Thursday, December 15, 2011

TJC Issues Call to Action to Prevent Healthcare Worker Fatigue

The link between health care worker fatigue and adverse events is well documented, prompting The Joint Commission (TJC) to issue a new Sentinel Event Alert: Health care worker fatigue and patient safety.

The Alert urges greater attention to preventing fatigue among health care workers and suggests specific actions for health care organizations to mitigate the risks. An article in the November 2007 issue of The Joint Commission Journal on Quality and Patient Safety reported that nurses who work more than 12-hour shifts and residents working recurrent 24-hour shifts were involved in three times more fatigue-related preventable adverse events. In addition, health care professionals who work long hours are at greater risk of injuring themselves on the job.

“Health care is a round-the-clock job, and safety has to be the priority,” says Mark R. Chassin, M.D., FACP, M.P.P., M.P.H., president, The Joint Commission. “The recommendations in this Alert give health care organizations the strategies to help mitigate the risks of fatigue that result from extended work hours – and, thereby, reduce the likelihood that fatigue will contribute to preventable patient harm."

The Alert addresses the effects and risks of an extended work day and of cumulative days of extended work hours. The Joint Commission Alert recommends that health care organizations:
- Assess fatigue-related risks such as off-shift hours, consecutive shift work and staffing levels.
- Examine processes when patients are handed off or transitioned from one caregiver to another, a time of risk that is compounded by fatigue.
- Seek staff input on how to design work schedules that minimize the potential for fatigue and provide opportunities for staff to express concerns about fatigue.
- Create and implement a fatigue management plan that includes scientific strategies for fighting fatigue such as engaging in conversation, physical activity, strategic caffeine consumption and short naps.
- Educate staff about good sleep habits and the effects of fatigue on patient safety.

The Joint Commission also suggests that health care organizations encourage teamwork as a strategy to support staff who work extended work shifts or hours. For example, use a system of independent second checks for critical tasks or complex patients. Also, organizations should consider fatigue as a potentially contributing factor when reviewing all adverse events, and educate employees on the importance of good sleep habits, including ensuring their rest environment is conducive to sleeping.

The warning about health care worker fatigue is part of a series of Alerts issued by the Joint Commission. Previous Alerts have addressed diagnostic imaging risks, violence in health care facilities, maternal deaths, health care technology, anticoagulants, wrong-site surgery, medication mix-ups, health care-associated infections, and patient suicides, among others.

Source: TJC News Release

Partnership for Patients Initiative to Improve Hospital Care

Hospitals across the country will have new resources and support to make health care safer and less costly by targeting and reducing the millions of preventable injuries and complications from healthcare acquired conditions, the U.S. Department of Health and Human Services (HHS) announced. As a part of the Partnership for Patients initiative, a nationwide public-private collaboration to improve the quality, safety, and affordability of health care for all Americans, $218 million will go to 26 state, regional, national, or hospital system organizations.

Source: HHS News Release

New Data Indicates Affordable Care Act Provision Has Given 2.5m Young Adults Health Insurance

The National Center for Health Statistics at the Centers for Disease Control and Prevention (CDC) released data illustrating that the Affordable Care Act continues to significantly increase the number of young adults who have health insurance.

Because of the health care law, young adults can stay on their parents' insurance plans through age 26. This policy took effect in September 2010. Data from the National Health Interview Survey (NHIS) shows that since September 2010, the percentage of adults aged 19-25 covered by a private health insurance plan increased significantly, with approximately 2.5 million more young adults with insurance coverage compared to the number of young adults who would have been insured without the law.

“Thanks to the Affordable Care Act, 2.5 million more young adults don’t have to live with the fear and uncertainty of going without health insurance,” said Secretary Kathleen Sebelius. “Moms and dads around the country can breathe a little easier knowing their children are covered.”

The numbers show a continuation of the coverage gains due to the health care law as students graduate from high school and college in May and June and otherwise would have lost coverage.

The data is consistent with estimates from surveys released earlier in the year. Those surveys have shown an increase in the number and percentage of young adults 19 to 25 with health insurance coverage. Specifically, the Census Bureau and the Gallup-Healthways Well-Being Index Survey, as well as the NHIS release of data through March 2011, reported similar trends through early 2011.

The results, highlighted in an HHS issue brief, show that the initial gains from the health care law have continued to grow.

“The data announced today show that, because of the health care law, there is a continued and consistent pattern of improved health coverage among young adults,” said Sherry Glied, Ph.D., HHS assistant secretary for planning and evaluation. “The Affordable Care Act has helped literally millions of young adults get the health insurance they need so they can begin their careers with the peace of mind that they’re covered.”

For more information about this announcement, please see the HHS Issue Brief at

For more information about the CDC NHIS data released today, please visit

Source: HHS News Release

Tuesday, December 13, 2011

Health Care Fraud Crackdown Recovers $2.9b

Vice President Joe Biden, the U.S. Department of Health and Human Services (HHS) and the U.S. Department of Justice (DOJ) are teaming up to crack down on fraud. HHS and DOJ recovered $2.9 billion in health care fraud in 2011. HHS also announced it was taking more steps to prevent Medicare prescription drug fraud.

Source: HHS News Release

AHRQ Releases Medication Reconciliation Toolkit

The Agency for Healthcare Research and Quality (AHRQ) of the U.S. Department of Health and Human Services (HHS) released a new toolkit to help hospitals improve their medication reconciliation processes to reduce adverse drug events.

The Medications at Transitions and Clinical Handoffs (MATCH) Toolkit provides step-by-step instructions on how to improve a medication reconciliation process, from planning—including how to get leadership support—to pilot testing, implementation, and evaluation. Included is a workbook that helps users implement the Toolkit. The Toolkit is available at:

Source: AHRQ News Release

CMS Issues Rule on Availability of Medicare Data for Performance Measurement

Consumers and employers will have the health care information they need to make more informed choices about their care, thanks to the Affordable Care Act, the Centers for Medicare & Medicaid Services (CMS) announced in a final rule.

The rule gives qualified organizations, like employers and consumer groups, access to data that can help them identify high quality health care providers or create online tools to help consumers make educated health care choices. Information that could identify specific patients, however, will not be publicly released and strong penalties will be in place for any misuse of data.
“This is a giant step forward in making our health care system more transparent and promoting increased competition, accountability, quality and lower costs,” said Marilyn Tavenner, Acting CMS Administrator. “This provision of the health care law will ensure consumers have the access they deserve to information that will help them receive the highest quality care at the best value for their dollar.”

For years, employers, consumers, and health care quality advocates have expressed frustration about the limited and piecemeal availability of Medicare data that could be used to help evaluate health care provider or supplier performance. Although many health plans have created provider and supplier performance reports, these reports are based solely on the health plans' own claims, and do not reflect information from other health plans, including Medicare.

Providers, too, have expressed frustration at receiving performance reports that are piecemeal and produced without an opportunity for review and correction. This final rule creates a framework for providers to receive a single, actionable performance report covering all or most of their practice.

The final rule makes a number of important changes from the original proposed rule. The final rule makes this data less costly for qualified entities, gives qualified organizations more flexibility in their use of Medicare data to create performance reports for consumers, and extends the time period for health care providers to confidentially review and appeal performance reports before they become public. The rule also includes strict privacy and security requirements to protect patients, health care providers, and suppliers as well as stringent penalties for any misuse of Medicare data.

Click here for more information on the final rule.

The final rule on Availability of Medicare Data for Performance Measurement may be viewed here:

Source: CMS News Release

Thursday, December 8, 2011

Webcast of ONC Annual Meeting Available

The Office of the National Coordinator for Health Information Technology (ONC) held its 2011 ONC Grantee and Stakeholder Summit on November 17, 2011.

An archived webcast of this event is now available at:

Key speakers included:
Aneesh Chopra, United States Chief Technology Officer, Office of Science and Technology Policy, Executive Office of the President
Farzad Mostashari, MD, ScM, National Coordinator for Health Information Technology
David Blumenthal, MD, Samuel O. Thier Professor of Medicine and Professor of Health Care Policy at Massachusetts General Hospital/Partners HealthCare System and Harvard Medical School
Leon Rodriguez, Director, HHS Office for Civil Rights
Rick Gilfillan, MD, Acting Director, Center for Medicare & Medicaid Innovation (CMMI), Centers for Medicare and Medicaid Services
Jay Walker, Curator, TEDMED Conference

Source: ONC News Release

Wednesday, December 7, 2011

Obama Administration Takes New Steps to Encourage Doctors, Hospitals to Adopt HIT

U.S. Department of Health and Human Services (HHS) Secretary Kathleen Sebelius released a report showing that doctors’ adoption of health information technology (IT) doubled in two years. HHS also announced new actions to speed the use of health IT in doctors’ offices and hospitals nationwide, which will improve health care and create jobs nationwide.

While protecting confidential personal information, health IT can improve access to care, help coordinate treatments, measure outcomes and reduce costs. The new administrative actions announced today, which were made possible by the HITECH Act, will make it easier for doctors and other health care professionals to receive incentive payments for adopting and meaningfully using health IT.

“When doctors and hospitals use health IT, patients get better care and we save money,” said Secretary Sebelius. “We’re making great progress, but we can’t wait to do more. Too many doctors and hospitals are still using the same record-keeping technology as Hippocrates. Today, we are making it easier for health care providers to use new technology to improve the health care system for all of us and create more jobs.”

In addition to improving the health care system, data indicate that the national transition to health IT is creating jobs. Over 50,000 health IT-related jobs have been created since the enactment of the HITECH Ac. According to the Bureau of Labor Statistics, the number of health IT jobs across the country is expected to increase by 20 percent from 2008 to 2018, much faster than the average for all occupations through 2018.

HHS also announced its intent to make it easier to adopt health IT. Under the current requirements, eligible doctors and hospitals that begin participating in the Medicare EHR (electronic health record) Incentive Programs this year would have to meet new standards for the program in 2013. If they did not participate in the program until 2012, they could wait to meet these new standards until 2014 and still be eligible for the same incentive payment. To encourage faster adoption, the Secretary announced that HHS intends to allow doctors and hospitals to adopt health IT this year, without meeting the new standards until 2014. Doctors who act quickly can also qualify for incentive payments in 2011 as well as 2012.

These policy changes are accompanied by greater outreach efforts that will provide more information to doctors and hospitals about best practices and to vendors whose products allow health care providers to meaningfully use EHRs. For example, in communities across the country HHS will target outreach, education and training to Medicare eligible professionals that have registered in the EHR incentive program but have not yet met the requirements for meaningful use. Meaningful use is the necessary foundation for all impending payment changes involving patient-centered medical homes, accountable care organizations, bundled payments, and value-based purchasing.

These efforts will complement existing outreach efforts to doctors and hospitals including the Obama Administration’s work to create a nationwide network of 62 Regional Extension Centers. The extension centers are comprised of local nonprofits that provide guidance and resources to help eligible health care providers participate in the Medicare and Medicaid EHR Incentive Programs and meaningfully use health IT.

Also released, a new Centers for Disease Control and Prevention (CDC) survey found 52 percent of office-based physicians in the U.S. now intend to take advantage of the incentive payments available for doctors and hospitals through the Medicare and Medicaid EHR Incentive Programs. EHR incentive payments for eligible health care professionals can total as much as $44,000 under the Medicare EHR Incentive Program and $63,750 under the Medicaid EHR Incentive Program. The CDC data also show the percentage of physicians who have adopted basic electronic health records in their practice has doubled from 17 to 34 percent between 2008 and 2011 (with the percent of primary care doctors using this technology nearly doubling from 20 to 39 percent).

To meet the demand for workers with health IT experience and training, the Obama Administration has launched four workforce development programs that help train the new health IT workforce. The training is provided through 82 community colleges and nine universities nationwide. As of October 2011, community colleges have had 5,717 professionals successfully complete their training in health information technology. Currently there are 10,065 students enrolled in the training programs across the nation. As of November 2011, universities have graduated over 500 post-graduate and masters-level health IT professionals, with over 1700 expected to graduate by July 2013.

While improving the health care system, health IT can help keep information private and secure. Federal laws require key persons and organizations that handle health information to have policies and security safeguards in place to protect health information—whether it is stored on paper or electronically.

For more information on how health IT can lead to safer, better, and more efficient care, and for a fact sheet about today’s announcement, visit

For more information about the Medicare and Medicaid EHR Incentive Programs, see

For more information on the 2011 CDC survey data referenced above, see

For more information about the HHS Recovery Act health IT programs, see

Source: HHS News Release

Monday, December 5, 2011

CMS Issues Final Medical Loss Ratio Rule

The Centers for Medicare & Medicaid Services (CMS) issued a final regulation that will ensure health insurance companies spend at least 80 percent of consumers’ health insurance premiums on medical care, not income, overhead and marketing. Insurance companies that fail to meet the new standard are required to provide a rebate to consumers.

Known as the Medical Loss Ratio (MLR), this rule provides unprecedented transparency and accountability of health insurance companies for customers. Created by the Affordable Care Act, the MLR requirements provide protection and value to approximately 74.8 million insured Americans. Estimates from last year indicate that, starting in 2012, up to nine million Americans could receive rebates worth from $0.6 to $1.4 billion. However, early reports suggest insurers lowered premium growth rather than face the prospect of providing rebates – a win-win for consumers.

“Under the Affordable Care Act, consumers are already seeing better value from their health insurance companies,” said CMS Acting Administrator Marilyn Tavenner. “If your insurance company doesn’t spend enough of your premium dollars on medical care or quality improvement this year, they’ll have to give you rebates next year. This will bring costs down and give insurance companies the incentive to focus on what matters for patients – high quality health care.”

MLR rules took effect on January 1, 2011 but the final rule makes modifications and provides certainty to how the MLR is calculated. These modifications are based on public comments solicited in an earlier version of the rule published by CMS in the spring.

The modifications made in the new rule:
- Make the MLR rebate tax free: Rather than having insurers send checks that could be taxed, workers in group health plans can receive rebates in a way that is not taxable.
- Increase transparency: Consistent with comments from consumer groups, the new regulation proposes that all consumers receive a notice, showing not just the amount of any rebate, but what the insurer’s MLR means regardless of whether there is a rebate, and how the insurer’s MLR has improved under the new law. In addition, data on the special types of plans, mini-meds and ex-patriate plans, will be publicly posted in the Spring.
- Keep strong policies on how MLR is calculated: The final rule makes only a minor change to a quality improvement definition to promote insurer improvements in defining or coding of medical conditions for a limited window of time.
- Phase down the special circumstances adjustment for mini-med plans: In 2011, so-called mini-med plans received a special circumstances adjustment to their MLR in the form of a multiplier of 2.0 for 2011. The final rule phases it down from 1.75 in 2012 to 1.5 in 2013 to 1.25 in 2014. Mini-med plans will be banned by the prohibition on annual limits in the Affordable Care Act starting in 2014.
- Recognize circumstances of special types of plans: The final rule, after reviewing data, keeps the ex-patriate plan multiplier adjustment at 2.0 due to their unique structure. It also levels the playing field between non-profit and for-profit insurers in states with premium taxes.

For more information on the final rule, visit:

Source: CMS News Release

Timeline for Health Care Reform

According to a recently published timeline for the implementation of the Affordable Care Act (health care reform), in 2012, Affordable Care Organizations will be voluntarily formed by health care providers to assume care for groups of 5000 or more Medicare patients.

The goal of the initiative is to lower the cost of health care without sacrificing quality.

Source: Article in Times Free Press

Thursday, December 1, 2011

Study: E-prescribing Is Safe, Efficient, but Barriers Remain

Physician practices and pharmacies generally view electronic prescribing as an important tool to improve patient safety and save time, but both groups face barriers to realizing the technology's full benefit, according to a study funded by the U.S. Department of Health and Human Services' (HHS) Agency for Healthcare Research and Quality (AHRQ). The study is published online in the Journal of the American Medical Informatics Association.

Electronic prescribing, or e-prescribing, has multiple potential benefits, including helping to reduce the risk of medication errors caused by illegible or incomplete handwritten prescriptions. The study focused on a key aspect of e-prescribing: the electronic exchange of prescription data between physician practices and pharmacies, which can save time and money by streamlining the way in which new prescriptions and renewals are processed.

Physician practices and pharmacies generally were positive about the electronic transmission of new prescriptions, the study found. However, prescription renewals, connectivity between physician offices and mail-order pharmacies, and manual entry of certain prescription information by pharmacists—particularly drug name, dosage form, quantity, and patient instructions—continue to pose problems.

"Physicians and pharmacies have come a long way in their use of e-prescribing, and that's a very positive trend for safer patient care and improved efficiency," said AHRQ Director Carolyn M. Clancy, M.D. "This study identifies issues that need attention to improve e-prescribing for physicians, pharmacies, and patients."

Researchers at the Center for Studying Health System Change, Washington, D.C., conducted 114 interviews with representatives of 24 physician practices, 48 community pharmacies and three mail-order pharmacies using e-prescribing. Community pharmacies were divided between local and national companies.

Physician practices and pharmacies used e-prescribing features for electronic renewals much less often than for new prescriptions. More than a quarter of the community pharmacies reported that they did not send electronic renewal requests to physicians. Similarly, one-third of physician practices had e-prescribing systems that were not set up to receive electronic renewals or only received them infrequently.

Physician practices reported that some pharmacies that sent renewal requests electronically also sent requests via fax or phone, even after the physician had responded electronically. At the same time, pharmacies reported that physicians often approved electronic requests by phone or fax or mistakenly denied the request and sent a new prescription.

The study noted that resolving e-prescribing challenges will become more pressing as increasing numbers of physicians adopt the technology in response to federal incentives. Physicians can qualify for Medicare and Medicaid electronic health record incentive payments by generating and transmitting more than 40 percent of all prescriptions to pharmacies electronically, excluding prescriptions for controlled substances, as part of the HITECH Act of 2009.

The study, "Transmitting and processing electronic prescriptions: Experiences of physician practices and pharmacies," concludes that a broad group of public and private stakeholders will need to work together to address these issues. Stakeholders include the federal government, e-prescribing standard-setting organizations, vendors and others. It is available at

Source: AHRQ News Release

Wednesday, November 30, 2011

Smart Card Alliance Releases White Paper on Health ID

The Smart Card Alliance Healthcare Council released a white paper providing smart card guidance for the Workgroup for Electronic Data Interchange (WEDI) Health Identification Card Implementation Guide. The white paper provides WEDI-compliant smart card designs and includes a discussion of the features and benefits of smart ID cards for healthcare providers and payers.

“The Smart Card Alliance supports WEDI’s goal to enable automated and interoperable identification using standardized machine-readable health identification cards,” said Randy Vanderhoof, executive director of the Smart Card Alliance. “This white paper complements the WEDI guide by outlining how smart card technology provides a strong foundation for health ID cards. They enable improvement in healthcare processes and in patient identity verification, while securing patient information and protecting patient privacy.”

“The intent of the WEDI Guide and its underlying ANSI standard is to standardize present practice and bring uniformity of information, appearance, and machine-readable technology. It offers great benefit; yet it is a simple identification card. Smart card technology, with its far greater capacity and ability to be updated, brings opportunity for heightened security and new health applications,” said Peter Barry, co-chair, WEDI Health ID Card workgroup.

The white paper provides a thorough explanation of smart card technology, as well as the benefits of smart cards for healthcare applications for payers, healthcare delivery organizations, patients, healthcare providers, and healthcare employers. Some of these benefits include:
- Accurate identification of the patient
- Accurate information on patient health plan
- Reduction in medical fraud
- Reduction of duplicate tests and payments
- Streamlined patient registration
- HIPAA compliance
- Improved patient privacy and information security
- Support for meaningful use requirements
- Reduced costs

“The WEDI Health ID Implementation Guide specifically mentions smart cards as an appropriate card type, and this white paper expands on the idea. Smart cards are the only technology that can provide the security and privacy features that are fundamental to any patient identity management system,” said Michael Magrath, chairman of the Smart Card Alliance Healthcare Council and business development director for Gemalto.

Please click here for more information.

Source: Smart Card Alliance News Release

HHS Awards Affordable Insurance Exchange Funds to States

The Department of Health and Human Services (HHS) awarded nearly $220 million in Affordable Insurance Exchange grants to 13 states to help them create Exchanges, giving these states more flexibility and resources to implement the Affordable Care Act. The health care reform law gives states the freedom to design Affordable Insurance Exchanges – one-stop marketplaces where consumers can choose a private health insurance plan that fits their health needs and have the same kinds of insurance choices as members of Congress.

The Department also released several Frequently Asked Questions providing answers to key questions states need to know as they work to set up these new marketplaces. Critical among these are that states that run Exchanges have more options than originally proposed when it comes to determining eligibility for tax credits and Medicaid. And states have more time to apply for “Level One” Exchange grants.

The awards bring to 29 the number of states that are making significant progress in creating Affordable Insurance Exchanges. States receiving funding today include: Alabama, Arizona, Delaware, Hawaii, Idaho, Iowa, Maine, Michigan, Nebraska, New Mexico, Rhode Island, Tennessee, and Vermont.

“We are committed to giving states the flexibility to implement the Affordable Care Act in the way that works for them,” HHS Secretary Kathleen Sebelius said. “Exchanges will give consumers more choices and make it easy to compare and shop for insurance plans.”
In the new Exchanges, insurers will provide new information such as an easy-to-understand summary of benefits and costs to consumers. The level of detail will sharpen competition between carriers which will drive costs down.

HHS also released a set of Frequently Asked Questions (FAQs) in anticipation of state legislative sessions beginning in January. Answers will help advance state policy development for Exchanges. For example, they clarify that Exchange grants can be used to build a state Exchange that is operational after 2014; that state-based Exchanges will not be charged for accessing Federal data needed to run Exchanges in 2014; and that state insurance rules and operations will continue even if the Federal government is facilitating an Exchange in the state. HHS will also allow greater flexibility in eligibility determinations, allowing, for example, a state-based Exchange to permit the Federal government to determine eligibility for premium tax credits.

Of the 13 states awarded grants today, 12 are receiving Level One grants, which provide one year of funding to states that have already made progress using their Exchange planning grant. The 13th state, Rhode Island, is receiving the first Level Two grant, which provides multi-year funding to states further along in the planning process.

Forty-nine states and the District of Columbia have already received planning grants, and 45 states have consulted with consumer advocates and insurance companies. Thirteen states have passed legislation to create an Exchange.

States have many opportunities to apply for funding. To accommodate state legislative sessions and to give states more time to apply, HHS also announced a six-month extension for Level One establishment grant applications. Applications now will be accepted until June 29, 2012 (the original deadline was December 30, 2011).

For the FAQs, visit

For more information on Affordable Insurance Exchanges, visit

For more information on the states receiving grants, visit

Source: HHS News Release

HHS Releases Tool to Help Small Businesses Compare Insurance Plans

A greatly expanded website to give small business owners an unprecedented detailed review of their health insurance plan choices was announced by the U.S. Department of Health and Human Services (HHS).

Just in time for 2012, this powerful new tool allows small business owners to compare the benefits and costs of health plans and choose those that are best for their employees. For the first time ever, it will allow small businesses to research locally available products in an unbiased manner and foster a more transparent and competitive marketplace.

“This new information will help business owners navigate what has traditionally been a complicated and confusing decision,” said HHS Secretary Kathleen Sebelius. “Both owners and their employees can feel more confident that the plans offered will be the best to suit everyone’s needs.”

In addition to the market being difficult to analyze, small businesses do not fare as well large employers when negotiating health care prices, on average small businesses spend 18 percent more for the same health insurance coverage. This new tool brings needed transparency to the marketplace, which will help ensure insurance companies will compete for business on the basis of price and quality.

The tool is located on, which was created under requirements contained in the Affordable Care Act, the new health care law of 2010. The website is the first of its kind to bring information and links to health insurance plans to one place, and to make it easy for consumers to learn about and compare their insurance options. The Centers for Medicare & Medicaid Services worked to define and collect detailed benefits and premium rating information from insurers across the country to develop the site.

The new information added gives small business owners access to the following:
Insurance product choices for a given ZIP code, sorted by out-of-pocket limits, average cost per enrollee, or other factors.

A summary of cost and coverage for small group products that shows the available deductibles, range of co-pay options, included and excluded benefits, and benefits available for purchase at additional cost.

The ability to filter product selection based on whether the plans are Health Savings Account eligible, have prescription drug, mental health, or maternity coverage, or allow for domestic partner or same sex coverage.

More than 530 insurers have provided information for more than 2,700 coverage plans across all states and the District of Columbia.

“Tens of thousands of small businesses from across America have already logged-on to to see what health coverage options are available to them,” said Steve Larsen, director of the Center for Consumer Information and Insurance Oversight. “The new, unprecedented ability to search at this level of detail will bring the marketplace into better balance by giving insurance purchasers the power of information.”

In addition, the website provides extensive information about consumer rights, tips for how to navigate the market’s complexities, and details on how the Affordable Care Act provides new protections for beneficiaries.

To access the small business Insurance Finder, go to the home page of and click on the blue tab at the top of the page.

For more information, visit, or access the HHS Facebook page or Twitter account. To download a Insurance Finder widget visit

Source: HHS News Release

TJC To Launch Enhanced e-App

The Joint Commission announced that on December 28, 2011, it will launch an enhanced electronic application for accreditation (E-App) for all accreditation programs, except for the laboratory accreditation program and certification programs.

Source: TJC Release

NIH Undergraduate Design Challenge Focuses on Healthcare Tech Solutions

A competition for undergraduate students to foster the design and development of innovative diagnostic and therapeutic devices, and technologies to aid underserved populations and the disabled is being sponsored by the National Institute of Biomedical Imaging and Bioengineering (NIBIB), part of the National Institutes of Health. The Design by Biomedical Undergraduate Teams (DEBUT) Challenge is part of NIBIB's efforts to build, strengthen, and prepare the future workforce of biomedical engineers.

One winning student team will be selected for each of three challenge categories: diagnostic devices/methods; therapeutic devices/methods; and technology to aid underserved populations and individuals with disabilities. Eligible team candidates must be full time undergraduate students and U.S. citizens or permanent residents. Each winning team will receive a $10,000 prize, to be distributed among the team members. Winners will be honored at an award ceremony during the 2012 Annual Meeting of the Biomedical Engineering Society (BMES) in Atlanta, Ga. Each winning team will also receive up to $2,000 towards travel and registration costs to attend the awards ceremony.

Dr. Zeynep Erim, the architect of the NIBIB challenge, said "At NIBIB, we aim to prepare the next generation of engineers working at the intersection of the biological and physical sciences to improve human health. This program challenges up-and-coming biomedical engineers to force the boundaries of their design skills and knowledge to develop innovative biomedical technology for health care."

"As a nation, we have reached a crossroads where there is a tremendous opportunity to harness the science, engineering, and mathematics talent within our universities to address challenges in health care," stated Dr. Roderic Pettigrew, NIBIB director. "NIBIB's DEBUT Challenge, authorized under the America Competes Act, seeks to promote competitiveness in these disciplines and to put American ingenuity to work to address some of the unmet medical needs that are most prevalent in our country. I look forward to seeing what technological innovations our best and brightest students can offer to improve health care in our nation."

Details on how to enter, requirements and general information about the challenge can be found at

For updates and additional information, visit

Source: NIH News Release

CMS Announces New Demonstrations to Help Curb Improper Medicare, Medicaid Payments

The Office of Management and Budget (OMB) announced that the Administration cut wasteful improper payments by $17.6 billion dollars in 2011 as part of the Obama Administration’s Campaign to Cut Waste, fueled by decreases in payment errors in Medicare, Medicaid, Pell Grants, and Food Stamps. Combined with the avoided improper payments in 2010, agencies have avoided making over $20 billion in improper payments in the two years since President Obama issued an Executive Order initiating an aggressive campaign against the wasteful payment errors.

To help cut improper payments, the Centers for Medicare & Medicaid Services (CMS) has announced it will launch demonstration programs beginning in January 2012 targeting some of the most common factors that lead to improper payments. The demonstration programs will help strengthen Medicare by aiming at eliminating fraud, waste, and abuse.

To see the OMB press release, please visit:

To learn more about CMS efforts to cut improper payments, please visit:

Source: HHS News Release

Monday, November 28, 2011

Patient Engagement Important to Success of Health Care Reform

Kenneth Bertka, MD, recently authored an article about the importance of patient engagement in the success of health care reform. In his article Patient Engagement's Critical Role in Post-Reform Success: 6 Steps to Improve Patient Centeredness, Dr. Bertka says that "[p]atient more than a nice thing to do. Engaged patients are more likely to comply with their treatment and prevention plans, which results in higher quality care, fewer medical errors and lower cost."

Read Dr. Bertka's article here.

Source: Becker's Hospital Review

Wednesday, November 9, 2011

OCR Launches Privacy and Security Audits

The American Recovery and Reinvestment Act of 2009, in Section 13411 of the HITECH Act, requires the U.S. Department of Health and Human Services (HHS) to provide for periodic audits to ensure covered entities and business associates are complying with the HIPAA Privacy and Security Rules and Breach Notification standards. To implement this mandate, the HHS Office for Civil Rights (OCR) is piloting a program to perform up to 150 audits of covered entities to assess privacy and security compliance. Audits conducted during the pilot phase will begin in November 2011 and conclude by December 2012.

More information regarding OCR’s Pilot Audit Program is available on the OCR website at

Source: OCR News Release

Monday, November 7, 2011

PCPAN Coalition Urges Opposition to Merger of Two Large Pharmacy Benefit Chains

More than 50 consumers, small business owners and community pharmacists with Preserve Community Pharmacy Access NOW! (PCPAN) Coalition gathered in Washington, D.C. on November 4 to urge Congress and the Federal Trade Commission (FTC) to support patient care and oppose the planned merger between Express Scripts Inc. and Medco Health Solutions Inc, two of the nation’s largest pharmacy benefit management (PBM) companies.

Several Members of Congress attended the press conference to express their opposition to the merger.

“If allowed to go forward, this merger would have devastating effects on consumers and small businesses, alike,” said Congressman Joe Courtney (D-CT). “In an industry that already offers few choices, further market concentration would squeeze out the community pharmacies many of us have come to trust the most.”

“Right now, there is not a level playing field which is why I feel we need to act now,” said Congressman Thomas Marino (R-PA). “I supported community pharmacies when I sponsored a bill that sets out to level that playing field – and that would not cost the federal government or anyone else a penny. As a matter of fact, it would actually lower the prices for independent pharmacies and they, in turn, would pass it on to the consumer. I continue to support community pharmacies now.”

Pharmacy benefit managers (PBMs) manage prescription drug benefit programs for employers, unions, health plans and others. PBMs control the drug benefits of more than 200 million patients nationwide. This number includes a diverse group of Americans such as Medicare Part D beneficiaries, servicemen and veterans that are TRICARE beneficiaries, and more.

"[Dr]ugstores are lobbying against the merger, arguing that the deal, in which Express Scripts would acquire Medco for $29 billion, would put drugstores out of business and lead to higher consumer prices," reports

The House Judiciary Subcommittee on Intellectual Property, Competition and the Internet held a hearing on the merger on September 20. The Senate Judiciary Subcommittee on Antitrust, Competition Policy and Consumer Rights plans to hold a hearing on the merger in December.

Thursday, November 3, 2011

TJC, SGS Form Alliance to Offer Coordinated Accreditation and ISO Certification Option

The Joint Commission (TJC) and SGS Group are joining forces to offer hospitals and critical access hospitals in the United States the option of pursuing both accreditation and certification to various ISO and industry best practice standards beginning in early 2012.

This program combines The Joint Commission’s modern health care quality and safety standards, survey process, and accountability performance measures with SGS management system audits including certification to the ISO 9001 quality management system standards. The combination of accreditation and ISO offers hospitals the tools to maintain best practices and lower costs across their entire operation while remaining focused on their core service – delivering quality health care to patients.

ISO standards articulate management systems to consistently meet established requirements. Joint Commission standards supply the valuable quality and safety enhancing requirements which can be integrated into an organization’s quality management system. By encouraging leadership commitment to maintaining focused, organized and dynamic processes, the coordinated option has the potential to deliver extra value by improving the operating performance of the organization.

SGS, a public company, is the world’s leading verification, inspection, certification, and testing company focused on providing independent certification and quality assurance services through its worldwide network of subsidiaries, branches and agencies. SGS operates a network of 1,250 offices around the world.

The Joint Commission, and its affiliate Joint Commission International, are the leading health care accrediting bodies, both in the United States and internationally, utilizing up-to-date standards they have developed working with the health care community to help improve the quality and safety of care.

“We are providing this option for hospitals and critical access hospitals in the United States that are interested in exploring the combination of ISO education and certification with Joint Commission accreditation as a mechanism to more precisely identify system vulnerabilities and inefficiencies. Future plans are to expand the option to organizations accredited under other Joint Commission accreditation programs,” says Ann Scott Blouin, RN, Ph.D., FACHE, executive vice president, Accreditation and Certification Operations, The Joint Commission.

“Providing this enhanced service to health care organizations through the alliance of SGS and The Joint Commission is a natural progression for health care performance improvement,” says Tony Perkins, senior vice president, SGS. “We are offering health care organizations an opportunity to take advantage of a number of ISO standards which complement Joint Commission accreditation requirements. This provides a method for hospitals to focus on improvements in quality and customer service in all departments, as well as their facility’s impact on the environment.”

Click here for more information.

Source: TJC News Release

EHNAC Requests Public Review of Program Accreditation Criteria

The Electronic Healthcare Network Accreditation Commission (EHNAC), a non-profit standards development organization and accrediting body, announced that it has posted new versions of program criteria for general public review. EHNAC seeks interested parties to provide opinions, comments and suggestions for the upgraded criteria versions that have been developed for each of EHNAC’s accreditation programs with regard to the necessity, appropriateness and workability of the criteria versions proposed for adoption.

Comments are due on Nov. 26, 2011.

Below is a listing of the eleven affected programs:
ePAP – e-Prescribing Accreditation Program
FSAP EHN – Financial Services Accreditation Program for Electronic Health Networks
FSAP Lockbox – Financial Services Accreditation Program for Lockbox Services
HIEAP – Health Information Exchange Accreditation Program
HNAP-70 – Healthcare Network Accreditation Plus Select SAS 70©1 Criteria Program
HNAP EHN – Healthcare Network Accreditation Program for Electronic Health Networks [Includes Payer]
HNAP Medical Biller – Healthcare Network Accreditation Program for Medical Billers
HNAP TPA – Healthcare Network Accreditation Program for Third Party Administrators
MSOAP – Management Service Organization Accreditation Program
OSAP – Outsourced Services Accreditation Program
OSAP HIE – Outsourced Services Accreditation Program for Health Information Exchange Services

Please click here for more information and to review the criteria.

Source: EHNAC News Release

Wednesday, November 2, 2011

ONC Seeks Opinions on Mobile Devices as Health Information Tools

The Office of the National Coordinator for Health Information Technology’s (ONC) Office of the Chief Privacy Officer plans to perform a project using a qualitative data collection approach to obtain in-depth information from mHealth users regarding privacy and security concerns with this technology and perspectives on potential safeguards.

mHealth refers to the use of mobile devices to communicate health information, and includes text messaging, email accessibility on the device, Skype, or the use of applications downloaded to the device.

ONC is conducting focus group research to identify and explore the attitudes and preferences of a diverse sample of consumers with respect to the communication of health related information on mobile phones and devices, including text messaging. Results from this focus group research are expected to be available in 2012. For more information on this and other mHealth initiatives at HHS, please visit

Source: ONC News Release

Monday, October 31, 2011

HHS Announces Refined Survey Standards to More Constitently Measure Care Disparities

The U.S. Department of Health and Human Services (HHS) released final standards to more consistently measure race, ethnicity, sex, primary language, and disability status, thereby improving the ability to highlight disparities in health status and target interventions to reduce these disparities.

“It is our job to get a better understanding of why disparities occur and how to eliminate them. Improving the breadth and quality of our data collection and analysis on key areas, like race, ethnicity, sex, primary language and disability status, is critical to better understanding who we are serving,” said HHS Secretary Sebelius. "Today, through these new standards, we are providing a new set of powerful tools to help us achieve our vision of a nation free of disparities in health and health care.”

The Affordable Care Act requires new standards for the collection and reporting of health care information based on race, ethnicity, sex, and primary language. Making data standards consistent will help identify the significant health differences that often exist between and within ethnic groups, particularly among Asian, Hispanic/Latino and Pacific Islander populations.

For example, a study showed that the diabetes-related mortality rate for Mexican Americans (251 per 100, 000) and Puerto Ricans (204 deaths per 100, 000) was twice as high as the diabetes-related mortality rate for Cuban Americans (101 deaths per 100, 000). However, this information would have remained unknown if only the umbrella terms of “Hispanic” or “Latino” had been used.

By adding Mexican American and Chicano/a, Puerto Rican, Cuban, and other Hispanic Latino/a or Spanish origin as explicit categories required on all HHS-sponsored health surveys, we can better capture the individual ethnic group challenges that are often found within minority populations. This specificity allows for better measurement and tracking of health differences in these populations and target interventions appropriately.

The new data collection requirements also will improve researchers' ability to consistently monitor more dimensions of health disparities among people with disabilities. Collection of all data will take place under HHS’ longstanding, strict commitment to protecting privacy.

“Many racial and ethnic minorities, people with limited English proficiency, people with disabilities, and other populations face unique health challenges, often have reduced access to health care and often pay the price with poorer health,” said Garth Graham, M.D., MPH, HHS deputy assistant secretary for minority health. “Today we are implementing an important provision of the Affordable Care Act that reinforces our commitment to reducing these health disparities. These new standards will help us carry forward the HHS Action Plan to Reduce Racial and Ethnic Health Disparities and our work to address disparities in people with disabilities as well.”

The standards, effective upon publication today, apply to health surveys sponsored by HHS where respondents either self-report information or a knowledgeable person responds for all members of a household. The standards will be used in all new surveys and at the time of revision to current surveys.

For more information on the final data standards, visit

Source: HHS News Release

NLM Honors Winners of Software Development Challenge

Five innovative software applications that help researchers, health professionals, and the general public in their quest for medical and scientific information are the winners of the National Library of Medicine's first software development challenge.

The winning applications can help people learn about anatomy, help researchers find gene information in research literature, and help people sift through large amounts of scientific and medical information.

The library's software development challenge, Show off Your Apps: Innovative Uses of NLM Information, solicited applications that used the library’s data to develop innovative ways for people to obtain and share scientific and medical information. Entrants could create a new app, or submit an existing one. An independent panel of judges chose five winners and five honorable mentions.

The National Library of Medicine (NLM), part of the National Institutes of Health, is the world’s largest medical library and itself a pioneer and innovator in the use of technology to improve access to biomedical and health information. NLM provides a wide variety of information online by developing groundbreaking databases and software tools that enable people to explore medical literature, clinical trials, historical images, DNA sequences and much more.

"NLM was a leader in open data long before that term was coined," says U.S. Department of Health and Human Services (HHS) Chief Technology Officer Todd Park. "Challenges like this one bring the library’s rich data sources to the attention of new groups of innovators."
"By making our data available for others to use, we spark more innovation and give taxpayers a bigger dividend on their investment," says Donald A.B. Lindberg, M.D., director of the NLM, which is celebrating its 175th anniversary this year.

Click here to view the winners of the Challenge.

Click here for more information about the Software Development Challenge.

Source: NIH News Release

Monday, October 24, 2011

CMS Proposes Regulatory Reduction Rules

On October 18, the Centers for Medicare & Medicaid Services (CMS) took steps to reduce unnecessary, obsolete, or burdensome regulations on American hospitals and healthcare providers. These steps would help achieve the key goal of President Obama’s regulatory reform initiative to reduce unnecessary burdens on business and would save nearly $1.1 billion across the health care system in the first year for a total of over $5 billion over 5 years.

CMS proposed two sets of regulatory reforms and finalized a third. All are designed to improve transparency and help providers operate more efficiently by reducing their regulatory burden. One set proposes updates to the Medicare Conditions of Participation (CoPs) for hospitals and critical access hospitals (CAHs). The second set addresses regulatory requirements for a broader range of health care providers and suppliers who are regulated under Medicare and Medicaid. CMS also finalized a third rule reducing regulatory burden for ambulatory surgical centers (ASCs).

CMS estimates that annual savings to hospitals from the proposed revisions to the Conditions of Participation could exceed $900 million in its first year as hospitals increasingly use this new flexibility. The Medicare Regulatory Reform rule could save up to $200 million in the first year. The final rule for ASCs could generate an extra $50 million in savings per year.

Taken together, these three rules would reduce hospital and other healthcare provider costs by nearly $1.1 billion the first year. These cost savings would come directly from reduced regulatory burdens, and are not accompanied by reimbursement reductions. As such, all of these savings would be available to help providers improve the quality of care they provide to Medicare beneficiaries and all Americans.

Click here to view the news release.

Source: CMS News Release

CMS Launches Innovation Advisors Program

The Centers for Medicare & Medicaid Services (CMS) announced that it was accepting applications for a new Innovation Advisors program to help health professionals deepen skills that will drive improvements to patient care and reduce costs. These health care improvements will benefit people enrolled in Medicare, Medicaid, and the Children’s Health Insurance Program (CHIP). Made possible by the Affordable Care Act, this initiative will be managed by the Center for Medicare and Medicaid Innovation (Innovation Center).

“We seek to support and expand the number of health care leaders with the knowledge and the vision to find innovative ways to improve care for patients and use our healthcare dollars more wisely,” said CMS Administrator Don Berwick, M.D. “The CMS Innovation Center is an ideal host for this network of experts. It will support their work on efforts that can strengthen public-private partnerships and ensure patients can spend more time with their doctor and get higher-quality care and lower costs.”

Under the new program, there will be up to 200 Innovation Advisors, including clinicians, allied health professionals, health administrators and others. They will attend in-person meetings as well as remote sessions to expand their skills and knowledge, and apply what they learn in their organizations and areas.

After an initial, intensive orientation phase, Innovation Advisors will work with the Innovation Center to test new models of care delivery in their own organizations and communities. They will also create partnerships to find new ideas that work and share them regionally and across the United States.

Innovation Advisors will be expected to commit up to 10 hours per week to the Innovation Advisor Program during the initial six months of the program, with part of that time devoted to seminars and instruction. The rest of that time will be devoted to implementing the improvement project they propose in their initial application. The Innovation Advisors who are selected will meet regularly to exchange insights, report on successes and discuss common challenges.

This initiative is just one of a number of efforts made possible by the Affordable Care Act to help bring better health and better health care not just to Medicare beneficiaries, but also to all Americans, while helping use healthcare dollars more wisely. Already, more than 5,000 organizations have joined the Partnership for Patients and pledged to reduce hospital-acquired conditions and improve transitions in care. The Bundled Payments for Care Improvement initiative will give providers flexibility to work together to coordinate care for patients over the course of a single episode of an illness. The Comprehensive Primary Care Initiative will allow CMS and other payers, such as employer-based health plans, to align strategies designed to strengthen primary care services delivered to Medicare beneficiaries.

Applications for the Innovation Advisors program are due on November 15, 2011. Applications will be reviewed and Innovation Advisors will be notified of their selection by mid-December 2011.

More information, including a fact sheet, frequently asked questions, application and terms and conditions can be found at:

Source: CMS News Release

HHS Releases New Program to Help Providers Give Better Care to Medicare Patients

People with Medicare will be able to benefit from a new program designed to encourage primary care doctors, specialists, hospitals, and other health care providers to coordinate their care under a final regulation issued today by the Department of Health and Human Services (HHS).

Created by the Affordable Care Act, these final rules on Accountable Care Organizations add to the menu of options for providers looking to better coordinate care for patients and will make it easier for providers to deliver high quality care and use health care dollars more wisely.
The initiatives announced are just two of several efforts made possible by the Affordable Care Act to help bring better health, better care and lower costs not just to Medicare beneficiaries, but to all Americans. For example, the Bundled Payments for Care Improvement Initiative and Comprehensive Primary Care Initiative offer alternatives to coordinate and improve health care.

“Today we have taken another step to improve health care for people with Medicare,” said HHS Secretary Kathleen Sebelius. “We are excited to give doctors, hospitals and other providers the flexibility and support they need to work together and focus on making sure patients get the care they need.”

“This model of delivering care may not be right for everyone, but it provides new incentives for doctors, hospitals, and other health care providers to work together in new ways,” said Secretary Sebelius.

The two initiatives launched – the Medicare Shared Savings Program and the Advance Payment model – will help providers form Accountable Care Organizations and reflect the significant input provided by stakeholders as well as lessons learned by innovators in care coordination in the private sector.

The Medicare Shared Savings Program will provide incentives for participating health care providers who agree to work together and become accountable for coordinating care for patients. Providers who band together through this model and who meet certain quality standards based upon, among other measures, patient outcomes and care coordination among the provider team, may share in savings they achieve for the Medicare program. The higher the quality of care providers deliver, the more shared savings the providers may keep.

The Advance Payment model will provide additional support to physician-owned and rural providers participating in the Medicare Shared Savings Program who also would benefit from additional start-up resources to build the necessary infrastructure, such as new staff or information technology systems. The advanced payments would be recovered from any future shared savings achieved by the Accountable Care Organization.

“As a physician I understand the complexities of caring for a patient who may have multiple providers,” said Donald M. Berwick, M.D., administrator of the Centers for Medicare & Medicaid Services (CMS). “This opportunity to coordinate care among providers could greatly improve the quality of care Medicare beneficiaries receive.”

Both the Medicare Shared Savings Program and Advance Payment model create incentives for health care providers to work together to treat an individual patient across care settings – including doctors’ offices, hospitals, and long-term care facilities.

Unlike a managed care plan, Medicare beneficiaries will not be locked into a restricted panel of providers. Rather, a determination of whether an Accountable Care Organization was responsible for coordinating care for a beneficiary will be based on whether that person received most of their primary care services from the organization.

“We listened very carefully to the more than 1,300 comments we received on the proposed rule released this spring, and this final rule includes a number of improvements suggested by those comments that will strengthen the program,” Dr. Berwick said. “For example, the final rule will increase the incentives and streamline the Shared Savings Program, extending the benefits of the new program to a broader range of beneficiaries.”

Other changes from the proposed rule include making the one-sided model truly one-sided, expanding participation to Rural Health Clinics and Federally Qualified Health Centers and organizations where specialists provide primary care, and providing a flexible starting date in 2012. Federal savings from this initiative could be up to $940 million over four years.

To aid organizations interested in becoming Accountable Care Organizations, CMS offers a number of learning opportunities for providers, including the third Accelerated Development Learning Session on November 17-18 in Baltimore. This free session will offer providers the opportunity to learn more about this option for providing care. For more information, visit

People with Medicare have received information about what an Accountable Care Organization could mean for them in the annual issue of “Medicare & You” and if their current health care provider is participating in an Accountable Care Organization, they will receive additional information from their provider.

The Shared Savings Program final rule can be found at: (See Final Rule on Shared Savings Program: Accountable Care Organizations)

The Advanced Payment solicitation is posted at:

For more information, fact sheets are posted at: and

The joint CMS and Department of Health and Human Services Office of Inspector General (OIG) Interim Final Rule with Comment Period addressing waivers of certain fraud and abuse laws in connection with the Shared Savings Program can be found at: (See Request for Public Comment on Final Waivers in Connection with the Shared Savings Program).

The Antitrust Policy Statement is posted at: and

The Internal Revenue Service (IRS) Fact Sheet, Tax-Exempt Organizations Participating in the Medicare Shared Savings Program through Accountable Care (FS-2001-11), is posted at:,,id=248490,00.html.

Source: HHS News Release

Medical Office Survey on Patient Safety Culture Comparative Database & Toolkit Available

AHRQ’s Medical Office Survey on Patient Safety Culture is a tool for medical offices to use to assess clinician and staff opinions about the culture of patient safety in their medical offices.
The database is a central repository for survey data from medical offices, health care systems, or survey vendors that have administered the AHRQ medical office survey instrument. It will produce comparative results among users to help medical offices identify strengths and opportunities for improvement in their patient safety culture.

Select for more information.

Source: AHRQ News Release

EHR Decision Support Tool Saved Physicians Time, Errors in Retrieving Clinical Information

A decision support tool generated by an electronic health record (EHR) that collects clinical information on ambulatory diabetes care saved primary care physicians more than 4 minutes compared to the conventional method of searching on multiple EHR screens, an AHRQ-funded study has found. Writing in the September/October 2011 issue of the Annals of Family Medicine, researchers at the University of Missouri family medicine department created an EHR-generated diabetes “dashboard” with the technology company Cerner. The dashboard collects important diabetes clinical data on one page and mirrors the information sought by national organizations to benchmark high-quality diabetes care. Physicians using the dashboard located the 10 data elements within 1.3 minutes, compared to 5.5 minutes among physicians searching multiple EHR screens. Physicians who used the dashboard correctly identified the data requested 100 percent of the time, compared to 94 percent for physicians using the conventional method.

Select for the article.

Source: AHRQ News Release

EHR Use Results in Higher Quality Care, AHRQ-Funded Study Finds

Patients who are treated by physicians using electronic health records (EHRs) were significantly more likely to receive care that corresponds to accepted treatment standards and get better care than patients treated by physicians who rely on paper records, a new AHRQ-funded study concludes. The study, published in the September 1 issue of the New England Journal of Medicine, examined physician practices in the Cleveland, OH, area that treated more than 27,000 adults with diabetes. Regardless of insurance mix, practices using EHRs showed higher achievement of care and outcome standards and greater improvement in diabetes care. Nearly half (43.7 percent) of the patients at EHR practice sites had diabetes outcomes that met at least four of the five standards, compared to 15.7 percent of patients at paper-based practice sites. Annual improvements in meeting care standards and quality outcomes were faster in practices with EHRs than paper-based practices. Select to access the article.

Source: AHRQ News Release

AHRQ Launches Initiative to Encourage Better Communication Between Clinicians and Patients

The U.S. Department of Health and Human Services (HHS) Agency for Healthcare Research and Quality (AHRQ) announced a new initiative with the Ad Council to encourage clinicians and patients to engage in open communication to ensure safer care and better outcomes.

AHRQ has long supported patients getting more involved in their health care, and this effort builds on previous public education campaigns with the Ad Council that encouraged patients to ask questions. In the new campaign, clinicians are reminded that a “simple question can reveal as much medical information as a medical test.”

The campaign also includes a series of videos featuring actual patients and clinicians who discuss why asking questions and sharing information is so important. Other elements of the campaign include an interactive tool that lets patients create a personalized list of questions based on their health condition; a new brochure that helps patients be more prepared before, during and after their appointment; and upcoming ads about the campaign for clinicians that will appear in a variety of print and online journals, including the New England Journal of Medicine, the Journal of the American Medical Association, and others.

Select for more information on the new initiative.

Source: AHRQ News Release

Tuesday, October 18, 2011

New CMS Proposed Rules Designed to Cut Red Tape

New proposed rules released by the Centers for Medicare & Medicaid Services (CMS) would reduce unnecessary, obsolete, or burdensome regulations and save hospitals and healthcare providers nearly $1.1 billion each year and over $5 billion over 5 years. The new proposals regarding the rules for hospitals that treat Medicare and Medicaid patients were developed in response to President Obama’s call on all Federal agencies to eliminate burdensome and unnecessary regulations.

“The President and I have challenged agencies to hunt down burdensome regulations,” said Vice President Joe Biden. “Today’s steps will remove outdated, duplicative, unnecessary burdens on hospitals - saving money and improving care.”

“President Obama has been clear: it’s time to cut the red tape,” said HHS Secretary Kathleen Sebelius. “Our new proposals eliminate unnecessary and obsolete standards and free up resources so hospitals and doctors can focus on treating patients.”

CMS proposed two sets of regulatory reforms and finalized a third. All are designed to improve transparency and help providers operate more efficiently by reducing their regulatory burden.

One set proposes to update the rules for hospitals that treat Medicare and Medicaid patients -- the Medicare Conditions of Participation. As an example, the proposed reforms would consolidate patient care plans and eliminate outdated requirements for hospital management. This could save hospitals over $900 million per year and perhaps grow to much more over time as hospitals increasingly use this new flexibility.

The second set of reforms address regulatory requirements for providers other than hospitals and could save up to $200 million in the first year. The rule would identify and begin to eliminate duplicative, overlapping, outdated, and conflicting regulatory requirements for healthcare providers and suppliers such as end-stage renal disease facilities and durable medical equipment suppliers. Examples of these reforms include updating obsolete e-prescribing technical requirements to meet current standards and eliminating other out-of-date and overly prescriptive requirements for healthcare providers.

CMS is also finalizing a third rule that reduces regulatory burden for ambulatory surgical centers (ASCs), which is expected to save ASCs $50 million per year. This rule makes common-sense changes to the requirements ASCs must follow in order to meet Medicare and Medicaid health and safety standards.

These regulatory reforms are just one part of a wide-ranging effort by the Obama Administration to improve the quality of health care and lower costs for all Americans, using important new tools provided by the Affordable Care Act. These efforts include the National Quality Strategy and the Partnership for Patients. These initiatives aim to reform the health care delivery system and bring together both private and public sector partners to keep patients from getting injured or sicker in the health care system and to improve transitions between care settings. CMS intends to invest up to $1 billion to help drive these changes through the Partnership for Patients initiative. And beginning in FY 2013, for the first time, the Hospital Value-Based Purchasing program authorized by the Affordable Care Act will pay hospitals’ inpatient acute care services based partially on care quality, not just the quantity of the services they provide.

To view the proposed and final rules, please visit:

Both proposals invite the public, including doctors, hospitals, patient advocates, and other stakeholders, to comment. To submit a comment, visit, enter the ID number CMS-9070-P or CMS-3244-P, and click on “Submit a Comment.”

For additional information on these and other Conditions of Participation, visit

For additional information on the Department of Health and Human Services overall Plan for Retrospective Review of Existing Rules, visit

Source: HHS News Release

Monday, October 17, 2011

Health Care Reform Presents Opportunities for Performance Improvement

A recent article Becker's Hospital Review says that providers will need to find ways to reduce costs - particularly in Medicare and Medicaid - while maintaining or improving quality.

William C. Mohlenbrock, MD, FACS, discusses "three specific initiatives to improve quality and control costs [in the healthcare reform law]: the Medicare Shared Savings Program, which establishes Medicare accountable care organizations; the Bundled Payments for Care Initiative, which expands CMS' Acute Care Episodes; and Consumer Operated and Oriented Plans."

Source: Becker's Hospital Review

Friday, October 14, 2011

Journal of Hospital Medicine Shows Link Between Accreditation, Quality

New research published in the October issue of the “Journal of Hospital Medicine” shows that hospitals accredited by The Joint Commission outperformed non-accredited hospitals on nationally standardized quality measures of acute myocardial infarction (AMI), heart failure, and pneumonia and that the performance gap between Joint Commission accredited and non-accredited hospitals increased over the years of the study.

The study, “Hospital Performance Trends on National Quality Measures" is the first to show the association between Joint Commission accreditation status and performance improvement over a five-year reporting period.

Source: TJC News Release

HHS announces record number of National Health Service Corps members

U.S. Department of Health and Human Services (HHS) Secretary Kathleen Sebelius announced that the number of participants in the National Health Service Corps (NHSC) has nearly tripled because of investments in the National Health Service Corps through the Affordable Care Act, the American Recovery and Reinvestment Act and annual appropriations. The NHSC has awarded nearly $900 million in scholarships and loan repayment to health care professionals to help expand the country’s primary care workforce and meet the health care needs of communities across the country.

“Thanks to the National Health Service Corps, more Americans can see a doctor and get the health care they need,” said HHS Secretary Sebelius. “The investments we made are improving health and creating access to care, fueling economic activity nationwide.”

Analysts: Debt Reduction Talks Stalling Hospital Expansion

Wall Street panelists at the Center for Studying Health System Change's (HSC) recent "Wall Street Comes to Washington" Conference say that expansions and construction of new hospitals aren't happening because of investor fears and over potential cuts that may be made by Congress to reduce the national debt.

"I think right now the biggest hurdle is planning," said Fitch Ratings analyst Jeff Schaub. "There are so many things that are unknown. And the planning cycle at acute care providers is five years, 10 years they’re looking out and there’s a big black hole starting 2013, 2014 and extending through 2017. So capital decisions that need to be made now, organizational decisions, affiliation decisions that really need to be made now are being made with a certain amount of contingency. Very often when I meet with hospitals they’re talking about...five, six, maybe even 20 different alternative views of the future and trying to quantify and make decisions among that entire array of possible outcomes."

Citigroup analyst Gary Taylor said that facilities that should be being built right now are probably not because investors do not know if how or if Congress will cost shift Medicare and Medicaid cuts to publicly-traded hospitals. “Since this debt ceiling debate took over and we’ve made commitments to reduce entitlement spending etcetera, publicly traded hospital stocks are down probably 40 percent on average, [and] nursing home stocks are down 70 and 80 percent on average,” Taylor said according to a report in CQHealthbeat (subscription required). “The collective wisdom of the market right now is that investing in . . . certain types of health care providers is extraordinarily risky because of the policy changes, primary reimbursement cuts, that are going to potentially come out of Congress.”

Source: CQ Healthbeat (subscription required); HSC Conference Transcript

ONC/FHA Call For Participants in HIMSS 2012 Interoperability Showcase

Is your organization successfully using nationally recognized standards to securely share patient data with other organizations? Demonstrate your successes within the Office of the National Coordinator for Health IT (ONC) and Federal Health Architecture (FHA) area in the HIMSS 2012 Interoperability Showcase!

ONC and FHA are looking to highlight cutting-edge interoperable health information exchange at HIMSS 2012, with a focus on ONC-related initiatives, including:

Nationwide Health Information Network
Direct Project
State HIE Programs
S&I Framework
SHARP Program
Regional Extension Centers
Beacon Communities

All nominated demonstrations must include interoperable health information exchange among at least three end user organizations. End users include healthcare organizations (hospitals, clinics, state or federal agencies, etc.) and health information exchanges, not health IT vendors or IT service providers. All demonstrations must be live. No canned demonstrations or static presentations will be considered.

A panel of ONC staff will evaluate all nominations and determine which nominated demonstrations will be included within the ONC/FHA area of the Interoperability Showcase. Only nominations directly related to ONC programs will be considered. Nominations are due October 26th at 5:00 p.m. ET, and the determination of who will be included will be made by November 2nd.

Complete information is here:
Source: ONC/FHA News Release

Friday, October 7, 2011

HSPH Study: Lower Quality, High Cost Hospitals Treat More Poor, Minorities

Hospitals with the lowest scores on certain quality and cost measures treat more than twice as many minority and poor patients as hospitals with the highest scores, according to a Harvard School of Public Health study published in Health Affairs.

The study compared quality and cost measures at roughly 3,200 hospitals with the proportion of minority and Medicaid patients the hospitals served. "As the United States embarks on efforts to improve hospital care using value-based purchasing principles, we will need to help hospitals improve quality and efficiency simultaneously and to monitor the results of their efforts, so that we do not inadvertently worsen disparities in care," the study concludes.

Maulik Joshi, president of the Health Research & Educational Trust and senior vice president of research for the AHA, said the AHA "is committed to sharing with hospitals tools and strategies that can help eliminate disparities in care. As noted by today's study and others in Health Affairs, there are many community-based influences on health and health care. We need to address the many factors that impact community health, such as access to preventive and follow-up care, and work with all stakeholders to ensure improved care for patients and communities."

Source: AHA News Release

Wednesday, October 5, 2011

Blue Cross Blue Shield Association Unveils Action Plan To Improve Healthcare Quality; Rein In Costs

The Blue Cross and Blue Shield Association (BCBSA) released a comprehensive, interconnected action plan that fundamentally transforms the healthcare system, moving it away from a fee-for-service model to a patient-centered model. The action plan, Building Tomorrow's Healthcare System: The Pathway to High-Quality, Affordable Care in America, provides specific recommendations to improve healthcare quality and tackle rising costs and is based on the experience of BCBSA's 39 Plans in all 50 states and federal territories, in every market and every zip code. An independent economic analysis of the recommendations shows that, if adopted, this action plan will achieve more than $300 billion in federal savings over the next 10 years.

"We believe that the healthcare system needs to fundamentally change so that people get the best, most affordable care possible. We need to put the patient back in the center of healthcare and this is going to take a significant collaborative effort between both public and private sectors," said Scott P. Serota, president and CEO of BCBSA. "It's time to stop the finger pointing and start working together to make our system the best for patients. In Building Tomorrow's Healthcare System, we make specific recommendations for what the government should do and show how Blue companies nationwide have been working with doctors, hospitals, consumers and policymakers to transform the healthcare system."

The proposal lays out specific, actionable steps the government should take in four key areas:
1.Reward Safety: National and local leadership along with new provider incentives are needed to eliminate preventable medical errors, infections and complications that harm hundreds of thousands of people each year and cost billions of dollars.
2.Do What Works: The incentives in our system must be changed to advance the best possible care and reward quality outcomes, instead of paying for more services that are ineffective or redundant and add unnecessary costs to the system.
3.Reinforce Front-Line Care: A higher value must be placed on primary care and on ensuring there is an adequate workforce of professionals to deliver necessary, timely and coordinated care that results in better outcomes and lower costs.
4.Inspire Healthy Living: With 75 percent of today's healthcare dollar spent on the treatment of chronic illnesses — many of which are preventable — consumers must be empowered and encouraged to make better choices, live healthier lives and better manage their health.

If adopted, the recommendations would save $319 billion over the next decade according to an economic analysis by Ken Thorpe, Ph.D., Robert W. Woodruff Professor and Chair Department of Health Policy & Management Rollins School of Public Health, Emory University.

"The BCBSA proposal reflects a clear understanding of the transformational approach needed to reform our prevention and healthcare delivery system," said Thorpe. "Building evidence-based approaches to coordinate care for Medicare and Medicaid patients that will improve the quality and reduce healthcare spending is a discussion we need to have. Rather than simply shifting federal costs to seniors, the states, or elsewhere, these proposals have the potential to reduce total healthcare spending."

The proposal contains several examples of Blue Cross and Blue Shield initiatives underway across the country that can work as models for improving care and reducing costs. One example is the Michigan Health and Hospital Association's Keystone: ICU Program, which has dramatically reduced central line-associated bloodstream infection rates and ventilator-assisted pneumonia rates in ICU patients. More than 70 Michigan hospitals participate in this program and over a six-year period the initiative has saved 1,830 lives, eliminated an estimated 140,700 avoidable hospital days for patients, and saved more than $300 million.

"This action plan recommends changes that will bring about real improvement for our fragmented healthcare system," said Daniel Loepp, president and CEO, Blue Cross Blue Shield of Michigan. "In Michigan, and in local communities across the country, the Blues are seeing first hand the difference that these types of programs can make for patients. That is why we're encouraging the government to work with the private sector to expand on efforts that improve the quality and affordability of care."

To read Building Tomorrow's Healthcare System: The Pathway to High-Quality, Affordable Care in America, please visit

Source: BCBSA Press Release