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AHA report examines value of CME   09/18/2014
A new report from the AHA’s Physician Leadership Forum recommends ways to improve the value of continuing medical education to hospitals. Hospitals provided 35% of the accredited CME in 2013, investing close to $1 billion. “CME allows physicians to reach their full potential both as caregivers and leaders of the health care field,” said AHA Senior Vice President John Combes, M.D. “We have an opportunity to use CME strategically to achieve the goals not only of individual physicians but the entire delivery system to meet the needs of the patients and communities we serve.” To improve the use of CME as a strategic resource for hospitals, the report recommends greater use of performance-based CME; more streamlined accreditation standards; broader sharing of best practices; increased communication between CME departments and senior leadership; and greater involvement of physician leaders as CME champions. The report “Continuing Medical Education as a Strategic Resource,” is available at www.ahaphysicianforum.com.
CDC revises pneumococcal vaccination recommendations for seniors   09/18/2014
The Centers for Disease Control and Prevention today published revised pneumococcal vaccination recommendations for adults aged 65 and older. The recommendations call for adults 65 and older to receive first one dose of pneumococcal conjugate vaccine and then one dose of pneumococcal polysaccharide vaccine, ideally six to 12 months later. Adults 19 or older with compromised immune systems also should receive both pneumococcal vaccines. Depending on risk factors, some adults may need as many as three doses of pneumococcal polysaccharide vaccine in a lifetime, but only one dose of pneumococcal conjugate vaccine is recommended. The vaccines protect against pneumococcal disease, which can cause a severe type of pneumonia, as well as meningitis, blood poisoning and other infections. Either pneumococcal vaccine can be given at the same time as the flu vaccine.
CDC: Hospitals, others increase worker flu vaccinations   09/18/2014
An estimated 90% of hospital workers report receiving a flu vaccine for the 2013-14 flu season, up from 83% in 2012-13, according to a survey released today by the Centers for Disease Control and Prevention. Coverage for health care workers in all settings was 75%, up from 72% in 2012-13. Coverage was 98% among workers in hospitals requiring vaccination, compared with 80% in those that promoted but did not require vaccination. To protect the lives and welfare of patients and hospital employees, the AHA supports mandatory patient safety policies that require either flu vaccination or wearing a mask in the presence of patients across health care settings during flu season. In related news, CDC reported an 82% flu vaccination rate for hospital-based health care personnel at 4,254 acute-care hospitals reporting data to the CDC’s National Healthcare Safety Network for the period October 2013 through March 2014. Those vaccination rates varied by state and personnel category, with the highest rate (86%) among employees and the lowest (62%) among licensed independent practitioners. Hospitals began reporting the data in 2013 under the inpatient quality reporting program. Facility-level reports will be published on Hospital Compare in 2014.
CMS to host call on ICD-10 preparation   09/18/2014
The Centers for Medicare & Medicaid Services will host a national provider call on transitioning to the ICD-10 coding system on Nov. 5 at 1:30 p.m. ET. CMS experts will discuss ICD-10 implementation issues, opportunities for testing and resources available to help with the transition. To register, see the call notice. The Department of Health and Human Services in July issued a final rule establishing Oct. 1, 2015 as the date on which health care providers must include ICD-10 diagnosis and procedure codes on Medicare and other health care claims. The AHA has updated its ICD-10 Executive Action Guide that AHA member hospital and health system leaders can use to help with their transition to the new ICD-10 coding system.
HHS to sponsor development of portable ventilator for public health emergencies   09/18/2014
The Department of Health and Human Services has entered into a  three-year, $13.8 million contract with Philips Respironics to develop “portable, low-cost, user-friendly and flexible” ventilators to deploy during a pandemic or other public health emergency, the agency announced yesterday. “In pandemics and other emergencies, doctors must have medicines, vaccines, diagnostics, and critical equipment such as mechanical ventilators at the ready in order to save lives,” said Robin Robinson, director of HHS’s Biomedical Advanced Research and Development Authority. “An affordable portable ventilator will help us meet the needs of critically ill patients during a public health emergency, whether due to a naturally occurring pandemic or an act of bioterrorism.” According to HHS, the number of individuals requiring mechanical ventilation could overwhelm capacity during a severe pandemic or other public health emergency. The new ventilators will be designed to be manufactured quickly to meet a surge in demand and will not require special training for health care workers.
Study: Six in 10 marketplace consumers find premiums affordable   09/18/2014
Sixty-one percent of adults who purchased single coverage through the Health Insurance Marketplaces during open enrollment are finding it “very” or “somewhat” easy to afford their premiums, according to a survey released today by the Commonwealth Fund. That includes 65% of adults earning less than 250% of the federal poverty level ($28,725) and 54% of those earning more. About 70% of adults earning less than $28,725 paid no premium or less than $125 per month, compared to 64% of those with employer-sponsored plans, the survey found. Adults with higher incomes received no or smaller premium subsidies, and 59% of them had deductibles of $1,000 or more, compared to 30% of adults with employer-based coverage. According to the survey, 62% of adults rated their marketplace experience as fair or poor, but 68% were happy with their coverage and 71% were confident they would receive high-quality care.
AHA-supported bill would help hospitals meet FY 2015 EHR requirements   09/17/2014
Reps. Renee Ellmers (R-NC) and Jim Matheson (D-UT) last night introduced the Flexibility in Health IT Reporting (Flex-IT) Act (H.R. 5481), AHA-supported legislation that would give hospitals and eligible professionals more flexibility in meeting meaningful use requirements for electronic health records in 2015. Specifically, the legislation would shorten the 2015 reporting period to 90 days from the current 365 for Medicare and Medicaid EHR Incentive Program participants using the 2014 Edition Certified EHR. Without this change, the vast majority of hospitals are required to meet all Stage 2 requirements on Oct 1. “Hospitals continue to be challenged with the current regulatory timeline for EHR delivery, installation and implementation,” AHA Executive Vice President Rick Pollack said in a letter of support to the bill’s sponsors. “Additionally, they are challenged to find enough other providers capable of receiving a summary of care document to meet the transitions of care objective in the EHR Incentive Program…Without relief from the full year of use and reporting requirement, hospitals will face financial penalties despite their best efforts at compliance.”
AMA outlines priorities to improve EHR usability   09/17/2014
The American Medical Association yesterday issued a framework for improving the usability of electronic health records for physicians. It calls for improving the design of EHR systems to: enhance physicians’ ability to provide high-quality care; support team-based care; promote care coordination; offer product modularity and configurability; reduce cognitive workload; promote data liquidity; facilitate digital and mobile patient engagement; and expedite user input into product design and post-implementation feedback. The recommendations build on a 2013 AMA study with RAND Corp. that found significant physician discontent with current EHR functionalities. "Physician experiences documented by the AMA and RAND demonstrate that most electronic health record systems fail to support efficient and effective clinical work," said AMA President-elect Steven Stack, M.D. "This has resulted in physicians feeling increasingly demoralized by technology that interferes with their ability to provide first-rate medical care to their patients."
CMS reports on ACO program results   09/17/2014
Accountable care organizations participating in the Medicare Shared Savings Program and Pioneer ACO Model have saved Medicare more than $372 million while outperforming published benchmarks for quality and patient experience of care, the Centers for Medicare & Medicaid Services announced yesterday. The results include preliminary quality and financial data from the second year of performance for 23 Pioneer ACOs and the first year of performance for 220 Shared Savings Program ACOs. According to CMS, MSSP participants improved on 30 of 33 quality measures last year, while Pioneer participants improved on 28 of 33 measures with an average improvement of 14.8% across all measures. For more information, see the CMS factsheet.
Court dismisses rebilling lawsuit   09/17/2014
A federal district court today ruled that Medicare law does not provide a basis for the court to exercise its power to consider the AHA and four hospital organizations’ legal challenge to the Centers for Medicare & Medicaid Services’ rebilling policy and dismissed the lawsuit. “Plaintiffs argue that it is arbitrary and capricious, and thus unlawful, for CMS to refuse to create an additional categorical exception [to the one-year time limit for submitting a claim for Medicare payment] for those claimants that, like them, seek to file a Part B claim after a Part A denial,” the court opined. “However, CMS’s non-exercise of the agency’s discretion to create an additional category of exceptions does not constitute a ‘final decision . . . after a hearing,’ as it must in order to justify the Court’s jurisdiction.” After the AHA and the hospitals filed the original lawsuit in November 2012, CMS conceded that its previous policy of categorically denying hospitals the right to rebill under Part B when a Recovery Audit Contractor had issued a wrong setting denial, except for certain ancillary services, was unlawful and the agency modified that policy to allow some limited rebilling if done within the year the services were delivered. The AHA and the hospitals are considering an appeal of the dismissal.