News 10/22/15

October 22, 2015 News Comments Off

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

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News 10/21/15

October 21, 2015 News Comments Off

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.

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JennHIStalk

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

October 21, 2015 News Comments Off

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.

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JennHIStalk

News 10/20/15

October 20, 2015 News Comments Off

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.

JennHIStalk

News 10/19/15

October 19, 2015 News Comments Off

Top News

Athenahealth launches Let Doctors Be Doctors, a website and hashtag that physicians can use to complain about their EHRs. It’s a fairly brilliant marketing move, given that the company’s product development team will benefit from the feedback. Plus, ZDoggMD seems to be a campaign spokesperson, ratcheting up the cool factor considerably.

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

Executives attending the KLAS Keystone Summit in Utah agree to objective interoperability metrics and ongoing reporting, though no details are released as to what the measures are; how they were agreed upon; and how executives from Epic, Cerner, Greenway Health, Athenahealth, and EClinicalWorks, among seven other vendors, will go about reporting them. KLAS naturally plans to serve as the organization that will assist the vendors in creating a plan to launch and monitor the collaboration. Though the announcement is vague, I would be interested to learn what a dozen leading EHR vendors, particularly Epic, agree upon, and how ambulatory might figure into the equation.

Relay Health announces the successful processing of $25 billion in ICD-codes stemming from 13 million claims made using the company’s RCM technologies.

Announcements and Implementations

Talksoft offers a mobile survey tool to benchmark patient experience and practice performance.

EClinicalWorks launches 10e, a cloud services platform incorporating EHR functionality with population health and patient engagement tools

X-Ray Associates of New Mexico, the state’s largest outpatient provider of medical imaging services, selects the RIS V7.6 software suite from MedInformatix.

Reliance Medical Group (NJ) implements MD Revolution’s RevUp for CCM solution, offering its 40 physicians clinical decision support, enhanced patient engagement services, and care-plan access in between patient visits.

Government and Politics

The American Osteopathic Association makes clear its disappointment with the Meaningful Use program, stressing that additional though unspecified changes are needed beyond those announced with much fanfare last week. “When only 10 percent of providers are in compliance, it’s clear that a substantial overhaul is needed in order for EHRs to achieve their stated purpose,” says John Becher, DO, president of the American Osteopathic Association. “At this juncture, the meaningful use program as it stands is not strengthening the critical physician-patient relationship that osteopathic physicians hold sacred, which is exactly the opposite of the law’s intent.”

Healthcare.gov bashing ramps up, with the New York Times pointing out that the federal health insurance exchange’s “window shopping” feature is behind schedule due to unanticipated bugs and a lack of payer-submitted data. Due to the delay, users shopping for policies ahead of open enrollment are not able to view health plan benefits, prices, and details. HHS now plans to launch the new search tool closer to November 1.

ONC’s Office of Standards and Technology Director, Steven Posnack, lays out how the agency plans to move forward with implementing the final rule’s regulatory requirements, including certification companion guides and draft test procedures for each EHR certification criterion. NIST will also make available “alpha” versions of 2015 Edition testing tools for early feedback and pilot testing.

Telemedicine

An Accenture report suggests that utilization of virtual tools in the areas of self-care, patient management, and annual visits could potentially save PCPs $10 billion annually. The report makes an interesting comparison to the amount of time PCPs could save if certain tools are used in certain care settings: For example, using virtual solutions in diabetes care could free up 11 percent of the PCP workforce, which the company equates to $2 billion in savings each year.

The American Academy of Sleep Medicine publishes a 12-page position paper with recommendations of technical specifications and best practices for specialists to consider when incorporating sleep telemedicine into their practice. Though comprehensive, the AASM makes sure to point out that specialists should be prepared to adjust their practices based on the anticipated rapid expansion of telemedicine technologies. The academy anticipates that potential areas of expansion will include high-risk population management, wearable device technology, bundled payment schemes, integrative care models of delivery, wellness programs, and home health.

Other

Researchers in London determine that physically fit office workers won’t benefit from working at a standing desk as opposed to a seated one, no doubt leaving millions of standing desk owners wondering about their return policies. The researchers found that “extended butt parking” didn’t result in a higher risk of premature death for employees already active, proving that a gym membership is far more valuable to your health than the latest ErgoDepot desk.

Sponsor Updates