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Posts Tagged ‘Healthcare reform’

Computed Tomography (CT) dose is on ECRI Institute’s 2010 list of top 10 technology hazards. Recommendations for regulating CT radiation dose is thus, expanded by the Institute.

High CT radiation doses are being delivered to patients on a daily basis, putting them at an increased risk of developing cancer. Hence, keeping CT radiation dose in check is a high priority safety concern for hospitals. While increased levels of radiations may put patients at risk, diminishing the same, will affect the image quality that may result in incomplete examination or rescanning of the image. The process will expose the patients to even more radiation.

Practical esteem to balance between the degree of radiation are presented in a new guidance article, “CT Radiation Dose: Understanding and Controlling the Risks,” released by ECRI Institute, an independent, nonprofit organization that researches the best modes of care. This comprehensive Health Devices article expands on the recommendations about controlling CT radiation dose published in ECRI Institute’s 2010 Top 10 Technology Hazards list.

ECRI Institute emphasizes that the responsibility also lies with the facility itself, referring physicians, medical physicists, radiation technologists, and CT device manufacturers. The article includes sixteen practical recommendations that every facility should identify with, to help control radiation dose in CT.

The recommendations are set in 5 major sections:

1. protocol optimization,
2. prioritizing dose reduction,
3. patient selection,
4. the technician’s responsibilities,
5. quality assurance.

Dr.Keller, vice president, health technology evaluation and safety, ECRI Institute, considers the latest CT models are created with dose-saving technologies, but they may not be very affordable for many organizations. “In time, these technologies will become more widely installed,” says Keller. “Until then, there are a number of effective strategies every facility can implement to reduce dosage.The article also includes a dedicated section on dose-reduction technologies and the amount of dose savings they each achieve.

Centers for Medicare and Medicaid Services ( CMS ), a division of the U.S. Department of Health and Human Services, announced on Apr-26th, 2010 that, Washington’s Medicaid program will receive federal matching funds for state planning activities required to utilize the electronic health record (EHR) incentive program formed by the American Recovery and Reinvestment Act of 2009 (Recovery Act). Washington is entitled to approximately $967,000 in federal matching funds.

EHRs are expected to serve the purpose of improving general health care for the people of Washington. These records are meant to fit in conveniently with various providers treating a Medicaid patient subject to care. Decision making comes in handy with EHRs. The Recovery Act provides a 90 percent federal match for state planning activities to administer the incentive payments to Medicaid assistants, to make sure of their payments through audits and statewide participation to promote “meaningful use” and work-structure within the block of EHR technology across Washington.

Washington intends to make full use of its federal matching funds for planning activities that include organising a detailed analysis to understand the recent situation of Health IT activities in the state. Data on issues such as existing barriers to its use of EHRs, provider eligibility for EHR incentive payments, and the creation of a State Medicaid HIT Plan, which will define the state’s vision for its long-term HIT use will taken into account.

We congratulate Washington for qualifying for these federal matching funds to assist its plan for implementing the Recovery Act’s EHR incentive program, Meaningful and interoperable use of EHRs in Medicaid will increase health care efficiency, reduce medical errors and improve quality-outcomes and patient satisfaction within and across the states.” said Cindy Mann, director of the Center for Medicaid and State Operations at CMS.

Other States who recieved similar funding include:

• New Mexico will be assigned about $405,000 for the EHR planning work.
• Missouri will receive approximately $1.53 million in federal matching funds.
• Puerto Rico will receive approximately $1.80 million in federal matching funds.
• Oregon will receive approximately $3.53 million in federal matching funds.

Associated Press reports that President Barack Obama’s healthcare reform overhaul will be more “expensive” instead of reducing cost.

According to Economists at the Health and Human Services Department, the healthcare overhaul will achieve Obama’s aim of expanding coverage but controlling costs still remains a major issue. It was also pointed out that, Medicare cuts may be impractical and unstable.

Economic experts at the Health and Human Services Department concluded in a report issued Thursday that the health care overhaul will insure more Americans but costs will also rise at the same time. Obama’s aim of expanding health insurance adding 34 million to the coverage rolls will be achieved but, raising projected spending by about 1 percent over 10 years. The amount may get higher with time. In particular, concerns about Medicare could become a major political liability in the midterm elections. Some of the cost-control measures in the bill, as in, Medicare cuts, tax on high-cost insurance and a commission to seek ongoing Medicare savings could however, help reduce cost increases in the long run.

Republicans are concerned with Obama’s 10-year plan to overhaul the health care system that may cost up to or nearly $1 trillion. His healthcare reform act will increase national health care spending by $311 billion from 2010-2019, or nine-tenths of 1 percent. Approximately $35 trillion is estimated to be spent on the cause during these 10 years.

However, the overhaul is meant to improve national health care spending by $311 billion from 2010-2019. Officials in the Presidential Adminstration support the increase as a bargain price for guaranteeing coverage to 95 percent of Americans. Reductions in payments to private Medicare Advantage plans would instigate a departure from the popular alternative.

Rep. Dave Camp, R-Mich., a leading Republican on health care issues says, “A trillion dollars gets spent, and it’s no surprise. Health care costs are going to go up.”

An earlier Kalorama report EMR 2010 (Market Analysis, ARRA Incentives, Key Players, and Important Trends), officially posted on April 7th-2010, states how HHS is being constantly urged by health practitioners’ organisations and Congress Members to unlax the ‘meaningful use’ criteria for active growth in the EMR industry. A $13.8 billion market is predicted in the report which can be successfully increased to almost its double earning by systematic use of incentives and urging of health systems. Kalorama identifies the standards of obtaining EMR status for a physician is the most important obstacle they are facing at the moment.

Certain criterias for medical practitioners by HSS, such as, submitting a percentage of claims electronically, implementing established diagnostic list such as ICD-9, common medications listed for every patient etc are required to be met in order to be elligible to earn the EMR incentives by 2011. Kalorama however, also believes that requiring 80% of orders via CPOE by 2011, or that half of patients get auto-reminders through an EMR system, may affect EMR systems sales.

It is also mentioned in the report, about the letter prepared by the Senate Finance Committee Chairman Max Baucus and his batch of thirty-seven U.S. Senators along with D-Montana, and American Senate Health, Education, Labor and Pensions Committee Chairman Tom Harkin, D-Iowa. It was about mprovements in an earlier proposal for distributing substantial amounts for health Information and Technology. The letter was published by the Centers for Medicare & Medicaid Services.The idea was to motivate provider participation.A total of 235 members of the United States House of Representatives insisted CMS to axpand its proposed definition and criteria for hospitals to be elligible for the ‘meaningful use’ of health IT incentives.

Kalorama quoted Mr.Bruce Carlson, the publisher of Kalorama Information saying, “Requiring physicians to undergo 25 mandates by next year may not be effective given the kind of real-world usage among physicians we see today.Getting physicians used to these systems is the challenge to a totally paperless healthcare system in the United States and we think gradual, achievable goals would be preferable.

The report can be purchased from Kalorama Information at: http://www.kaloramainformation.com/redirect.asp?progid=78541&productid=2503320.

President Obama signed a bill to law on 16th April 2010, to stretch the eligibility criteria of the EHR incentive program for physicians in hospital outpatient departments or in hospital-affiliated clinics, who would not have been otherwise eligible for the above mentioned incentives under the Centers for Medicare and Medic-aid Services’(CMS).

HANYS and HANYS’ HIT Strategy Group insisted on expansion of the EHR plan for the out-patient medical practitioners along with CMS, important members from the Congress board, committees of jurisdicition in partnership with AHA and President Obama’s Adminstration.

The bill is meant to expand unpaid or lapsed unemployment insurance benefits and higher subsidies for individuals buying health insurance through the Consolidated Omnibus Budget Reconciliation Act (COBRA). Provisions to delay a Medicare physician fee schedule until the end of May is also proposed in this bill.

According to HANYS, “all-or-nothing” requirements must be flexed out for hospitals and physicians to fit the EHR incentive bill criteria. Failure to meet the requirements by 2015 may affect Medicare payment penalties. They further pressed on EHR incentive base payment should be made to all Hospitals, with or without a Medicare provider number with other institutions.

The President of Stackpole & Associates, Irving Stackpole will talk about the effects of American health care reforms on medical tourism marketing on Monday, April 26th, ’10 at San Jose, Costa Rica at the First Latin American Global Medicine and Wellness Congress.

Global Medicine and Wellness Congress is the first Congress in Latin American Medical Tourism and it  aims to attract the attention and participation of major players in this industry.  Stackpole and Associates is actively involved in Client Market research and is successfully headed by Mr. Irving Stackpole with over 30 years of experience in the service industry.

The Medical Tourism is one of the most flourishing industries in the world and many people travel to United States each year with hope of finding expert treatments for their illness and now more insurance companies are coming forward to cover treatment abroad.

The healthcare reform bill being introduced by the Obama administration in the US is likely to have its effects on health tourism particularly regarding the uninsured Americans and self- insured American health plan providers.

Mr. Irving Stackpole’s presentation titled  “The Impact of US Health Care Reform on Medical Tourism Marketing” is going to focus on these issues and how far the new healthcare reform legislation can influence the booming medical tourism market. He is the featured speaker of the event.

Mr Irving stated in a press release that,  “The insurance industry will be in flux for at least the next two years as it responds to the changes in the marketplace as a result of health care reform. Until issues are ironed out over time, traditional medical tourism markets such as uninsured individuals and self-insured providers may not be the best targets for medical tourism marketing. A preliminary assessment of the law does identify some opportunities for international health travel organizations”.

Other dignitaries attending the event include Costa Rica’s Minister of Competitiveness, Jorge Woodbridge, who has contributed in making Costa Rica, an international health turf.

The presentation will be available on the company’s web site in the beginning of May 2010.

The healthcare reform law has included an amendment to the Fair Labor Standards Act (FLSA) according to which, the employers should provide reasonable unpaid break time to nursing mothers during the working hours to express milk to babies till the baby is one year old. The employer is also required to provide a clean and private area for the employee, other than rest room for this. The amendment is documented in the Section 4207 of the Patient Protection and Affordable Care Act.

Breastfeeding benefits both the mother and baby. It protects babies from sudden Infant Death Syndrome, asthma, juvenile diabetes etc and builds up the baby’s resistance to infections. Mothers are protected from diseases like diabetes, breast cancer, ovarian cancer and postpartum depression.

Interest in the study has been raised with the results of a new study published in the April 2010 issue of the ‘Pediatrics’ journal which states that if ninety percent of mothers in the United States breast feed their babies, the lives of upto 900 babies can be saved each year and save around $13 billion in health care costs per year.

While most women knows the benefits of breast feeding, working mothers are usually unable to do so from busy work schedules and lack of time in between. Lack of a private and hygenic place is also forbidding it and often women has to depend on public restrooms or their cars.

Even when the government has recognized the benefits and amended the FLSA to provide breaks for expressing breast milk, confusions exist regarding the law. The law has not defined how many breaks or how much time is alloted for the breaks and these breaks are not compensated. Employers with less than 50 employees are not required to furnish these reqirements if it causes undue hardship or financial burden to the employer. The law has also not defined any punishment to the employer who does not comply.

But even after considering these shortcomings, if the law is implemented, it can reduce the number of women leaving jobs after child birth and among working women, it eases tension, improves job productivity. It can also reduse illness among infants as well as mothers and thus reduce healthcare costs.

Dr. David Blumenthal, National Coordinator for Health Information Technology, recently announced that ONC has awarded $60 million in research grants through the Strategic Health IT Advanced Research Projects (SHARP) program to four renowned institutions.

The research grants worth $60 million were awarded to Mayo Clinic of Medicine, Harvard University, University of Texas Health Science Center at Houston,  and University of Illinois at Urbana-Champaign  through the SHARP program.

Dr. David Blumenthal said , “The Office of the National Coordinator for Health Information Technology (ONC) has created a solid foundation of programs and initiatives to support health care practitioners and hospitals in implementing meaningful use of certified EHR technology, but we are admittedly at the beginning of our journey. ONC is keenly aware that technology needs to continuously advance, bringing new solutions that will make it even more beneficial. While I’m proud of what ONC has achieved so far, I’m humbled by the size of the task still in front of us.”

The research projects in these institutions will be set to identify solutions – long-term as well as short-term – to address the fundamental challenges which include -

Researchers, the technology industry, and health care providers will be leading the multidisciplinary teams, and these teams are supposed to conduct these projects. The results of the team work will be practiced by producing innovative health IT solutions, so they can be deployed nationwide.

U.S. Department of Health and Human Services (HHS) Secretary Kathleen Sebelius wrote to governors and independent insurance commissioners of each state asking about their interest in participating in the temporary high risk pool program (which is part of the healthcare reform law).

The temporary high risk pool program is part of the new health insurance reform law and it addresses the people who could not be insured due to pre-existing medical conditions.

The letter, dated April 2, 2010, asks the states to express their interest in participating in the program and how they want to involve in it.

Sebelius announced that implementing the temporary new high risk pool program is amomg the initial tasks to be done in the new healthcare reform law and that the HHS will work closely with the states to clear their doubts regarding this.

A sum of $5 billion is allocated towards this program in the new insurance reform law, which will be available from July 1^st , as it is the start of the fiscal year in many states, till January 1, 2014. The amount disbursed to each state depends on its population and costs. Unissued funds will be reallocated after two years.

States can participate in this program through multiple options which includes:

• They can form a new high risk pool along with a current state high risk pool
• They can establish a new high risk pool if they don’t have one
• If they have a different program, states can build upon their existing one.
• States can also contract with a current HIPAA carrier to cover eligible individuals.

The letter asks the states to let their intentions be known by April 30^th. The letter also states that a conference call will be held in mid-April to enable learning additional details about the of the program, application requirements, as well as to respond to any questions regarding this program.

21st March 2010 saw the passage of healthcare reform bill by the U.S. House of Representatives with President Obama signing on the bill to pass it into law on March 23. For the betterment of the law, the Senate and the House passed an additional healthcare reform legislation on March 25, under budget reconciliation which will be signed by the President on March 30.

But, certain imaging related provisions contained in the bill affects ACR members. These issues are summarised below:

In a non-hospital environment, the utilization assumption rate helps in determining the technical side of reimbursement. This rate for equipments with a cost of $1 million and above is noted to be 62.5 percent in 2010, which will be increased to 75 percent by 2011, according to CMS. It is expected that the rate will increase to 90 percent by 2013. ACR could successfully influence the efforts of the Congress to raise the rate to 90 percent by 2011.

There will be an increase of 50 percent in discount for contiguous body parts by 2011, which is only 25 percent in 2010.

The new healthcare reform law comes as a blow to insurers as it, based on recommendations made by the US Preventative Services Task Force, prohibits insurers from denying coverage for breast cancer screening exams prohibits.

Self-referring physicians would have to inform their patients in writing that the physician/facility will benefit financially from the imaging procedure. The physician/facility should also provide a list of additional imaging facilities from which the patient may receive their imaging services. ACR will work with Congress to demonstrate the need for stricter self-referral guidelines.

The healthcare reform law has the provision for a Center for Medicare and Medicaid Innovation (CMI), aimed at addressing poor clinical outcomes or potentially avoidable expenditures. There is also a suggestion by ACR about linking payments to physicians who order advanced diagnostic imaging services to their adherence to and use of appropriateness criteria for the ordering of such services.

The rule also requires Medicare to reimburse DXA and VFA during 2010 and 2011 and that too at no less than 70 percent of the 2006 rates. This way DXA and VFA will be reimbursed at approximately $98 and $27 respectively.

Though the new law doesn’t repeal or make permanent Medicare’s Sustainable Growth Rate (SGR) formula, there are chances that the deadline for the 2009 SGR rates, which expires on April 5, may be extended until April 30. When the Congress returns from its two week spring recess, there is the likelihood of another bill being considered, which may result in extending the 2009 payment rate deadline until September 30.