Author: eric

FDA lays out digital health goals in 2018 strategic roadmap

Leveraging innovation and competition to better healthcare is one of the four cornerstones of the Food and Drug Administration’s 2018 policy roadmap
“The roadmap touches on several efforts to help develop medical devices, specifically the establishment of a Total Product Life Cycle Office within the Center for Devices and Radiological Health and the development of an alternative 510(k) pathway. FDA also plans to publish final guidance on what digital health technologies fall under FDA’s regulation and those that the agency plans to exercise enforcement discretion on. In December, the agency published a trio of documents that laid out its proposed thoughts on how it will approach its regulation of the space. The FDA chief acknowledged that modernizing how the agency regulates new areas such as digital health to ensure that the agency’s policies are suited to the new challenges. The plan pointed to enabling consumers to use new technologies, such as digital tools and medical apps, to make up-to-date decisions about their health.” Read the full article.
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CMS launches voluntary bundled payments model, first since spiking mandatory bundles

The agency’s Innovation Center said the new Bundled Payments for Care Improvement Advanced model is the first APM that would qualify under MACRA.
“The Centers for Medicare and Medicaid Innovation Center has launched a new voluntary bundled payment model called Bundled Payments for Care Improvement Advanced — which CMS Administrator Seema Verma said is the first Advanced APM. The current Bundled Payments for Care Improvement Initiative, or BPCI, is scheduled to end on Sept. 30. BPCI Advanced starts on Oct. 1 and runs through Dec. 31, 2023. The BPCI will qualify as an advanced alternative payment model under the quality payment program for MACRA. With advanced APMs, providers take financial risk, but can also reap an incentive payment reward.” Read the full article.
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Medical Device Data, UDIs on Claims Impact Costs, Patient Safety

According to recent reports, payers who incorporate medical device data and UDIs into their claims may improve costs and patient safety.
“Adding medical device data and unique device identifiers (UDIs) to insurance claims could have a significant positive impact on healthcare spending and patient safety, according to reports from Pew Charitable Trusts, Brigham and Womens Center of Surgery and Public Health, and OIG. However, most insurance providers, including Medicare, do not have the data collection methodologies in place to gather this valuable information, leaving providers, patients, and payers at risk for adverse outcomes.” Read the full article.
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Healthcare Data – How to Use it to Your Benefit

In today’s world, information travels at gigabit speeds. For business, this means near limitless opportunities to accumulate data and use it to make operations more efficient and therefore more profitable. One of the issues many businesses encounter when compiling all this data is finding an effective use for so much information. Understanding the data and incorporating it into useful business practices is especially problematic in the medical profession.

Healthcare has evolved with the rest of the business world, and has used technology to make leaps and bounds in providing patients, providers and payers with new opportunities to connect with each other and access information in real time. All this information that is being stored, creates the perfect opportunity to improve care, operations and finances within our healthcare system.

This is where HealthAxis Group’s Data Analytics comes into play. Our Data Analytics include a variety of services for both payers and providers. Data Analytics will find important and unknown trends in electronic health records and claims systems that provide insight on how to improve workflow, costs, patient care and growth. HealthAxis Group has proprietary solutions, like Doctor Dial, an automated calling system, that can be coupled with Data Analytics to automate the process of intervening at critical times in patient care in order to improve the lives of patients while improving the bottom line.

The ultimate goal of our Data Analytics Division is to offer payers and providers both an opportunity to fine tune the way they utilize the wealth of information and to save time and money while improving the quality of the services they have come to expect on a day-to-day basis. For more information about all of the Data Analytics HealthAxis Group can offer your business, visit us online at https://quizzical-mask.flywheelsites.com/data-analytics/ or contact us by phone at 888-974-2947 (AXIS) or send us an email at info@healthaxis.com

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Providers: Email is main data breach culprit

A recent survey by Mimecast and HIMSS Analytics states that providers overwhelmingly rank email as the No. 1 source of potential data breaches 
“Of physicians who experienced a cyberattack, nearly three in 10 with medium practices reported nearly an entire day of downtime as a result. As with the Mimecast-HIMSS survey, sharing personal health data between providers was a high priority. The survey data also show providers are looking to strengthen security. Nearly all of the respondents, about 95%, said preventing malware and/or ransomware attack is a top priority in their organization. The second highest objective was ‘training employees about how to be diligent when it comes to cybersecurity’.” Read the full article.
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OCR: 5 ways to fight internal health data breaches

Healthcare organizations can protect themselves from internal healthcare data breaches.
“Healthcare organizations are a prime target for internal breaches caused by former employees, but there are several steps that groups can take to protect themselves from the threat. The Department of Health and Human Services Office for Civil Rights (OCR) issued a number of tactics (PDF) to prevent recently terminated staffers from accessing private healthcare data.”  Read the full article.
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Healthcare finance executives see strong IT investment in 2018, but a bubble could be growing

KPMG and Leavitt Partners new survey found that health and life sciences organizations intend to invest in analytics and digital technologies.
“More than half of finance executives are projecting health IT and data to see strong investment activity in 2018 and 2019, according to a new survey. But they’re also concerned that a bubble is growing in certain health and life sciences realms. Fifty-two percent are projecting that the health IT and data subsectors will have a lot of investment activity in 2018-19, followed by outpatient services at 44 percent, and 33 percent each for pharma and biotech and also post-acute care services.” Read the full article.
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Claims Analytics Help Medicare Identify, Prevent Provider Fraud

The use of a claims analytics platform helped Medicare to identify and prevent millions of dollars in provider fraud.
“Close to a quarter of new Medicare fraud investigations started with the use of a claims analytics platform that has helped to save approximately $6.7 million in incorrect billings, a new GAO report found. After reviewing fraud prevention procedures and technologies within Medicare in 2016, GAO determined that the Fraud Prevention System (FPS) helped Medicare take corrective actions against 90 providers by suspending improper payments. The review also suggested that the FPS is helping CMS programs curb their historical fraud vulnerabilities.” Read the full article.
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Quality Payment Program needs more technical assistance, oversight, OIG finds

A new report by HHS’ Office of Inspector General gives CMS points for making significant efforts to implement the Quality Payment Program (QPP) but says challenges remain that could undermine the program’s success.
“Without sufficient technical assistance, participating clinicians could struggle to succeed, while others may opt out of the program altogether, the report warns. CMS also needs to develop a comprehensive program integrity plan to guard against fraud and improper payments, according to OIG. In terms of implementing QPP, CMS has focused heavily on clinician readiness and acceptance of the program. The report cites outreach efforts, eligibility information, subregulatory guidance and a service center to field questions.” Read the full article.
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More billing codes, demonstrations help bridge physician payment gap

In the 2018 Medicare Physician Fee Schedule, CMS said it is working incrementally to “identify gaps in appropriate coding and payment for care.”
“A new Robert Wood Johnson Foundation (RWJF) report analyzed how CMS has expanded billing codes and demonstrations focused on supporting primary care.  The report said primary care providers (PCPs) involved in CMS demonstrations are getting higher monthly payments. The shift has meant more up-front payments rather than end-of-year bonuses. Those providers are also being held accountable for a wide range of outcomes, but often “not expected to independently influence the total cost of all care received by Medicare beneficiaries,” according to the RWJF report.” Read the full article.
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