How the Supreme Court's Ruling Affects ACA's

Article VIA: http://www.ascassociation.org/ASCA/GovtAdvocacy/GovernmentAffairsUpdate/June2012/GovernmentAffairsUpdateJune282012/

The United States Supreme Court today upheld the Affordable Care Act’s (ACA's) requirement that individuals be required to have health insurance or face financial penalties while striking down the law’s requirement that states must expand their Medicaid programs or face federal funding consequences.

While neither of these rulings directly impacts the day-to-day operations of ASCs, the law’s transformation of the health care insurance marketplace has the power to affect ASCs for years to come.  ASCA will work at the state level and with the federal government to ensure that the law is implemented in a way that allows ASCs to remain as an efficient, high quality alterative for patients to receive outpatient care. 


Additionally the ruling leaves in place several provisions of the law that affect ASCs directly.  A summary of these provisions follow.

• Productivity Adjustment - ASCs, and other providers, will continue to see their Medicare Updates reduced each year by a productivity reduction mandated in the ACA. ASCA will continue to fight for adequate ASC reimbursement and for ASCs to be updated at the same rate as HOPDs.

• Colorectal Cancer Screening Cost Sharing Waiver - The waiver of Medicare beneficiary cost sharing (deductable and co-pay) that became effective for colorectal cancer screenings under the law will continue. This provision may incentivize more patients to have a colorectal cancer screening, which would be favorable to ASCs, since they are the lower cost provider of this service.  

• Independent Payment Advisory Board (IPAB) - The IPAB, created by the ACA, will remain operational. The board, consisting of fifteen unelected officials appointed by the President, is tasked with reining in Medicare’s costs beginning in 2014 by recommending specific Medicare reductions that will keep Medicare spending in line with pre-set spending targets. Because certain providers such as hospitals are exempt from the cuts until 2018, and because benefits cannot be targeted for cuts, the IPAB would by necessity have to target ASCs, physicians, drug manufacturers and nursing homes for reductions in order to meet their targets. ASCA has previously endorsed legislation to repeal IPAB.

• Medicare ACOs - The Medicare Accountable Care Organization (ACO) program established by the ACA will continue. Under the Medicare ACO program, health care providers are allowed to voluntarily form ACOs with the goal of reducing costs while providing high quality care. If these ACOs can generate savings while meeting quality targets, they share in the savings generated. ACOs are in the process of forming and their impact on ASCs remains to be determined.

• Centers for Medicare and Medicaid Innovation (CMMI) - The CMMI created under the ACA will continue its work investigating innovative payment and delivery system models that have the potential to reduce Medicare and Medicaid costs. The CMMI is in the initial phase of establishing these Medicare payment pilots. ASCA has been working with CMMI and evaluating the possibility of establishing a pilot to pay ASCs for performing total joint procedures on Medicare beneficiaries. 

Electronic Medical Records Now Available For Paramedics!

We know that Electronic Medical Records are the new staple in many hospitals and physician's offices but now they are extending further to Paramedics and Ambulatory services. Research leading to extension of electronic medical records to the ambulance was supported by grants from the U.S. Departments of Health and Human Services and Homeland Security.


This allows emergency services providers to make decisions based on previous medical history and make the appropriate decisions for care and location for treatment.


"Electronic medical record technology has been widely recognized for its role in improving quality of care, increasing efficiency of health care delivery, preventing medical errors and enhancing patient safety," said Regenstrief Institute investigator John T. Finnell, M.D., associate professor of emergency medicine at the Indiana University School of Medicine and director of health informatics at the IU School of Informatics, who developed the link between electronic medical records and emergency treatment in the field. 


Although the technology has not spread across the country yet, we are certain that it will soon! 

Monitoring Your Family's Health!

Don't you wish you could monitor a sick or elderly family member's health care on a daily basis? A parent across the country with Cancer, a grandparent in a nursing home or ailing family member under the care of a home care professional.


We wish we could be there every waking moment for those we care about but life keeps us busy working, often to support the family member we worry about. 


Kiran Kundagi, the creator of Nclave, a website that lets patients and their family members monitor their health online and share that information within small, controlled networks had this same conflict. Working miles away from his Cancer stricken Mother, he decided to do something. A former employee of Intel and Computer Science specialist, he decided to build a community that allows a group of users to better coordinate the care of a loved one — whether they want to monitor doctors’ appointments, medication schedules or simply see how the patient is doing


“A solution that leverages family relationships to enhance emotional wellness and allows family care-givers to assist their seniors remotely to monitor health, nutrition and medication compliance at home is a $2.5B opportunity in (the) U.S. alone,” he writes.


We are excited that health care is moving into the social stratosphere and look forward to all the possibilities in the future!

How eVillages are Stabilizing Underserved Regions

The Robert F. Kennedy Center and Physicians Interactive launched Health eVillages (pronounced “healthy villages”) to arm doctors in underserved regions with inexpensive phones and high-powered diagnosis tools. The program will deliver those doctors and healthcare workers with new and refurbished mobile devices preloaded with clinical decision support reference tools like drug guides, medical alerts, journal summaries and references pulled from Skyscape, a medical reference app company.

How Mobile Phones Are Repairing India’s Broken Healthcare System

Though India officially calls healthcare a right for all citizens, doctor and staff absenteeism from public medical facilities prevents many citizens from accessing their legally-entitled care.

Now, one non-profit has created a system that uses mobile phones to check up on healthcare workers’ attendance.

The Indo-Deutch Project Management Society (IDPMS) tracks SMS messages reporting staff absences sent by local patients, and maps the regions and facilities where absenteeism is prevalent. These maps are then made available to locals and policymakers.

“Technology presents great potential to influence the flow of information,” says Oscar Abello, senior program associate at the Results for Development Institute, which created the IDPMS video. “Information used to be spread by the country or the state. People can now start from the ground level to create a feedback loop, so the government can finally be held accountable.”

View Entire Article and Video: http://mashable.com/2012/06/06/mobile-health-accountability-india/

Tempted to Be Your Own Doctor? Think Twice

Have you ever felt a pain or something was off balance in your body and the first thing you did was reach for a device capable of allowing you to google your discomfort? According to a 2011 Pew study, 80% of Internet users look for health information online, making medical inquiries the third most popular web-based pursuit, following only email and search engine use.

Top health information searches involve food safety or recalls (29%), drug safety or recalls (24%) or pregnancy and childbirth (19%). Top symptom-related searches involve information about a specific disease or medical problem (66%), medical treatment or procedures (56%) or doctors or other health professionals (44%).

These investigations can bring both anxiety and relief. Sometimes in our busy day to day lives we feel as though we don't have the time for a doctor's appointment unless it was well planned or urgent. It is important to remember that not only is the Internet accessible to Physicians and Health care professionals but it is also open to patients and individuals who have not studied medicine to give a sound diagnosis or suggestion for treatment in your case.

Yes, the available information on the Web is helpful and has proven in some cases to be life-saving with stories like San Diego Padres pitcher Tim Stauffer’s 2010 medical emergency. Upon suffering abdominal pain, Stauffer researched his symptoms on the web via his iPhone and correctly diagnosed his condition as appendicitis. He was transported to the hospital, where doctors removed his appendix in a routine surgery.

The Facts

Nottingham University’s department of pediatrics released a 2010 study that evaluated the reliability and accuracy of health information accessed via the web. Researchers sought advice for five common pediatric questions and analyzed the first 100 search results for each inquiry. Of the 500 total sites, 39% contained correct information, 11% were incorrect and a whopping 49% failed to answer the question. Among the sites that supplied an answer, 78% gave the correct information, but consistency varied by type of medical query.

In general, the study found that the most reliable information came from government websites, and that 55% of news sites supplied correct advice. But none of the sponsored websites that researchers encountered provided accurate medical information.


Conclusion

The Web is a wonderful place to educate yourself on your body and health care information but remember to take these opinions as just that, opinions. If you want to be sure that you are receiving the proper diagnosis for whatever issue or answer to whatever questions you may have, contact your physician.


Based on: http://mashable.com/2012/06/15/online-medical-searches/

Are you up to date on healthcare reform?

The Court has a lot on its plate, as it will explore three primary issues related to the healthcare reform law:

• The so-called “individual mandate,” which requires most citizens and legal residents to maintain health insurance or pay a financial penalty, beginning in 2014. (Those who fail to meet certain minimum income levels will qualify for federal subsidies.) The federal government maintains it has the authority to require U.S. citizens to purchase health insurance or pay a penalty, under the Constitution’s “commerce clause.” But challengers (which, in the Supreme Court case, is a consortium of 26 states) argue that the government lacks the constitutional authority to require citizens to buy a product from a private entity. If the Court rules that the individual mandate is unconstitutional, it will then determine whether the rest of the ACA must be overturned, or whether it can stand without the mandate.

• The expansion of the Medicaid program to all citizens and certain legal residents with incomes up to 133 percent of the poverty level. The Court has been asked to decide whether the law’s Medicaid expansion is constitutional, and whether the federal government has the right to cut off state funding for non-compliance.

• The potential application of the Anti-Injunction Act, a federal statute dating from 1867, which generally provides that statutes that impose penalties may be challenged in litigation only when the penalties are actually imposed. At least one federal appeals court relied on this Act in declining to rule on the constitutionality of the individual mandate at this time. Should the Court conclude that the Anti-Injunction Act applies, any claims involving the constitutionality of the mandate could be delayed until 2015, when the first penalties are scheduled to kick in.

Great Article on how GPO's are critical to cost reduction in the Healthcare field!

VIA : http://www.healthcareitnews.com/news/hospital-spending-meets-patient-outcomes

Healthcare Group Purchasing Organizations (GPOs) – which are comprised of large hospital systems (IDNs) and individual hospitals; urban and rural – influence a majority of the dollars spent in the US healthcare market. Due to their unique position, GPOs are under increased pressure in today’s business and political climate to reduce healthcare costs and improve the visibility of their supplier selection and sourcing process.
In their simplest form, GPOs are committed to negotiating for the highest quality products at the lowest possible price without compromising on patient outcomes. One of the basic strategies for securing the lowest possible price from healthcare suppliers is to force as much volume to the contracted supplier as possible.
Beyond negotiating the lowest price, GPOs must also monitor contract compliance to ensure their members and vendors behave as promised. Finally, GPOs must go deep into analytics to identify opportunities to save money while maintaining and improving patient outcomes.

Contract Compliance: Critical for Cost Reduction
There are many reasons a member might buy a necessary item “off contract” and source outside the already researched and preapproved vendors. However, that decision can be costly for a hospital. For example, purchasing a single pacemaker off-contract may cost as much as $700 more than buying one from a vendor under contract – a tough pill to swallow in today’s budget-conscious healthcare environment.
For healthcare procurement executives looking to bring in costs and improve compliance, a new trend is arising. GPO executives are now deploying spends analysis more regularly to gain better visibility into areas of savings leakage, align physician supply preferences with patient outcomes and improve compliance tracking.

Spend Analysis: Key to Compliance and Cost Containment
Spend analysis is a technology enabled process that collects, cleanses, classifies and analyzes expenditure data with the objective of monitoring compliance, improving visibility, and identifying cost savings opportunities.
There are three core areas of spend analysis – visibility, analysis and execution. By leveraging all three, companies can answer crucial questions affecting their spending behavior, including:
• How are we spending our budget?
• Which supplies are we spending our budget with?
• Am I getting what has been promised?
• Are their functional equivalents supplies that can reduce costs?
Hospitals and GPOs have a wealth of information to use in the spend analysis process, including GPO contracts, commitments, purchase history, invoices, vendor data and most importantly, supply, physician and procedure level patient outcome data.

Realized Savings: Improved Patient Outcomes
Using spend analysis, GPOs actively monitor compliance and improve patient outcomes with existing agreements by analyzing pricing, allowing members to quickly address missed savings opportunities and identify opportunities to improve patient outcomes with less costly functional equivalent. GPOs can conduct spend analysis at a detailed level, often at individual facilities to ensure that compliance is monitored at all levels where purchasing activities take place. The spend analysis process cross-validates purchasing behavior with the contract terms to make sure that members and vendors are complying with contracts.
Spend analysis allows GPOs to enrich their spend data with outside information (market data, physician preferences, patient outcome data, etc.) to confirm that a contract is still providing value and to identify less expensive, more effective supply alternatives.
As one GPO Executive put it, “We know that if a member buys on contract, it’s saving on average 10 percent from current costs. Spend analysis gives us detailed visibility into network-wide spending and its comprehensive compliance analytics are essential to our ability to help our members achieve those savings, day in and day out without compromising patient outcomes.”
One compelling example is illustrated by the experience of a large hospital network which already had strong controls and processes in place. Using spend analysis, they recently identified $2 million in savings by tracking overpayments made in the last eight months. The member was very disciplined and surprised to learn, through this extra visibility, that they were throwing money away.
“When you have a network like GPOs do—with tens of millions of line items and many prices and contracts changing on a monthly basis—even small reductions lead to millions in savings,” said a GPO Executive.
“The visibility provided by spend analysis benefits members by helping both GPOs and their members track changes and preventing overpayment.”

Medical Waste Made Easy

Is your practice treating non-infectious waste such as packaging and disposable patient gowns the same way it treats regulated “red bag” waste? In the everyday hustle and bustle of patient care, even the best-trained staff may miscategorize waste. A good medical waste disposal program can help reduce your total waste costs. We can help you develop and execute such a program and tailor it to your facility’s exact needs.

Check Out www.newsource-medpro.com or call 1-877-373-1271!

HUGE ANNOUNCEMENT

We are extremely excited to share a big announcement with everyone next week...TUNE IN!