February 14, 2019 | Patient access is prime focus of new data rules from HHS
Long-anticipated rules on information blocking and patient access to health data were released this week from the Centers for Medicare & Medicaid Services and the Office of the National Coordinator for Health IT. Commenting at the HIMSS2019 meeting, ONC Director Elise Sweeney Anthony said the rules put patients in control of their records rather than a person being “acted upon.” There are few exemptions to information blocking, and health information exchanges and networks can be fined up to $1 million for lack of interoperability. (Health IT Analytics; Healthcare IT News)
Eight years since the Affordable Care Acts passed, the Commonwealth Fund’s insurance survey finds more people overall have coverage, but it’s not very affordable. More people in employer-based health plans are “inadequately insured” than before the ACA went into effect (28 percent versus 20 percent); among those buying coverage on their own or through the marketplaces, 42 percent are underinsured. High deductibles and out-of-pocket costs exceeding five to 10 percent of their household incomes means almost half of underinsured adults report medical bill and debt problems. They’re also more likely to delay care because of cost. (Commonwealth Fund brief)
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INNOVATION & TRANSFORMATION
More than 4.3 million visits at nearly 750 hospital emergency rooms in 2017 could have been avoided if patients had better primary care for chronic conditions, according to an analysis by Premier Inc. The study estimates $8.3 billion in potential cost savings with better care coordination and proactive care for patients with asthma, COPD, diabetes, heart failure, hypertension or a behavioral health condition. (Healthcare Dive; Premier study)
Efforts to fast track FDA approvals in the rapidly expanding device market may have consequences down the road. The 2017 FDA approval of Abiomed’s Impelle RP heart pump came with a requirement to track the device’s future recipients, probably because the study supporting its approval wasn’t randomized and included only 63 recipients. Followup data on patients receiving the device showed only 17 percent were alive within one month, compared to 73 percent reported in the original study. The FDA subsequently warned heart doctors that recipients of the pump were dying at higher rates, but even more concerning is the number of devices that are approved using lower safety and effectiveness standards than wha'’s demanded for drug approval. (Axios)
CONSUMERS & PROVIDERS
Hospitals that primarily treat minorities are less likely to offer patients palliative care in cases of a serious illness than other hospitals. The lower overall rate of palliative care services offered to cancer patients in a 600,000+ study applied to both minority and non-minority patients. According to Alexander Cole, a researcher at the Center for Surgery and Public Health at Brigham and Women’s Hospital, “We knew that black and Hispanic cancer patients receive palliative care at lower rates than white patients, but until now, we didn’t know why. Was it just that doctors were not offering these services to their black and Hispanic patients? Or is there some other factor at play?” (UPI)
Hospital prices for inpatient care grew 42 percent between 2007 and 2014, more than twice the rate of growth of physician prices. Hospital outpatient prices shot up 25 percent in the same period, while physician prices only went up 6 percent. The Health Affairs study data was questioned by the American Hospital Association, but other studies previously noted a trend in hospital price increases where provider mergers decreased competition in a geographic region. (Benefits Pro; Health Affairs; Modern Healthcare)
NEW & NOTED
Facebook tooling up for U.S. blood donor program : The social media giant is launching a new capability allowing users to get notifications when nearby blood banks need donors. Facebook already hosts the program in India, Pakistan, Brazil and Bangladesh, where it was alleged that the person-to-person aspect of the program contributed to a black market for blood. The U.S. version will only allow the Red Cross or hospitals to put out the call for donations. (Business Insider)
Patient dies, nurse charged : A Tennessee nurse has been charged with reckless homicide after the death of a patient who received Vecuronium, a paralyzing agent, rather than the sedative Versed for an MRI exam. The nurse picked the wrong drug from the hospital’s electronic prescribing cabinet, a digital ordering system, when she searched the system using only the first two letters for the drug ("Ve"). (Tennessean)
Big privacy breaches, big fines : The Health and Human Services office that enforces HIPAA violations saw record fines and judgments in 2018. The Office for Civil Rights recovered $28.7 million in fines and judgments against companies handling patient health information. Anthem’s breach that leaked information on almost 79 million consumers comprised $16 million of that total. (Fierce Healthcare)
H2R Minutes Reader Survey: We have a winner
The editors congratulate Lisa Herrera, director of quality outcomes for MCCI Group, on winning an iPad from Health2 Resources. Lisa was among hundreds of readers—providers (40 percent), payers (25 percent), researchers, policymakers and others—completing the recent H2R Minutes Reader Survey. In this our tenth year of publication, we’ll share more survey results with you in this space.
MARKETVOICES...QUOTES WORTH READING
“What is most worrying to me is that there has been fairly profound consolidation among hospitals and when they gain market power they have the ability to raise prices. They have the ability to gain more favorable contractual terms, which allows them to raise prices and resist the new, more sensible payment reforms."-- Zack Cooper, Health Affairs study co-author and associate professor of health policy at Yale University, as quoted by Modern Healthcare.