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Month: May 2018

Blockchain is proving itself for real-world healthcare applications

Experts from IEEE, UC San Diego and Health Linkages say the key is to make sure it’s the “right solution for the right problem.”

“Even if you don’t think blockchain is overhyped (and many people do), you may still be convinced that whatever real-world promise it holds for healthcare is either too far in the theoretical future to think much about, or it’s not yet worth the effort to implement. Whether it’s AI and machine learning, clinical trial recruitment, empowering patients to manage their own health records, IoT and assorted other clinical applications, IEEE is already deeply entrenched in advancing a wide array of uses for blockchain, said Palombini. ‘Some of the core principles of blockchain apply to healthcare,’ added Tim Mackey, director of the Global Health Policy Institute at UC San Diego. ‘This immutable distributed ledger can better ensure the resilience and provenance, traceability and management of healthcare data,'” Read the full article.

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Medicare Advantage gets supplemental benefits flexibility, including for transport

MA plans must still offer all enrollees uniform benefits, premiums and cost sharing.

“Under the bipartisan budget deal signed by the president in February, Congress expanded supplemental benefits for the chronically ill to include those that “have a reasonable expectation of improving or maintaining the health or overall function of the chronically ill enrollee and may not be limited to being primarily health related benefits.” The law also authorizes CMS to waive uniformity requirements, but only with respect to supplemental benefits for enrollees with chronic conditions. As healthcare’s focus shifts increasingly to population health, barriers such as transportation and food and housing insecurity are entering the equation of what it means to be and remain healthy. Without a reliable ride, for example, patients may miss scheduled appointments or fall treatment regimens, increasing the likelihood of more costly care in the future.” Read the full article.

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6 things keeping CIOs up at night

CIOs are acutely aware of the security complications medical devices and telehealth bring.

“Last month, LexisNexis brought together 30 high-level executives, most of whom were CIOs from hospitals, nursing homes and health plans of all sizes from across the county to find out what data-related issues are weighing on them most as we get further into 2018. Ed Domansky, LexisNexis manager of media and analyst relations, and Erin Benson, Director of market planning, said six major themes emerged from their responses. It seems merger and acquisition activity sent waves through the information security sector as well, adding complexity in several areas. Also, innovation continues to be a multifaceted undertaking in that while it can yield clinical and operational gains it also means adding another dimension of risk, especially where security is concerned.” Read the full article.

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AHIP asks CMS to change Medicare Advantage payment formula

The Centers for Medicare and Medicaid Services should update its county benchmark calculation in the 2019 final notice being published April 2.

“America’s Health Insurance Plans is asking the Centers of Medicare and Medicaid Services to change the way the agency calculates Medicare Advantage payment rates, ahead of a final notice due out Monday. AHIP said it strongly believes CMS should update its benchmark calculation in the 2019 final notice. These reflect spending for enrollees with only Medicare Part A for care in hospitals and other facilities, enrollees with only Medicare Part B, which covers physician visits and medical supplies and enrollees with both Medicare Parts A and B. This method captures the expenditures of all Medicare beneficiaries, regardless of whether they’re in Part A, B or both. MA plans are required to provide coverage for all services included under both Parts A and B. AHIP said the cost data for beneficiaries who are only in Medicare Part A – for hospitalization – should be excluded from calculating MA payment rates. The Medicare Payment Advisory Commission has also recommended that CMS revise the calculation of benchmarks.” Read the full article.

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