Monthly Archives: December 2014

Latest News on the ICD-10 Date Roller Coaster: No Delay in Compliance Date

As mentioned last week, there were rampant rumors that ICD-10 compliance date delay language was to be inserted into the federal omnibus spending bill that was before congress last week.  The industry (minus a few physician groups in 3 states) breathed a collective sigh of relief as this did not materialize in the final drafts submitted to the House of Representatives nor the Senate.  In fact, congressional leaders released a statement reaffirming their commitment to the 2015 date:

As we look ahead to the implementation date of ICD-10 on October 1, 2015, we will continue our close communication with the Centers for Medicare and Medicaid Services to ensure that the deadline can successfully be met by stakeholders. This is an important milestone in the future of health care technologies, and it is essential that we understand the state of preparedness at CMS. Following the most recent delay of ICD-10, we heard from a number of interested parties concerned about falling behind or halting progress. We would like to acknowledge and thank these organizations and individuals for opening up this dialogue and expressing their thoughts and concerns regarding this issue. It is our priority to ensure that we continue to move forward in health care technology and do so in a way that addresses the concerns of all those affected and ensure that the system works.”

However, that doesn’t mean that we are out of the dark just yet.  As we saw w/the insertion of the delay language last March, the same SGR renewal bill is set to renew this spring.

Sharing Health Information and Data: It’s Not that Easy……

With the explosion of healthcare related data from all different places (claims data from providers, medical records from providers, information on clouds, encounter data exchanged between payers and states, and the list goes on and on), is it really all that hard to take this data, and share it on a broader level for the good of the general public and public health?  As you can imagine, it’s a bit more involved than that:

“Great opportunities have been created for global health cooperation, scientific discovery, and effective disease control programs by recent advances in public health data collection,” the report said. “These advancements are contrasted by real and potential barriers that limit the efficient use of these data. A global process will be essential for a more effective use of known solutions and to build consensus for new solutions to harness the potential of data towards a 21st century population health.” 

Thoughts?

ACOs and Shared Savings Dollars: Some ACOs are Doing Quite Well

There have been some news about groups dropping out of ACOs citing numerous reasons with no real economic benefit being one of them.  Well, some ACOs are realizing some serious cash in the first year of the shared savings program.  These range across the country and are:

1. Memorial Hermann Accountable Care Organization
State: Texas
Earned Shared Savings payments: $28,338,705
Assigned beneficiaries: 34,430
Generated savings: $57,834,092
Savings as percent of benchmark: 11.5%

2. Palm Beach Accountable Care Organization
State: Florida
Earned Shared Savings payments: $19,388,729
Assigned beneficiaries: 36, 268
Generated savings: $39,568,835
Savings as percent of benchmark: 6.5%

3. Catholic Medical Partners – Accountable Care IPA
State: New York
Earned Shared Savings payments: $13,682,060
Assigned beneficiaries: 33, 253
Generated savings: $27,922,572
Savings as percent of benchmark: 7.0%

4. SEMAC
State: Michigan
Earned Shared Savings payments: $12,094,617
Assigned beneficiaries: 17,303
Generated savings: $24,682,891
Savings as percent of benchmark: 9.1%

5. RGV ACO Health Providers
State: Texas
Earned Shared Savings payments: $11,900,756
Assigned beneficiaries: 7,089
Generated savings: $20,239,381
Savings as percent of benchmark: 14.4%

6. ProHEALTH Accountable Care Medical Group
State: New York
Earned Shared Savings payments: $10,737,854
Assigned beneficiaries: 28,651
Generated savings: $21,913,987
Savings as percent of benchmark: 6.1%

7. Triad HealthCare Network
State: North Carolina
Earned Shared Savings payments: $10,537,755
Assigned beneficiaries: 40,944
Generated savings: $21,505,622
Savings as percent of benchmark: 4.6%

8. WellStar Health Network
State: Georgia
Earned Shared Savings payments: 9,738,884
Assigned beneficiaries: 45,732
Generated savings: $19,875,274
Savings as percent of benchmark: 3.7%

9. MaineHealth Accountable Care Organization
State: Maine
Earned Shared Savings payments: $9,406,443
Assigned beneficiaries: 48,273
Generated savings: $19,196,711
Savings as percent of benchmark: 3.3%

10: Accountable Care Coalition of Texas
State: Texas
Earned Shared Savings payments: $9,357,388
Assigned beneficiaries: 33,739
Generated savings: 19,096,711
Savings as percent of benchmark: 3.5%

For more information, click here.

Top 10 Health Plans that are also Providers

One of the shifts currently happening in healthcare in healthcare is the blurring of the lines between the previous silos that separated providers and vendors.  Now, payers are buying providers and therefore becoming providers and more and more providers are becoming payers.  Talk about blurred lines!  Here is a listing of the top 10 health plans that are provider sponsored.  An Axiom client, Presbyterian in New Mexico, has made this list.