Population Health Management Weekly Wrap Up 10/25/15

Xavier University and Cincinnati-based startup Strap launch the Project X Health campaign to help the university gain a better understanding of the health of its 7,500 students, faculty, and staff. The program will use Strap software to connect and track participants through their smartphones, apps, and wearables; after which it will use analytics from that data to provide population health insights and trends. “We believe that engaging at this level with our population will enlighten our understanding of our population and help drive outcomes that we can’t possibly understand today,” says Shawn Nason, chief innovation officer at the university. “Xavier University is driven by the education of the whole person for each member of the university, and we see a healthy lifestyle as an integral part of what we can offer a student in four years.” The project is the first initiative in a larger partnership between Xavier’s Center for Innovation and Strap that will engage the community in digital population health programs.

Baptist Health Care (FL) chooses Allscripts products Sunrise, Sunrise Revenue Cycle Management, EPSi, FollowMyHealth, and dbMotion for population health management.

Northern Kentucky University breaks ground on its new $97 million Health Innovation Center, which will bring together leaders from NKU’s six colleges to create teams that will address issues like addiction and chronic disease by combining the studies of analytics, preventative care, psychology, and holistic approaches. “The future of population healthcare will increasingly depend upon gathering and analyzing data to determine which practices and policies are improving collective health outcomes,” says Dale Smith, dean of NKU’s College of Health Professions. “Our innovative approach will be a model for other educational institutions and communities to emulate.”

An EHealth Initiative study finds that only 17 percent of the 65 providers surveyed have integrated population health analytics into their EHRS. Analytics tools were most often used for quality measurement and reporting, followed by physician benchmarking, identification of gaps in care and preventive services, and identification of outliers in cost and utilization. Respondents cited a lack of interoperability as the biggest barrier to successfully implementing population health initiatives.

HealtheConnections and the Cayuga Community Health Network launch HealtheCNY.org, a new website that allows users to view detailed population data for Central New York Communities, as well as best practices and resources for health-improvement programs.

The local paper covers the evolution of Bill Frist, MD’s NashvilleHealth, a soon-to-be nonprofit that is looking to transform the health of the Tennessee-based town’s 800,000 residents. The organization, which will first focus on hypertension, smoking cessation, and child health, is working with Vanderbilt University’s School of Medicine on the data and research behind the projects. Frist has tapped Caroline Young (Nashville Health Care Council) to serve as executive director. “Most CEOs in Nashville have no idea what the adult obesity rate is. We are worse than Charlotte, Austin,” explains Frist. “People think we’re beating all these other places. I just think it’s so dramatic that we can shock people, and by shocking people they will step up and pay attention.”

Contacts

Jennifer,  Mr. H, Lorre, Dr. Jayne, Dr. Gregg, Lt. Dan

More news: HIStalk, HIStalk Connect.

Get HIStalk Practice  updates.
Contact us online.
Become a sponsor.

News 10/22/15

Top News

CVS Health opens its 1,000th MinuteClinic, shoring up the notion that retail healthcare is gaining a stronger foothold in the US and giving PCPs a run for their money. The company seems fairly savvy when it comes to opening up patient access points; it acquired Target’s pharmacy and clinics earlier this year, and announced telemedicine partnerships with American Well, Doctor on Demand, and Teladoc in August. It’s also looking to offer “new and innovative medical services” through in-store clinics and is working on clinical collaborations with over 60 health systems.

HIStalk Practice Announcements and Requests

Now that MGMA has passed, it’s time to turn my attention to the rest of my fall conference calendar. Tomorrow will see me at the Georgia HIMSS annual trade show. I’ll be back at the same venue on November 3rd for the Health IT Leadership Summit. Coincidentally, both events have the same headliner – MedAssets founder John Bardis, which is a bit surprising given the large pool of healthcare IT talent in and around Atlanta. What’s on your conference dance card between now and the holidays? Share your must-see events, especially any in the Southeast, via the comments below.

Webinars

None in the coming days. Contact Lorre for webinar services. Past webinars are on our HIStalk webinars YouTube channel.

Announcements and Implementations

DrFirst launches MyBenefitCheck, which enables physicians to look up a patient’s prescription benefit coverage in real time. The new tool will become available to users of DrFirst’s Rcopia e-prescribing solution on October 26. A wider roll out to users of the company’s 300-plus EHR partners will begin November 1. Humana has rolled out the tool to its physicians under the name IntelligentRx.

Government and Politics

President Obama announces a public health effort to combat the use of opioids, with support from the National Association of Boards of Pharmacy and dozens of public and private-sector organizations. The initiative includes a goal of doubling the number of physicians who have registered with their state’s prescription drug monitoring programs within the next two years. The President’s announcement notes that the DoD and Indian Health Service are working to integrate prescription data directly into their EHRs.

Morris County, NJ launches a Medicaid pilot program that will use Xerox, the state’s health benefits coordinator, to process annual eligibility determinations. “With the implementation of Medicaid expansion and changes in various funding streams that support some of our most critical services,” explains Morris County Director of Human Services Jennifer Carpinteri, “we must look at our infrastructure to find efficiencies while continuing to provide high quality services.” The project’s goals include improving timely and appropriate eligibility determinations and customer experience.

Telemedicine

San Diego-based Diet Doc launches telemedicine services for it weight-loss customers.

Virtual exam device startup MedWand names Doctor on Demand as its preferred telemedicine provider. The two companies plan to market their services together moving forward.

Research and Innovation

A G Data report finds that 26.6 percent of all malware attacks thus far in 2015 have been aimed at healthcare websites – the first time medical-related sites have attracted this much malicious attention. The most commonly seen malware campaign, “Money Rain,” has been connected to 37 percent of the healthcare websites studied.

Other

The Medical Board of California launches a public relations effort to help patients understand that they can – and should – verify physician licensing and disciplinary action via its online verification tool. The campaign stems from a petition filed earlier this month by Consumers Union urging the board to require that physicians on probation tell their patients. There are almost 500 doctors in the state whose patients don’t know they have faced disciplinary action.

Contacts

Jennifer,  Mr. H, Lorre, Dr. Jayne, Dr. Gregg, Lt. Dan

More news: HIStalk, HIStalk Connect.

Get HIStalk Practice  updates.
Contact us online.
Become a sponsor.

News 10/21/15

Top News

Serial entrepreneur Jay Mason launches Intellivisit with seed funding of over $1.6 million from such backers as former Wisconsin Governor and HHS Secretary Tommy Thompson. The startup’s product, piloted by Memorial Physician Services (IL), offers virtual diagnosis and prescriptions, triage, and appointment scheduling. It’s looking to raise an additional $2.5 million, and is initially prospecting health systems and employers.

HIStalk Practice Announcements and Requests

I’m still processing all of the show-floor conversations and session themes I overheard at MGMA in Nashville a few weeks ago. My experience at the conference (which you can read about here, here, and here) led me to jump at the chance to host tomorrow’s #kareochat tweet chat, happening at 12 pm ET. We’ll cover the issues and decisions keeping physicians and practice managers up at night, focusing on physician burnout, chronic-care management, ICD-10, hospital employment, and moving to value-based care. Hope to see you there.

Webinars

None in the next few days. Contact Lorre for webinar services. Past webinars are on our HIStalk webinars YouTube channel.

Acquisitions, Funding, Business, and Stock

Lake Oswego, OR-based CarePayment opens a Nashville, TN office, where it will base operations around its patient-friendly financing programs and engagement platform. The company also has named Ed Caldwell (MediTract) chief revenue officer, and added George Lazenby (OrderInsite) and Mark Emkjer (WebMD Health Services) to its Board of Directors.

People

Micky Tripathi (Massachusetts EHealth Collaborative) joins The Sequoia Project’s Board of Directors.

Announcements and Implementations

RCM and EHR vendor Medical Practice Partners adds an ICD-10 translation tool and predictive rules engine platform from RCxRules to its service line.

Government and Politics

ONC seeks a chief scientist to advice the national coordinator on organization health IT programs; and develop, execute, and coordinate scientific and technology grant program policies and activities, among other duties. The position seems to have been vacant since former Chief Scientist Doug Fridsma, MD left ONC in late September 2014.

The Michigan Dept. of Health and Human Services touts its new Medicaid Management Information System, developed by CNSI in partnership with the State of Illinois, as the nation’s first MMIS to be completely automated and cloud-enabled. “Moving to the cloud allows us to better serve our residents and improve health care delivery, all while reducing costs,” says MDHHS Director Nick Lyon. “This unique initiative enhances our ability to maintain Medicaid systems, meet state and federal guidelines, and work with partners such as Illinois to create a multi-state platform that can meet the specific needs of our residents.”

Research and Innovation

MGMA 15 organizers sent me the results of daily attendee polling, though they didn’t note how many physicians and/or practice managers were surveyed. The most IT-related question revolved around the changes practices have made in response to the increase in high-deductible health plans:

• Six percent added more staff.
• Twenty-three percent added technology to quickly and accurately determine benefits and liability.
• Twenty-one percent changed financial responsibility policy or paperwork presented to patients (which also might have IT implications).
• Thirty-one percent did more than one of the above.
• Nineteen percent have not made any changes (meaning there’s some room in the market for vendors, assuming practices have the budget).

Fast Company looks at the ways in which the University of Southern California’s Virtual Care Clinic will use virtual reality, artificial intelligence, mobile apps, and wearables to redefine healthcare. USC’s Center for Body Computing is developing two technologies leading up to the clinic’s launch – hologram house calls and a diagnosis and treatment app incorporating technology from Dr. Evidence, a software platform that pulls data from published clinical studies.

Telemedicine

Blue Cross and Blue Shield taps American Well as its telemedicine partner of choice for its 29 independent health plans across 26 states.

I couldn’t resist: Vet on Demand officially launches the first veterinary telemedicine app, enabling “pet parents” to save preferred veterinarians for future contact, and retain a call history with notes and digital health records. Calls are just $25, slightly cheaper than the typical telemedicine app. AmeriDoc founder David Lindsey is an investor in the Santa Monica, CA-based business. (I love that their website’s footer says “All rights, human and animal, reserved.”)

Other

Today marks “Back to the Future Day,” the official celebration of Marty McFly’s and Doc Brown’s trip to the future time of October 21, 2015. Ride-sharing service Lyft got into the spirit of things, offering their New York City customers the option to ride in a DeLorean via the “McFly Mode” option on its app. The company made it clear that while the rides were free, travel through time was highly unlikely given that the car needs to reach 88 mph and Big Apple speed limits hover only around 25.

Sponsor Updates

• EClinicalWorks recaps its user conference in a series of posts.
• Healthwise will exhibit at the HealthTrio 2015 Users Group Conference October 26-28 in Tucson, AZ.
• Aprima will exhibit at the AAP Experience National Conference & Exhibition October 24-27 in Washington, DC.

Blog Posts

• Orthopedics: Specialists Report Top Challenges (Greenway Health)
• CMS updates to MU Stage 3 and 2015 reporting (AdvancedMD)

Contacts

Jennifer,  Mr. H, Lorre, Dr. Jayne, Dr. Gregg, Lt. Dan

More news: HIStalk, HIStalk Connect.

Get HIStalk Practice  updates.
Contact us online.
Become a sponsor.

Readers Write: What Physicians Need to Know About Getting Paid for CPT 99490

What Physicians Need to Know About Getting Paid for CPT 99490
By Nat Findlay

Right now it seems like Medicare’s Chronic Care Management Program is the best kept secret in healthcare. After all, receiving money for a service that physicians traditionally perform for free appears to be a win/win for all involved.

However, there are certain provisions you should be aware of to make sure you are paid fully and on time for chronic care management (CCM), with minimal difficulties. To help you navigate this sometimes complicated process, here are five things you should know about getting paid for CPT 99490.

1) Money is already being made. The CMS has established a baseline payment rate of $42.60 for CCM that can be billed up to once per month per qualified patient. Physicians are already taking advantage, and so can you. Multiply that above figure by the number of your patients with chronic conditions, and it’s apparent why recent estimates indicate that a typical practice could see up to $77,000 in increased annual revenue by participating.

2) Certain codes cannot overlap. One tricky aspect of CCM is that 99490 cannot be billed in the same service period alongside other codes that are sometimes used for elderly patients or end-of-life care. This includes CPT 99495–99496 (transitional care management), HCPCS codes G0181/G0182 (home health care supervision/hospice care supervision), or CPT codes 90951–90970 (certain End-Stage Renal Disease services). Awareness of these restrictions at your practice will help you avoid unpleasant billing errors and devise better care plans.

3) You must prove compliance. Since the end goal of CCM is improving care, a major goal of the program is to ensure that providers are designing better patient-centered care plans and accurately capturing the patient’s health over an extended period of time. As such, making sure that this information is accurately captured in a certified EHR is of the utmost importance; without it, you cannot be paid on time or prove value. This worksheet explains what is needed to make sure you’re not stepping outside any of the CMS guidelines.

4) There may be a co-pay. To enroll a patient in a CCM program, he or she may need to agree to a monthly co-pay of $8. About 90 percent of patients will pay nothing out of pocket, but some 10 percent of beneficiaries who rely solely on the Medicare program for healthcare coverage will be liable for that small co-pay for each virtual visit. Convincing patients to sign up for CCM might be not be the most fun job you’ll have, but carefully explaining that they will never have to wait for a medication to be refilled, or someone to fix their wheelchair — and that the service is available on a 24×7 basis — is mighty compelling.

5) Both physicians and non-physician practitioners may bill the code, but only once per month. One of the more appealing parts of participating in CCM is that it does not require the PCP to complete the patient call, as various licensed providers may do so, including physician assistants, advanced practice registered nurses, clinical nurse specialists, and certified medical assistants. However, only one practitioner may be paid for the CCM service for a given calendar month; dedicating multiple personnel towards the program might improve patient outcomes, but it won’t get you paid any extra.

(Bonus) Check out this CMS tool. If you’re still feeling unsure, this Physician Fee Schedule Search Tool from CMS should helpful relieve your anxieties. It allows you to search by location, facility price, and other variables to see how much you’ll be getting paid for attesting to 99490.

Nat Findlay is CEO of Hello Health in New York City.

Contacts

Jennifer,  Mr. H, Lorre, Dr. Jayne, Dr. Gregg, Lt. Dan

More news: HIStalk, HIStalk Connect.

Get HIStalk Practice  updates.
Contact us online.
Become a sponsor.

News 10/20/15

Top News

Teladoc conducts its 1 millionth visit, making it the first telemedicine vendor to reach that particular milestone. The 13 year-old company also touts other milestones, including being the first and so far only telemedicine company to be certified by the National Committee for Quality Assurance for its physician credentialing process. The news comes just a few weeks after news broke that Highmark will not renew its contract with the company for fully insured members, causing Teladoc shares to take a sizeable tumble. Experts haven’t yet weighed in on whether or not the company will realize its hoped-for Q3 revenue of between $19 million and $19.5 million – a nudge up from Q2’s $18.2 million.

Webinars

None in the next few days. Contact Lorre for webinar services. Past webinars are on our HIStalk webinars YouTube channel.

Announcements and Implementations

San Jose, CA-based Bizmatics retools customer support for its Prognocis EHR via adoption of a cloud-based phone system from 8×8.

MedSafe launches an ICD-10 education and compliance program for physician practices.

Less than a week ahead of the Genomics pre-conference scheduled at its annual conference, WEDI creates a Genomic Data Exchange Workgroup to develop a plan for incorporating genomic data into the healthcare system. AMA Personalized Medicine Program Director Katherine Taber, Aetna Vice President of Consumer Clinical Strategy Adam Scott, and Intermountain Healthcare Clinical Genetics Institute Senior IT Strategist Grant Wood will lead the new group.

Mental health startup Lantern adds stress to its line of Web-based cognitive behavioral therapy programs. The new stress track includes podcasts, exercises, interactive techniques, and secure messaging with a health coach.

San Francisco-based startup Amino launches a platform to connect consumers to physicians with experience in treating certain conditions. The tool, which also lets consumers filter physicians based on location and accepted insurance plans, is based on the claims data of 188 million patients that the company has been gathering since 2013. Co-founder and CEO David Vivero, who spent a year as an executive at Zillow, penned a personal post explaining why his healthcare experiences prompted him to truly put “consumer” into the “consumerization of healthcare.”

Acquisitions, Funding, Business, and Stock

Venture capital company ISelect invites over 200 physicians to Evidence-Based Innovation 1.0, a November 3rd event in St. Louis that aims to connect MDs with local healthcare startups. “St. Louis’ innovative early-stage healthcare companies need doctors as customers,” explains ISelect CEO Carter Williams. “We’re bringing the doctors and the early-stage companies together. Sort of an obvious thing, but it’s never been done before.”

People

Jodi Daniel (ONC) joins Crowell & Moring as a partner in its Health Care Group.

Kyle Duke (TennCare) joins PatientFocus as EVP of operations.

Research and Innovation

Rock Health publishes findings from its first survey on consumer adoption of digital health technologies, finding that less than 20 percent of the general public engages with any digital health tools beyond online searches for medical conditions and online doctor review sites. HIStalk Connect’s Lt. Dan digs into the details here.

A KLAS interoperability brief puts Athenahealth ahead of Epic and Cerner in the category of “Easiest to Connect To,” citing high marks from Athena customers relating to integrating outside patient data into their workflows, and the hassle-free experiences non-customers have reported in interfacing with the company’s technology.

Government and Politics

American College of Cardiology members converge in Washington, DC as part of the organization’s yearly legislative conference. Talking points include EHR usability and the promotion of transparency in EHR vendor contracts by making gag clauses illegal.

Other

Medscape takes a look at the worst healthcare predictions over the last 20 years, showing special love to EHRs: “Policy-makers, including but not limited to President Obama, predicted that we could use the savings from digitizing medical records to pay for extending insurance coverage. It’s the worst prediction because what resulted — the current-day EHR — is an unmitigated disaster. EHRs not only remove the humanity from the patient/doctor interaction, they distract caregivers from what is most important. Distraction … is our number-one patient safety issue. EHRs make it worse.”

Contacts

Jennifer,  Mr. H, Lorre, Dr. Jayne, Dr. Gregg, Lt. Dan

More news: HIStalk, HIStalk Connect.

Get HIStalk Practice  updates.
Contact us online.
Become a sponsor.