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Mnet Health News delivers the latest news and information articles for the world of healthcare.

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More than 100,000 Providers Paid for Using Electronic Health Records

More than 100,000 health care providers are using electronic health records that meet federal standards and have benefitted from the Medicare and Medicaid Electronic Health Record (EHR) Incentive Programs, the Centers for Medicare & Medicaid Services (CMS) and the Office of the National Coordinator for Health Information Technology (ONC) announced on June 19, 2012.

The EHR Incentive Programs, established by the Health Information for Clinical and Economical Health Act of 2009, provide incentive payments to eligible professionals, hospitals, and critical access hospitals as they adopt, implement, upgrade, or meaningfully use certified EHR technology in ways that improve care.

As of the end of May 2012:
- More than 110,000 eligible professionals and over 2,400 eligible hospitals have been paid by the Medicare and Medicaid HER Incentive Programs.
- Approximately 48 percent of all eligible hospitals and critical access hospitals in the U.S. have received an incentive payment for adopting, implementing, upgrading, or meaningfully using an EHR.
- One out of every 5 Medicare and Medicaid eligible professionals in the U.S. has received an incentive payment for adopting, implementing, upgrading, or meaningfully using an EHR.
- Over $5.7 billion in EHR Incentive Program payments were made.
- More than $3 billion in Medicare EHR Incentive Program payments were made between May 2011 (when the first payments were released) and the end of May 2012.
-More than $2.6 billion in Medicaid EHR Incentive Program payments were made between January 2011(when the first states launched their programs) and the end of May 2012.


Written by Pulse

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Slow Health Care Spending Growth Predicted for 2013

Health care spending in the United States is expected to grow at a historically low rate of 7.5 percent in
2013, the fourth consecutive year of relatively low growth, according to a report by the PwC Health Research Institute. The projection continues a pattern of slower medical growth, a reflection of the sluggish economy, increased focus on cost containment by the industry, lower use of services by cost-conscious patients and efforts by employers to hold down expenses.

According to the report, employers are focused on two primary strategies to control medical costs in 2013, increasing the employee share of costs and expanding health and wellness programs. The survey also showed that plan design features with the most significant changes in 2012 were a considerable increase in in-network deductibles, emergency room co-payments and prescription drug copayments.

The report stated one of two factors expected to "inflate" the trend in 2013 is an uptick in the consumption of health care as newly hired workers obtain coverage and patients who postponed elective procedures feel more confident about spending. Medical and technological advances that provide more specialized, sophisticated and expensive treatment also are expected to push up overall healthcare spending.

Four factors researchers expects will "deflate" the medical cost trend in 2013 are: market pressure to reduce medical supply and equipment costs; increased popularity of new methods to deliver primary care; increased availability of comparative cost information; and accelerated savings from the pharmaceutical patent cliff.

The report is available at http://www.pwc.com/us/en/health-industries/behind-thenumbers/key-findings.jhtml.



Written by Pulse

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HHS Announces 89 New Accountable Care Organizations

Health and Human Services (HHS) announced on July 9, 2012, that 89 new Accountable Care Organizations (ACOs) began serving 1.2 million people with Medicare in 40 states and Washington, D.C. on July 1, 2012. ACOs are organizations formed by groups of doctors and other health care providers that have agreed to work together to coordinate care for people with Medicare. These 89 new ACOs have entered into agreements with Centers for Medicare and Medicaid Services (CMS), taking responsibility for the quality of care they provide to people with Medicare in return for the opportunity to share in savings realized through high quality, well-coordinated care.

Participation in an ACO is purely voluntary for providers. The Medicare Shared Savings Program (MSSP), and other initiatives related to ACOs, is made possible by the 2010 Affordable Care Act. Federal savings from this initiative could be up to $940 million over four years.

Beginning this year, new ACO applications will be accepted annually.


Written by Pulse

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Election Aftermath: What Effect on ASC’s & Health Care?

The recent Presidential election and subsequent Inauguration clearly had serious implications for the field of health care and ASC’s regardless of one’s political leanings. The liberal wing of the Democratic Party was concerned that a Romney administration would put an end to one of the most noteworthy pieces of social legislation in recent memory. At the same time, the Conservative arm of the Republican Party believed that a second term for President Obama would prove to be the catalyst for the implementation of a monstrous entitlement program. For those in the field of health care though, the biggest source of anxiety as Election Day drew near was the thought that this issue would leave the system in total chaos.

Some Reform but More to Come

Even though the Affordable Care Act will not be fully operational until 2014, there has already been a massive amount of money exchanged since the first phase of reform was put in place in 2010. For example, many young adults who are up to 26 years of age have been added to their parent’s health insurance policies. Another new option available was that people under the age of 65 who are covered by private health insurance have now been offered an array of free wellness benefits; and in 2012 a report from HHS showed about 54 million had taken advantage of them. Also, some states have already begun to set up consumer assistance bureaus for the benefit of consumers and to create the infrastructure for an exchange that will facilitate the purchase and sale of private health insurance options. Putting an end to what had already been set in motion would very likely have created a sense utter pandemonium.

But when the Supreme Court upheld the constitutional nature of the health reform in 2012, the challenge of legitimacy was effectively squelched. With the re-election of President Obama, Administration officials will now be in place during the full-scale implementation of the law, which should imply that patients and providers alike can expect the Affordable Care Act to be put into effect methodically in the coming years. It has also been reported recently that new regulations regarding reform were held back prior to the election to avoid added controversy. Because of this, it can be expected that a stockpile of regulations will be quickly released in the near future; with some of them possibly addressing the question of what expenses and services will be required under the new reform.

The governors of many states will now have to make the choice of whether or not they wish to create an insurance marketplace to regulate small business and individual health plans. If a state chooses not to set up such an exchange, the federal government will step in instead. Governors and legislatures on the state level will also have to decide whether they wish to allow wider eligibility for the public option insurance program. It has also been reported that some Republicans are expected to get on board with certain aspects of the law now that it has firmly been set in place.

Leaders of Ambulatory Surgery Centers across the country seem to be in agreement that the currently divided Congress should prevent any further funding by the Government. Some suggest that ASC lobby efforts should be promoted. Others ponder whether or not the new Act could be good for ASCs, since it will require that a greater number will be insured. Will a greater number of insured patients increase the volume at ASC facilities? If so, will these facilities find a way to prosper even though the reimbursement level has decreased? A majority of the leaders in the ASC world appear to agree that whatever adversities arise; they can be overcome once the rules have been fully revealed. What the rules are and how they will be carried out should become ever clearer in the near future.

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Final Rule Increases Payments to Hospitals

On Aug. 1, 2012, the Centers for Medicare & Medicaid Services (CMS) issued a final rule that updates fiscal year (FY) 2013 Medicare payment policies and rates for inpatient stays at general acute care and long-term care hospitals (LTCHs), and builds on the Obama Administration's work to slow growth in future health care costs by improving patient care.

The final rule also implements key elements of the Affordable Care Act's hospital value-based purchasing and hospital readmissions reduction programs. The rule advances Administration efforts to tie Medicare payments to quality health care across the delivery system, with new quality reporting measures for general acute care hospitals in FY 2015 and FY 2016; new measures for long-term care hospitals in FY 2016, and new quality reporting programs for psychiatric hospitals and cancer hospitals. In addition, the rule establishes new reporting and other requirements for the Ambulatory Surgical Center Quality Reporting (ASCQR) Program.

Under the final rule, payment rates to general acute care hospitals will increase by 2.8 percent and LTCH payments are expected to increase by $92 million or 1.7 percent in FY 2013.

To provide hospitals with an incentive to reduce hospital readmissions and improve care coordination, the Affordable Care Act created a Hospital Readmissions Reduction Program that will reduce payments beginning in FY 2013 (for discharges on or after October 1, 2012) to certain hospitals that have excess readmissions for three selected conditions: heart attack, heart failure and pneumonia. The rule finalizes a methodology and the payment adjustment factors to account for excess readmissions for these three conditions.

For further information, please visit http://www.cms.gov/apps/media/press_ releases.asp.

Written by Pulse

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What should we be looking for in a collection vendor?

Having a professional collection agency as a vendor to recover bad debt is not an unusual or uncommon practice in the United States. No matter what the needs of the health care provider, whether they require traditional collection services, payment solutions, or a series of collection letters, the right collection vendor can provide an array of services that can help the provider reach their financial goals.

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