had what I call a more standard physician rewards program for the last five or six years, and it’s really progressed as the industry has progressed. Outside of the markets that have been more mature in it, the program is offered to engage and support physicians early on around certain quality metrics. It provides financial and clinical data to manage that core, founding population. We work with them along the journey to determine if and when they’re ready to move beyond just upside only and take some element of risk.

We start with physicians early on, looking at opportunities and ensuring that they’re provided with adequate data that is actionable around their population. We help them grow critical mass with them, mitigating any volatility in the numbers to help move them farther along that continuum where, eventually, they can share in some of the upside and downside risk.

How does Humana recruit physicians for the program?

We don’t have a formal recruiting program. We have a lot of local resources on the ground through our market and our leadership team through building relationships with physicians and understanding what their needs are – what programs we can offer to meet them along the way. We have over 900 value-based relationships and that continues to grow. We have increasing goals each year to put more and more physicians in our value-based programs, but I emphasize it’s not just around the number. It’s around really finding the right partnership and the right place on the continuum. I think with that it’s not so much a recruitment as it is just building deeper relationships with our physicians and finding out how we can support them.

How has technology impacted the ability of practices to succeed in your value-based programs?

Technology is critical to a physician’s ability to effectively manage population in the value-based space. Humana does provide some population health capabilities that provide financial and clinical data to the physicians around the population that they’re managing. We now have an increasing utilization of this capability from the physician’s self-service perspective. Historically, we have provided the data and the reports directly to them, which we continue to do but are now allowing functionality where they can access it themselves and use that data to turn it into actionable information to manage their population.

How does the quality rewards program fit into physician plans to participate in MACRA and its quality-improvement programs?

We’re all learning about MACRA. At a high level, it’s value-based, so MACRA is CMS’ way of moving physicians from just volume to value, and rewarding them for improvement in quality around certain metrics. I would say the fundamental feature of our value-based program does that. It has quality metrics built in and we work with the physicians on measuring, improving on, and rewarding for those metrics. Fundamentally, the concept is the same. How our program evolves to align with MACRA is in progress. We’re determining what will make the most sense for physicians to mitigate a lot of disruption, but continue an improved experience where ultimately their patients are getting the most high-quality care.

Aside from the quality rewards program, how is Humana helping physician practices implement population health management programs? You alluded to data earlier. Are there any other ways you’d like to highlight?

Yes, continuing evolution of the data and actionable information that we can provide to them. I don’t want to underestimate the local resources that we have on the ground. We have regular joint operating committees with our value-based physicians to review data, understand obstacles and barriers, and understand what they need to continue successful evolution in their value-based programs. That face to face relationship with the physician I think is instrumental to continuing success.

Outside of that local market level, we now have value-based executive care forums that are led by our office of the CMO. We call in value-based physicians from around the country and have a day-and-a-half session – an open forum – so they can learn from each other, we can hear directly from them and understand how we can support them in population health.

Given the direct feedback you’ve received, what are the biggest barriers practices face when it comes to implementing population health management or value-based programs, and how is Humana working to help practices overcome those barriers?

One of the biggest things we hear, and it’s not unique to Humana, is that we need to do something different for everyone. Even looking at MACRA coming up, what does that mean? To report different data when you have traditional Medicare, plus a handful of health plans … it’s the different offices and the different programs. Payers including Humana can look at how we can provide a physical solution to them to improve the administrative burden, if you will, of all those different programs so that they can focus on patient care and adhering to one program that ultimately meets the quality of their patients and improves their experience.

Do you have any final thoughts?

No, other than Humana recognizes the world of value-based care is evolving and every physician’s need is different, every practice’s need is unique. We continue to learn from each market and each physician, and strive to evolve our programs, options, and capabilities to best meet them where they are so they can successfully grow in this space.

Contacts

Jenn, Mr. H, Lorre

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News 1/11/17

Top News

Cal Index – the nonprofit medical data exchange founded by Anthem and Blue Shield of California in 2014 – will merge with the Inland Empire HIE. The newly combined organization (which will be renamed in the coming weeks) will facilitate access to the insurance claims and medical records of 1.67 million patients, making it one of California’s largest HIEs. Claudia Williams will lead the new organization beginning February 1 (making her the HIE’s fourth CEO). She comes with a strong background in technology, having served as senior advisor for health innovation and technology in the White House Office of Science and Technology Policy, and as ONC’s director of HIE.

Webinars

January 18 (Wednesday) 1:00 ET. “Modernizing Quality Improvement Through Clinical Process Measurement.” Sponsored by LogicStream Health. Presenters: Peter Chang, MD, CMIO, Tampa General Hospital; Brita Hansen, MD, CHIO, Hennepin County Medical Center. The presenters will describe how they implemented successful quality governance programs, engaged with their health system stakeholders, and delivered actionable information to clinical leadership and front-line clinicians. Q&A will follow.

January 26 (Thursday) 1:00 ET. “Jump Start Your Care Coordination Program: 6 Strategies for Delivering Efficient, Effective Care.” Sponsored by Healthwise. Presenters: Jim Rogers, RN, RPSGT, director of healthcare solutions, Persistent Systems; Jason Burum, chief client officer, Healthwise. This webinar will explain how to implement a patient-centered care coordination program that will increase quality as well as margins. It will provide real-world examples of how organizations used care coordination to decrease readmission rates, ED visits, and costs.

Acquisitions, Funding, Business, and Stock

Northwell Health (NY) launches practice management firm Formativ Health with backing from private-equity firm Pamplona Capital Management. The company, which will draw on Northwell’s management services expertise and partnership with Georgia-based RCM vendor NThrive (the former MedAssets-Precyse), looks to offer employed and independent physicians RCM, patient access, PM, and advisory services. Dennis Dowling (third from the right), who oversaw Northwell’s ambulatory services, will lead the new company.

Announcements and Implementations

Orca Health updates its point-of-care patient education app, giving physicians the ability to digitally send care plans to patients for review.

Healthcare analytics company Innovaccer develops an ACO comparison dashboard to help providers benchmark performance against CMS reporting measures, and compare beneficiaries and shared savings over a three-year period.

MedEvolve adds financial, operational, and clinical analytics to its PM and RCM offerings.

People

Intelligent Medical Objects promotes Eric Rose, MD to VP of terminology management.

Telemedicine

TechCrunch profiles San Francisco-based Remedy, a telemedicine startup just out of beta that uses artificial intelligence to power its virtual consult platform. Led by former SpaceX engineer and Milwaukee Brewers analytics consultant William Jack, the company is hoping to differentiate itself from its competitors by offering continuous physician engagement after the initial visit and potentially opening brick-and-mortar clinics.

WEDI publishes a brief introducing physicians to codes for telemedicine services. The challenges related to coding for telemedicine include the creation of codes for universal use that are still capable of capturing detailed telemedicine services, and a lack of consistency among payers when it comes to requirements, coverage, valuation, and payment.

Government and Politics

CMS releases more details on the Medicare ACO Track 1 model, which has been designed to encourage small practices to move forward with performance-based risk. The track, which starts in 2018, incorporates more limited downside risk thank Tracks 2 and 3, and will meet the elements required to be an Advanced Alternative Payment Model.

Other

Say it ain’t so, Hasbro: In an effort to refresh the classic game of Monopoly, the toy company is asking players to vote on new game tokens, including a hashtag, winky face and kissy emojis, and a thumbs-up. The winning tokens will be revealed in March and included in the new Token Madness edition. I guess the game gathering dust in my closet is fairly old since it contains the iron, which was replaced by a cat in 2013. I wonder what kind of tokens we could come up with for a health IT version. A Blue Button? Wearable?

I love this idea: The Society for Participatory Medicine seeks donations for a travel fund it’s setting up for e-patients who want to attend, speak, and cover industry conferences. HIStalk offered several HIMSS scholarships to a handful of patients several years ago; their feedback on the sessions and exhibit hall was definitely refreshing.

Sponsor Updates

Blog Posts

• Top Three AdvancedMD Product Web Pages in 2016 (AdvancedMD)
• Millenials want streamlined healthcare service (Intelligent Medical Objects)

Contacts

Jenn, Mr. H, Lorre

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News 1/10/17

Top News

Aledade raises $20 million in an investment round led by Biomatics Capital, bringing its total raised to $55 million since launching in 2014. Founder and CEO Farzad Mostashari, MD provides plenty of commentary on the Series B round in a string of tweets from the JP Morgan Healthcare Conference going on this week in San Francisco. Ever the cheerleader for independent physicians and the role healthcare technology can play in helping them move the needle on value-based care, he seems certain the funding will help the company continue to grow its line of Medicare ACOs, adding that “creating a bridge from ACOs to Medicare Advantage is an obvious extension, that we may pull forward with this funding.” Biomatics Capital cofounder Julie Sunderland will join Aledade’s Board of Directors.

Webinars

January 18 (Wednesday) 1:00 ET. “Modernizing Quality Improvement Through Clinical Process Measurement.” Sponsored by LogicStream Health. Presenters: Peter Chang, MD, CMIO, Tampa General Hospital; Brita Hansen, MD, CHIO, Hennepin County Medical Center. The presenters will describe how they implemented successful quality governance programs, engaged with their health system stakeholders, and delivered actionable information to clinical leadership and front-line clinicians. Q&A will follow.

January 26 (Thursday) 1:00 ET. “Jump Start Your Care Coordination Program: 6 Strategies for Delivering Efficient, Effective Care.” Sponsored by Healthwise. Presenters: Jim Rogers, RN, RPSGT, director of healthcare solutions, Persistent Systems; Jason Burum, chief client officer, Healthwise. This webinar will explain how to implement a patient-centered care coordination program that will increase quality as well as margins. It will provide real-world examples of how organizations used care coordination to decrease readmission rates, ED visits, and costs.

Announcements and Implementations

HealthTap introduces the artificial intelligence-powered Dr. AI in an effort to triage the healthcare concerns of its users. The next-generation chat bot offers up contextual advice, including virtual visit or physician referral, based on information already found in a user’s personal HealthTap record. The company assures users that Dr. AI is “trained in the art of digital empathy to converse with people using a patient, polite and compassionate bedside manner.”

Acquisitions, Funding, Business, and Stock

IBM touts the fact that in 2016 it received the most patents ever issued to one company in a single year. All of the 8,088 patents (an average of 22 granted per day) reflected the company’s high-growth areas, which include artificial intelligence, cognitive computing, cognitive health, cloud, and cybersecurity. The news coincides with the company’s decision to add Watson capabilities to Illumina’s tumor-sequencing technology in an effort to up the ante on genomic data interpretation and subsequent research. Watson for Genomics consumes data from 10,000 scientific articles and 100 new clinical trials each month, and, in combination with Illumina technology, can reduce the amount of time it takes scientists to compile genetic reports from one week to several minutes.

Government and Politics

Massachusetts joins California, Indiana, and Washington in going public with the information it has been collecting about data breaches since 2007. State The data, which includes the type of breach and personal identifying information such as Social Security and credit card numbers, is being released in the interest of transparency and to help consumers “track trends and identify [u]nsecure interactions.” The data set may also be a good starting point for patients looking to avoid providers who have been the victim of a breach.

ONC updates its Certified Health IT Product List dashboard with pages devoted to decertified products for both 2014 and 2015 editions, and developers who are no longer allowed to apply for certification.

The State of Minnesota prepares to truly put the concept of coordinated care into practice with the launch of Certified Community Behavioral Health Clinics. The six clinics are part of a national pilot program that seeks to bring primary and behavioral healthcare together, particularly for those suffering from mental illness and/or substance abuse. The eight states selected to participate have until July 1 to begin their two-year demonstration programs.

On the eve of President Obama’s farewell speech, Acting CMS Administrator Andy Slavitt shares his own parting reflections. His remarks, given at the JP Morgan Healthcare Conference, not only focus on the center’s successes, but on the current nationwide tension building around repeal and replace. A few highlights:

“The good news is we have don’t have to take a step backward,” Slavitt writes. “The American public expects us to take what is working and build on it. The immensely popular features of the ACA like free preventive care and ending the pre-existing condition limitations should be left alone and the focus should be on a limited number of improvements that spur competition and increase affordability.

I’ve had many conversations with physicians over the last year since I made a statement here at JPM that we had lost the hearts and minds of physicians. Many of them say they want to experience the joy of medicine again—to be able to make a living from listening to their patients, coordinating their care, improving their health, and get paid for what works.

Whether you call these ACOs or Medical Homes or Bundled payments frankly doesn’t matter. What matters is that we can develop these innovative practices locally, test them, and spread them.

Converting to a relationship-based system takes work and investment from all parties. We’ve started the process with the broad participation of physicians and patients. Using the CMS Innovation Center, which is part of the ACA, as well as through MACRA, the HITECH Act, and 21^stCentury Cures, we are making the investments that unlock research, data, innovation and reduce the burdens and distractions that don’t support care. They demonstrate that we can work in a bipartisan fashion on important issues in health care.”

Other

The local news highlights the impact the New Jersey Project ECHO (Extension for Community Healthcare Outcomes) Academic Medical Center Hub is having on patient care in the Garden State. The Hub’s participating physicians disseminate specialty expertise to PCPs in rural areas via remote education clinics, helping those rural providers avoid referring patients to distant specialists. The program, made possible by a $1.9 million grant from the Nicholson Foundation , offers clinics for the treatment of hepatitis C; autism, ADHD, and pediatric mental health; and advanced endocrinology. “If they go see a specialist, there are often higher co-pays and costs in addition to having to make extra trips,” explains participating Hub physician Vinod Rustgi, MD. “This program saves them money, time and travel distance. Now, if they are in Atlantic City, they don’t have to travel all the way to me, but they still get quality specialty care through their primary doctor.”

Contacts

Jenn, Mr. H, Lorre

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Readers Write: Maximizing Patient Engagement Amid Resource Limitations

Maximizing Patient Engagement Amid Resource Limitations
By Devin Gross

In today’s rapidly evolving healthcare environment, new reform measures and emerging payment models have put a focus on delivering positive health outcomes and high-quality healthcare, while containing costs. These new demands can only be fully achieved when healthcare organizations and physicians actively – and successfully – engage patients in their care. This requires organizations to extend the reach of their clinicians beyond the clinical setting to drive enhanced relationships with patients that generate stronger engagement.

This poses a significant challenge for independent practices as, historically, reimbursement models have not been optimized for them, nor are these groups fully equipped to engage patients beyond episodic visits. Traditionally, reimbursement for physician practices has been tied to episodic care, with little incentive to collaborate or activate patients in care decisions. These newly introduced value-based payment programs are requiring a change in care delivery for maximum reimbursement and encouraging a more coordinated care effort across patient populations. This additional step serves as an added hurdle for physician practices, which are navigating these complex requirements while facing significant bandwidth issues generated by consolidation pressures and resource constraints.

While physician practices are facing numerous challenges, they must consider new approaches to drive quality outcomes, and effectively treat and engage patients. These methods go beyond employing a larger staff to reach populations, which can be a significant undertaking. Technology can serve as a powerful tool to help extend the reach of physician practices in an effective engagement strategy. Developing and implementing an engagement strategy requires a thoughtful methodology. Before deploying a new strategy, there are three things every practice should consider:

1. An engagement strategy must fit within the current workflow and culture, and align with the organization’s business priorities. If a strategy does not seamlessly fit into the organization, it will not be supported by the stakeholders expected to adopt it. Thoughtful planning and deployment is required for success.
2. An engagement strategy must address patient needs. Patient engagement initiatives must be delivered to patients at the right place and right time, but also be designed to create an emotional connection that cultivates and extends the patient-provider conversation. Technology can support this. But, technology that fails to mimic human interaction and is designed without an empathetic approach to communication and content will not be successful in strengthening the physician’s relationship with the patient.
3. Measurement is key. It is important to establish goals and regularly measure progress. Understanding what is not working is as critical as understanding what is, so necessary refinements can be made. This intel can only be gained by consistently evaluating the efficacy of an engagement strategy.

While the race to implement a patient engagement strategy can be seen as an uphill battle, technology can play a significant role in overcoming barriers. Practices are typically built to support episodic patient visits. But the transition to value-based care requires maintaining relationships beyond the clinical setting – an expensive task if poorly executed. This, coupled with limitations created by inadequate resources, increases the strain on physicians to manage these patient populations, making way for technology to deliver on its promise.

Patient engagement isn’t easy, and pressure will continue to mount for practices to engage patients in the management of their own care. Extending the clinician’s reach and, ultimately, the relationship with the patient beyond the four walls of the clinical setting, is necessary to successfully engage patients that generate optimal reimbursement as financial models continue to emerge and evolve. The need for technology will be driven by resource constraints on independent practices hoping to survive amidst the changes. The potential value of technology is great – and practices able to recognize that value and implement in a meaningful way will not only be able to drive improved clinical outcomes, but also address key business problems impacting reimbursement.

Devin Gross is CEO of Emmi Solutions in Chicago.

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Jenn, Mr. H, Lorre

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