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CMS considers easing two-midnight rule for hospital stays
Medicare officials are proposing to ease the requirements of the so-called two-midnight rule governing how the agency pays for short hospital stays, deferring more to the medical judgment of the admitting physician.
For stays in which the physician expects the patient to need less than two midnights of hospital care for procedures not on the inpatient only list or listed as a national exception, “an inpatient submission would be payable under Medicare Part A on a case-by-case basis based on the judgment of the admitting physician. The documentation in the medical record must support that an inpatient admission is necessary, and is subject to medical review,” officials at the Centers for Medicare & Medicaid Services wrote in a fact sheet.
The change is included in the proposed annual update to the Hospital Outpatient Prospective Payment System. The proposed rule is scheduled to be published July 8 in the Federal Register, but was made available online July 1.
It would be “rare and unusual for a beneficiary to require inpatient hospital admission for a minor surgical procedure or other treatment in the hospital that is expected to keep him or her in the hospital for a period of time that is only a few hours and does not span at least overnight,” CMS added.
Medicare’s payment policy would not change when hospital stays span two midnights or longer, the agency said.
The proposal comes after extensive input from physicians and hospitals, as well as the results of “probe and educate” audits. Currently, CMS policy states that stays of at least two midnights are generally paid under Medicare Part A, while stays that are expected to be shorter are classified as outpatient stays and are paid under Medicare Part B.
Enforcement for this two-midnight policy would also shift under the proposal. Quality improvement organizations (QIOs) rather than Medicare administrative contractors (MACs) or recovery auditors would conduct first-line medical reviews of providers submitting claims for inpatient admissions. Recovery auditors will conduct reviews for those hospitals that have consistently high denial rates based on QIO patient status review outcomes.
“QIOs have a significant history of collaborating with hospitals and other stakeholders to ensure high quality care for beneficiaries,” CMS stated.
Overall, the proposed Hospital Outpatient Prospective Payment System update is expected to result in a –0.2% adjustment for hospital payments in 2016, which includes a 2.7% projected hospital market basket increase minus adjustments for multifactor productivity and other required cuts.
Medicare officials are proposing to ease the requirements of the so-called two-midnight rule governing how the agency pays for short hospital stays, deferring more to the medical judgment of the admitting physician.
For stays in which the physician expects the patient to need less than two midnights of hospital care for procedures not on the inpatient only list or listed as a national exception, “an inpatient submission would be payable under Medicare Part A on a case-by-case basis based on the judgment of the admitting physician. The documentation in the medical record must support that an inpatient admission is necessary, and is subject to medical review,” officials at the Centers for Medicare & Medicaid Services wrote in a fact sheet.
The change is included in the proposed annual update to the Hospital Outpatient Prospective Payment System. The proposed rule is scheduled to be published July 8 in the Federal Register, but was made available online July 1.
It would be “rare and unusual for a beneficiary to require inpatient hospital admission for a minor surgical procedure or other treatment in the hospital that is expected to keep him or her in the hospital for a period of time that is only a few hours and does not span at least overnight,” CMS added.
Medicare’s payment policy would not change when hospital stays span two midnights or longer, the agency said.
The proposal comes after extensive input from physicians and hospitals, as well as the results of “probe and educate” audits. Currently, CMS policy states that stays of at least two midnights are generally paid under Medicare Part A, while stays that are expected to be shorter are classified as outpatient stays and are paid under Medicare Part B.
Enforcement for this two-midnight policy would also shift under the proposal. Quality improvement organizations (QIOs) rather than Medicare administrative contractors (MACs) or recovery auditors would conduct first-line medical reviews of providers submitting claims for inpatient admissions. Recovery auditors will conduct reviews for those hospitals that have consistently high denial rates based on QIO patient status review outcomes.
“QIOs have a significant history of collaborating with hospitals and other stakeholders to ensure high quality care for beneficiaries,” CMS stated.
Overall, the proposed Hospital Outpatient Prospective Payment System update is expected to result in a –0.2% adjustment for hospital payments in 2016, which includes a 2.7% projected hospital market basket increase minus adjustments for multifactor productivity and other required cuts.
Medicare officials are proposing to ease the requirements of the so-called two-midnight rule governing how the agency pays for short hospital stays, deferring more to the medical judgment of the admitting physician.
For stays in which the physician expects the patient to need less than two midnights of hospital care for procedures not on the inpatient only list or listed as a national exception, “an inpatient submission would be payable under Medicare Part A on a case-by-case basis based on the judgment of the admitting physician. The documentation in the medical record must support that an inpatient admission is necessary, and is subject to medical review,” officials at the Centers for Medicare & Medicaid Services wrote in a fact sheet.
The change is included in the proposed annual update to the Hospital Outpatient Prospective Payment System. The proposed rule is scheduled to be published July 8 in the Federal Register, but was made available online July 1.
It would be “rare and unusual for a beneficiary to require inpatient hospital admission for a minor surgical procedure or other treatment in the hospital that is expected to keep him or her in the hospital for a period of time that is only a few hours and does not span at least overnight,” CMS added.
Medicare’s payment policy would not change when hospital stays span two midnights or longer, the agency said.
The proposal comes after extensive input from physicians and hospitals, as well as the results of “probe and educate” audits. Currently, CMS policy states that stays of at least two midnights are generally paid under Medicare Part A, while stays that are expected to be shorter are classified as outpatient stays and are paid under Medicare Part B.
Enforcement for this two-midnight policy would also shift under the proposal. Quality improvement organizations (QIOs) rather than Medicare administrative contractors (MACs) or recovery auditors would conduct first-line medical reviews of providers submitting claims for inpatient admissions. Recovery auditors will conduct reviews for those hospitals that have consistently high denial rates based on QIO patient status review outcomes.
“QIOs have a significant history of collaborating with hospitals and other stakeholders to ensure high quality care for beneficiaries,” CMS stated.
Overall, the proposed Hospital Outpatient Prospective Payment System update is expected to result in a –0.2% adjustment for hospital payments in 2016, which includes a 2.7% projected hospital market basket increase minus adjustments for multifactor productivity and other required cuts.
CMS improves Open Payments system, but not enough
Improvements to the Open Payments reporting system are welcome, but don’t go far enough.
That was the message from the American Medical Association upon the July 1 release of another round of data in the financial disclosure system created by the Affordable Care Act.
CMS “has improved our interface for both collecting and reporting this data about compensation and other payments between drug and medical device manufacturers and physicians and teaching hospitals,” Dr. Shantanu Agrawal, CMS deputy administrator and director of the Center for Program Integrity, said in a statement.
“While we appreciate the efforts of the Centers for Medicare & Medicaid Services to verify the data submitted by industry, the complicated and cumbersome process for physicians to register to review their data and seek correction of any inaccuracies continues to hinder their participation in the validation process,” the AMA said in a statement.
Dr. David O. Barbe, a family physician in Mountain Grove, Mo., noted that “the ability to navigate [Open Payments] has substantially improved since the first iteration of this. You can get around the website pretty well. ... You can sort the data. You can search on individuals. You can sort it by large amounts, either by individual physician or by payer.”
However, the approach used still makes it extremely difficult for determining the validity and accuracy of the information that is being presented, said Dr. Barbe, a member of the AMA Board of Trustees.
“I am looking at one physician here who has 511 total transactions,” he said. “There is no way that that physician can legitimately validate or even refute those transactions. I can’t imagine what the record-keeping would be like if he were to attempt to track 511 transactions from industry over the course of the year.”
The complexity of tracking all those data could be the reason so few transactions have been disputed. In 2014, CMS reported data on 10.8 million general payments to physicians and teaching hospitals; 1,732 were transactions disputed. In 2013, data were reported on 4.1 million general payments, with 880 disputed. The value of general payments rose to $2.6 billion ($5.1 million disputed) from $972 million (nearly $2 million disputed).
Open Payments captured payments to 607,000 physicians and to 1,121 teaching hospitals made by 1,444 companies in 2014, up from 470,000 physicians and 1,019 teaching hospitals receiving payments from 1,347 companies in 2013.
But Dr. Barbe said that his primary complaint remains that the information comes without any context and really doesn’t convey any useful information. They’re just data.
“To suppose that because he has a lot of transactions, that means there’s some kind of illicit or nefarious relationship that the physician has with industry, I think is also not necessarily a conclusion one can draw.”
Improvements to the Open Payments reporting system are welcome, but don’t go far enough.
That was the message from the American Medical Association upon the July 1 release of another round of data in the financial disclosure system created by the Affordable Care Act.
CMS “has improved our interface for both collecting and reporting this data about compensation and other payments between drug and medical device manufacturers and physicians and teaching hospitals,” Dr. Shantanu Agrawal, CMS deputy administrator and director of the Center for Program Integrity, said in a statement.
“While we appreciate the efforts of the Centers for Medicare & Medicaid Services to verify the data submitted by industry, the complicated and cumbersome process for physicians to register to review their data and seek correction of any inaccuracies continues to hinder their participation in the validation process,” the AMA said in a statement.
Dr. David O. Barbe, a family physician in Mountain Grove, Mo., noted that “the ability to navigate [Open Payments] has substantially improved since the first iteration of this. You can get around the website pretty well. ... You can sort the data. You can search on individuals. You can sort it by large amounts, either by individual physician or by payer.”
However, the approach used still makes it extremely difficult for determining the validity and accuracy of the information that is being presented, said Dr. Barbe, a member of the AMA Board of Trustees.
“I am looking at one physician here who has 511 total transactions,” he said. “There is no way that that physician can legitimately validate or even refute those transactions. I can’t imagine what the record-keeping would be like if he were to attempt to track 511 transactions from industry over the course of the year.”
The complexity of tracking all those data could be the reason so few transactions have been disputed. In 2014, CMS reported data on 10.8 million general payments to physicians and teaching hospitals; 1,732 were transactions disputed. In 2013, data were reported on 4.1 million general payments, with 880 disputed. The value of general payments rose to $2.6 billion ($5.1 million disputed) from $972 million (nearly $2 million disputed).
Open Payments captured payments to 607,000 physicians and to 1,121 teaching hospitals made by 1,444 companies in 2014, up from 470,000 physicians and 1,019 teaching hospitals receiving payments from 1,347 companies in 2013.
But Dr. Barbe said that his primary complaint remains that the information comes without any context and really doesn’t convey any useful information. They’re just data.
“To suppose that because he has a lot of transactions, that means there’s some kind of illicit or nefarious relationship that the physician has with industry, I think is also not necessarily a conclusion one can draw.”
Improvements to the Open Payments reporting system are welcome, but don’t go far enough.
That was the message from the American Medical Association upon the July 1 release of another round of data in the financial disclosure system created by the Affordable Care Act.
CMS “has improved our interface for both collecting and reporting this data about compensation and other payments between drug and medical device manufacturers and physicians and teaching hospitals,” Dr. Shantanu Agrawal, CMS deputy administrator and director of the Center for Program Integrity, said in a statement.
“While we appreciate the efforts of the Centers for Medicare & Medicaid Services to verify the data submitted by industry, the complicated and cumbersome process for physicians to register to review their data and seek correction of any inaccuracies continues to hinder their participation in the validation process,” the AMA said in a statement.
Dr. David O. Barbe, a family physician in Mountain Grove, Mo., noted that “the ability to navigate [Open Payments] has substantially improved since the first iteration of this. You can get around the website pretty well. ... You can sort the data. You can search on individuals. You can sort it by large amounts, either by individual physician or by payer.”
However, the approach used still makes it extremely difficult for determining the validity and accuracy of the information that is being presented, said Dr. Barbe, a member of the AMA Board of Trustees.
“I am looking at one physician here who has 511 total transactions,” he said. “There is no way that that physician can legitimately validate or even refute those transactions. I can’t imagine what the record-keeping would be like if he were to attempt to track 511 transactions from industry over the course of the year.”
The complexity of tracking all those data could be the reason so few transactions have been disputed. In 2014, CMS reported data on 10.8 million general payments to physicians and teaching hospitals; 1,732 were transactions disputed. In 2013, data were reported on 4.1 million general payments, with 880 disputed. The value of general payments rose to $2.6 billion ($5.1 million disputed) from $972 million (nearly $2 million disputed).
Open Payments captured payments to 607,000 physicians and to 1,121 teaching hospitals made by 1,444 companies in 2014, up from 470,000 physicians and 1,019 teaching hospitals receiving payments from 1,347 companies in 2013.
But Dr. Barbe said that his primary complaint remains that the information comes without any context and really doesn’t convey any useful information. They’re just data.
“To suppose that because he has a lot of transactions, that means there’s some kind of illicit or nefarious relationship that the physician has with industry, I think is also not necessarily a conclusion one can draw.”
Indoor Tanning Declines, says CDC
People are using indoor tanning less, according to new statistics released by the Centers for Disease Control and Prevention.
“We observed significant reductions in indoor tanning from 2010 to 2013: from 5.5% to 4.2% (P < .001) among all adults, from 8.6% to 6.5% (P < .001) among women, and from 2.2% to 1.7% (P < .001) among men,” Gery P. Guy Jr., Ph.D., health economist in the Centers for Disease Control and Prevention’s Division of Cancer Prevention and Control, and his colleagues wrote in a research letter published July 1 in JAMA Dermatology (2015 July 1 [doi:10.1001/jamadermatol.2015.1568]).
The authors cite a number of possible factors contributing to the decline of indoor tanning, including increased awareness of the potential skin cancer risk, laws restricting tanning bed use by minors (that may have changed public perception on safety), and a 10% excise tax implemented in 2010.
The authors reported no conflicts of interest.
People are using indoor tanning less, according to new statistics released by the Centers for Disease Control and Prevention.
“We observed significant reductions in indoor tanning from 2010 to 2013: from 5.5% to 4.2% (P < .001) among all adults, from 8.6% to 6.5% (P < .001) among women, and from 2.2% to 1.7% (P < .001) among men,” Gery P. Guy Jr., Ph.D., health economist in the Centers for Disease Control and Prevention’s Division of Cancer Prevention and Control, and his colleagues wrote in a research letter published July 1 in JAMA Dermatology (2015 July 1 [doi:10.1001/jamadermatol.2015.1568]).
The authors cite a number of possible factors contributing to the decline of indoor tanning, including increased awareness of the potential skin cancer risk, laws restricting tanning bed use by minors (that may have changed public perception on safety), and a 10% excise tax implemented in 2010.
The authors reported no conflicts of interest.
People are using indoor tanning less, according to new statistics released by the Centers for Disease Control and Prevention.
“We observed significant reductions in indoor tanning from 2010 to 2013: from 5.5% to 4.2% (P < .001) among all adults, from 8.6% to 6.5% (P < .001) among women, and from 2.2% to 1.7% (P < .001) among men,” Gery P. Guy Jr., Ph.D., health economist in the Centers for Disease Control and Prevention’s Division of Cancer Prevention and Control, and his colleagues wrote in a research letter published July 1 in JAMA Dermatology (2015 July 1 [doi:10.1001/jamadermatol.2015.1568]).
The authors cite a number of possible factors contributing to the decline of indoor tanning, including increased awareness of the potential skin cancer risk, laws restricting tanning bed use by minors (that may have changed public perception on safety), and a 10% excise tax implemented in 2010.
The authors reported no conflicts of interest.
FROM JAMA DERMATOLOGY
Indoor tanning declines, says CDC
People are using indoor tanning less, according to new statistics released by the Centers for Disease Control and Prevention.
“We observed significant reductions in indoor tanning from 2010 to 2013: from 5.5% to 4.2% (P < .001) among all adults, from 8.6% to 6.5% (P < .001) among women, and from 2.2% to 1.7% (P < .001) among men,” Gery P. Guy Jr., Ph.D., health economist in the Centers for Disease Control and Prevention’s Division of Cancer Prevention and Control, and his colleagues wrote in a research letter published July 1 in JAMA Dermatology (2015 July 1 [doi:10.1001/jamadermatol.2015.1568]).
The authors cite a number of possible factors contributing to the decline of indoor tanning, including increased awareness of the potential skin cancer risk, laws restricting tanning bed use by minors (that may have changed public perception on safety), and a 10% excise tax implemented in 2010.
The authors reported no conflicts of interest.
People are using indoor tanning less, according to new statistics released by the Centers for Disease Control and Prevention.
“We observed significant reductions in indoor tanning from 2010 to 2013: from 5.5% to 4.2% (P < .001) among all adults, from 8.6% to 6.5% (P < .001) among women, and from 2.2% to 1.7% (P < .001) among men,” Gery P. Guy Jr., Ph.D., health economist in the Centers for Disease Control and Prevention’s Division of Cancer Prevention and Control, and his colleagues wrote in a research letter published July 1 in JAMA Dermatology (2015 July 1 [doi:10.1001/jamadermatol.2015.1568]).
The authors cite a number of possible factors contributing to the decline of indoor tanning, including increased awareness of the potential skin cancer risk, laws restricting tanning bed use by minors (that may have changed public perception on safety), and a 10% excise tax implemented in 2010.
The authors reported no conflicts of interest.
People are using indoor tanning less, according to new statistics released by the Centers for Disease Control and Prevention.
“We observed significant reductions in indoor tanning from 2010 to 2013: from 5.5% to 4.2% (P < .001) among all adults, from 8.6% to 6.5% (P < .001) among women, and from 2.2% to 1.7% (P < .001) among men,” Gery P. Guy Jr., Ph.D., health economist in the Centers for Disease Control and Prevention’s Division of Cancer Prevention and Control, and his colleagues wrote in a research letter published July 1 in JAMA Dermatology (2015 July 1 [doi:10.1001/jamadermatol.2015.1568]).
The authors cite a number of possible factors contributing to the decline of indoor tanning, including increased awareness of the potential skin cancer risk, laws restricting tanning bed use by minors (that may have changed public perception on safety), and a 10% excise tax implemented in 2010.
The authors reported no conflicts of interest.
FROM JAMA DERMATOLOGY
AMA HOD: Preconception care, reducing opioid abuse are top issues
CHIGAGO – Primary care physicians need better training on preconception counseling, according to the American Medical Association House of Delegates.
At its annual meeting, the HOD passed without debate on June 9 a resolution that calls for the AMA to “support the training of all primary care physicians and relevant allied health professionals in the area of preconception counseling, including the recognition of long-acting reversible contraceptives as efficacious and economical forms of contraception.”
According to the reference committee report, the committee noted that “tremendously supportive testimony was heard for efforts to prevent teen pregnancy and for the use of long-acting reversible contraceptives (sic) methods to achieve such prevention and minimize barriers for the use of effective contraception.”
Delegates also called upon the AMA to work with federal stakeholders and pharmaceutical manufacturers to “intensify collaborative efforts involving a public health approach” to reduce harm from inappropriate use, misuse, and diversion of prescription controlled substances, increase awareness that substance use disorders are chronic diseases in need of treatment, and reduce the stigma associated with patients suffering from persistent pain and/or substance use disorders.
According to the report, limited testimony noted that it was “incumbent upon our AMA to continue to address these issues, and further intensify collaborative efforts in order to promote solutions to what are difficult and complex public health issues facing the American public, patients, and their families, and the health care professionals who are entrusted with their treatment.”
The reference committee tackled a number of other issues. Among them was a resolution targeting advocacy for hepatitis C virus education, prevention, screening and treatment. The resolution adopted without debate called for birth year–based HCV screening in alignment with recommendations of the Centers for Disease Control and Prevention; working with the CDC and others on education and prevention efforts; supporting screening, prevention, and treatment programs “targeted toward maximum health benefit”; supporting adequate funding and negotiation for affordable pricing for HCV treatments; and recognizing correctional physicians and other physicians in the public health sector as key stakeholders in the development of HCV treatment guidelines.
Also addressed were issues related to drug labeling, with calls to the AMA to work with the Food and Drug Administration to ensure that drug labels are updated quicker as new evidence comes to market.
Delegates called on the AMA to support federal efforts to stimulate early research and development of rapid infectious disease diagnostic technologies through increased funding for the appropriate agencies, and to work with payers to overcome reimbursement barriers.
CHIGAGO – Primary care physicians need better training on preconception counseling, according to the American Medical Association House of Delegates.
At its annual meeting, the HOD passed without debate on June 9 a resolution that calls for the AMA to “support the training of all primary care physicians and relevant allied health professionals in the area of preconception counseling, including the recognition of long-acting reversible contraceptives as efficacious and economical forms of contraception.”
According to the reference committee report, the committee noted that “tremendously supportive testimony was heard for efforts to prevent teen pregnancy and for the use of long-acting reversible contraceptives (sic) methods to achieve such prevention and minimize barriers for the use of effective contraception.”
Delegates also called upon the AMA to work with federal stakeholders and pharmaceutical manufacturers to “intensify collaborative efforts involving a public health approach” to reduce harm from inappropriate use, misuse, and diversion of prescription controlled substances, increase awareness that substance use disorders are chronic diseases in need of treatment, and reduce the stigma associated with patients suffering from persistent pain and/or substance use disorders.
According to the report, limited testimony noted that it was “incumbent upon our AMA to continue to address these issues, and further intensify collaborative efforts in order to promote solutions to what are difficult and complex public health issues facing the American public, patients, and their families, and the health care professionals who are entrusted with their treatment.”
The reference committee tackled a number of other issues. Among them was a resolution targeting advocacy for hepatitis C virus education, prevention, screening and treatment. The resolution adopted without debate called for birth year–based HCV screening in alignment with recommendations of the Centers for Disease Control and Prevention; working with the CDC and others on education and prevention efforts; supporting screening, prevention, and treatment programs “targeted toward maximum health benefit”; supporting adequate funding and negotiation for affordable pricing for HCV treatments; and recognizing correctional physicians and other physicians in the public health sector as key stakeholders in the development of HCV treatment guidelines.
Also addressed were issues related to drug labeling, with calls to the AMA to work with the Food and Drug Administration to ensure that drug labels are updated quicker as new evidence comes to market.
Delegates called on the AMA to support federal efforts to stimulate early research and development of rapid infectious disease diagnostic technologies through increased funding for the appropriate agencies, and to work with payers to overcome reimbursement barriers.
CHIGAGO – Primary care physicians need better training on preconception counseling, according to the American Medical Association House of Delegates.
At its annual meeting, the HOD passed without debate on June 9 a resolution that calls for the AMA to “support the training of all primary care physicians and relevant allied health professionals in the area of preconception counseling, including the recognition of long-acting reversible contraceptives as efficacious and economical forms of contraception.”
According to the reference committee report, the committee noted that “tremendously supportive testimony was heard for efforts to prevent teen pregnancy and for the use of long-acting reversible contraceptives (sic) methods to achieve such prevention and minimize barriers for the use of effective contraception.”
Delegates also called upon the AMA to work with federal stakeholders and pharmaceutical manufacturers to “intensify collaborative efforts involving a public health approach” to reduce harm from inappropriate use, misuse, and diversion of prescription controlled substances, increase awareness that substance use disorders are chronic diseases in need of treatment, and reduce the stigma associated with patients suffering from persistent pain and/or substance use disorders.
According to the report, limited testimony noted that it was “incumbent upon our AMA to continue to address these issues, and further intensify collaborative efforts in order to promote solutions to what are difficult and complex public health issues facing the American public, patients, and their families, and the health care professionals who are entrusted with their treatment.”
The reference committee tackled a number of other issues. Among them was a resolution targeting advocacy for hepatitis C virus education, prevention, screening and treatment. The resolution adopted without debate called for birth year–based HCV screening in alignment with recommendations of the Centers for Disease Control and Prevention; working with the CDC and others on education and prevention efforts; supporting screening, prevention, and treatment programs “targeted toward maximum health benefit”; supporting adequate funding and negotiation for affordable pricing for HCV treatments; and recognizing correctional physicians and other physicians in the public health sector as key stakeholders in the development of HCV treatment guidelines.
Also addressed were issues related to drug labeling, with calls to the AMA to work with the Food and Drug Administration to ensure that drug labels are updated quicker as new evidence comes to market.
Delegates called on the AMA to support federal efforts to stimulate early research and development of rapid infectious disease diagnostic technologies through increased funding for the appropriate agencies, and to work with payers to overcome reimbursement barriers.
AT THE AMA HOD MEETING
AMA HOD: Delegates advocate medical service, health system reforms resolutions with little debate
CHICAGO – Other than a brief amendment related to the 3-day rule, the American Medical Association House of Delegates adopted via voice vote a series of reference committee recommendations related to medical service and health system reform.
The lone item that came up for discussion during the June 9 vote at the AMA HOD annual meeting was related to the 3-day rule. The reference committee had substituted language of two separate resolutions and combined it into one, with two provisions: that the AMA “continue to advocate that Congress eliminate the 3-day hospital inpatient requirement for Medicare coverage of posthospital skilled nursing facility services, and educate Congress on the impact of this requirement on patients,” and that the association continue to advocate for the start of the timing clock toward meeting the 3-day rule being when the person enters the hospital or the emergency department or when under an observational status.
During the full-house session, a third resolution was added that the AMA work with the Centers for Medicare & Medicaid Services to eliminate any regulations requiring inpatient hospitalization as a prerequisite for a Medicare patient’s being eligible for skilled nursing facility or long-term care placement, language resurrected from one of the two earlier resolutions.
Other adopted resolutions cover a wide range of topics, including the high price of generic drugs, vasectomy coverage, end-of-life counseling, and understanding the effects of Medicaid expansion.
Various separate resolutions related to the high cost of generic drugs were rolled into one final resolution that calls for a number of actions.
First, it calls on the AMA to work collaboratively with Food and Drug Administration, the Federal Trade Commission, the Generic Pharmaceutical Association, and other relevant stakeholders to promote policies that address the rising cost of generic drugs. The resolution calls on the AMA to seek a legislative solution to ensure fair generic drug pricing and to educate Congress on the adverse effects of high generic drug pricing.
On Medicaid expansion, the house instructed the AMA to understand the level of health care access due to expansion, the quality of health care delivered, the adequacy of provider payments, and the effects of Medicaid expansion as a whole.
Delegates also adopted a resolution asking the AMA to encourage all private and public payers to reimburse for advanced care planning.
On contraception, the AMA was directed to work with national state and medical specialty societies “to advocate for patient access to the full continuum of evidence-based contraceptive methods and sterilization procedures, including vasectomy and male contraceptive counseling, to promote gender equality in contraceptive services under the ACA.”
With the move to alternate payment models that pay for value and outcomes, the AMA received direction to help practicing physicians with guidance and other assistance to help in the transition.
CHICAGO – Other than a brief amendment related to the 3-day rule, the American Medical Association House of Delegates adopted via voice vote a series of reference committee recommendations related to medical service and health system reform.
The lone item that came up for discussion during the June 9 vote at the AMA HOD annual meeting was related to the 3-day rule. The reference committee had substituted language of two separate resolutions and combined it into one, with two provisions: that the AMA “continue to advocate that Congress eliminate the 3-day hospital inpatient requirement for Medicare coverage of posthospital skilled nursing facility services, and educate Congress on the impact of this requirement on patients,” and that the association continue to advocate for the start of the timing clock toward meeting the 3-day rule being when the person enters the hospital or the emergency department or when under an observational status.
During the full-house session, a third resolution was added that the AMA work with the Centers for Medicare & Medicaid Services to eliminate any regulations requiring inpatient hospitalization as a prerequisite for a Medicare patient’s being eligible for skilled nursing facility or long-term care placement, language resurrected from one of the two earlier resolutions.
Other adopted resolutions cover a wide range of topics, including the high price of generic drugs, vasectomy coverage, end-of-life counseling, and understanding the effects of Medicaid expansion.
Various separate resolutions related to the high cost of generic drugs were rolled into one final resolution that calls for a number of actions.
First, it calls on the AMA to work collaboratively with Food and Drug Administration, the Federal Trade Commission, the Generic Pharmaceutical Association, and other relevant stakeholders to promote policies that address the rising cost of generic drugs. The resolution calls on the AMA to seek a legislative solution to ensure fair generic drug pricing and to educate Congress on the adverse effects of high generic drug pricing.
On Medicaid expansion, the house instructed the AMA to understand the level of health care access due to expansion, the quality of health care delivered, the adequacy of provider payments, and the effects of Medicaid expansion as a whole.
Delegates also adopted a resolution asking the AMA to encourage all private and public payers to reimburse for advanced care planning.
On contraception, the AMA was directed to work with national state and medical specialty societies “to advocate for patient access to the full continuum of evidence-based contraceptive methods and sterilization procedures, including vasectomy and male contraceptive counseling, to promote gender equality in contraceptive services under the ACA.”
With the move to alternate payment models that pay for value and outcomes, the AMA received direction to help practicing physicians with guidance and other assistance to help in the transition.
CHICAGO – Other than a brief amendment related to the 3-day rule, the American Medical Association House of Delegates adopted via voice vote a series of reference committee recommendations related to medical service and health system reform.
The lone item that came up for discussion during the June 9 vote at the AMA HOD annual meeting was related to the 3-day rule. The reference committee had substituted language of two separate resolutions and combined it into one, with two provisions: that the AMA “continue to advocate that Congress eliminate the 3-day hospital inpatient requirement for Medicare coverage of posthospital skilled nursing facility services, and educate Congress on the impact of this requirement on patients,” and that the association continue to advocate for the start of the timing clock toward meeting the 3-day rule being when the person enters the hospital or the emergency department or when under an observational status.
During the full-house session, a third resolution was added that the AMA work with the Centers for Medicare & Medicaid Services to eliminate any regulations requiring inpatient hospitalization as a prerequisite for a Medicare patient’s being eligible for skilled nursing facility or long-term care placement, language resurrected from one of the two earlier resolutions.
Other adopted resolutions cover a wide range of topics, including the high price of generic drugs, vasectomy coverage, end-of-life counseling, and understanding the effects of Medicaid expansion.
Various separate resolutions related to the high cost of generic drugs were rolled into one final resolution that calls for a number of actions.
First, it calls on the AMA to work collaboratively with Food and Drug Administration, the Federal Trade Commission, the Generic Pharmaceutical Association, and other relevant stakeholders to promote policies that address the rising cost of generic drugs. The resolution calls on the AMA to seek a legislative solution to ensure fair generic drug pricing and to educate Congress on the adverse effects of high generic drug pricing.
On Medicaid expansion, the house instructed the AMA to understand the level of health care access due to expansion, the quality of health care delivered, the adequacy of provider payments, and the effects of Medicaid expansion as a whole.
Delegates also adopted a resolution asking the AMA to encourage all private and public payers to reimburse for advanced care planning.
On contraception, the AMA was directed to work with national state and medical specialty societies “to advocate for patient access to the full continuum of evidence-based contraceptive methods and sterilization procedures, including vasectomy and male contraceptive counseling, to promote gender equality in contraceptive services under the ACA.”
With the move to alternate payment models that pay for value and outcomes, the AMA received direction to help practicing physicians with guidance and other assistance to help in the transition.
AT THE AMA HOD MEETING
AMA HOD: Delegates back ICD-10 reprieve, but gun proposals draw fire
CHICAGO – Physicians would have a 2-year reprieve from penalties while using the new ICD-10 coding set, under a resolution easily passed June 8 by the American Medical Association’s House of Delegates.
However, two proposals related to gun violence generated more heat than consensus among the AMA delegates at their annual meeting.
The ICD-10 resolution calls for the AMA to push the Centers for Medicare & Medicaid Services and other payers for a 2-year grace period from penalties physicians would otherwise face due to coding errors, mistakes, or other issues that might arise after the Oct. 1, 2015, transition to the new coding set.
The resolution passed without any discussion, other than a request that its reference committee report be considered at the top of the voting agenda so the AMA could begin working on it immediately.
The rest of the ICD-10 resolution calls for the AMA to educate physicians on how to meet obligations to Medicare and private payers if they choose to become a cash-only practice that no longer accepts insurance. The resolution also calls for the AMA to collect data on how ICD-10 implementation affects patients and changes practice patterns.
In contrast, two resolutions on gun-related violence produced far less agreement among the delegates.
The first resolution addressed prevention of firearm-related injuries and deaths among youth by calling on the AMA to work with other organizations to identify materials that could be handed out as educational material in clinical practice.
Some delegates were concerned that the resolution could open the door to partnerships with organizations such as the National Rifle Association. However, others saw that as a good thing, because it could open the door to the organizations working together and finding common ground. Some delegates also noted that the NRA has the ability to reach people to promote gun safety whom the AMA might not be able to reach.
After discussion, delegates passed the resolution with a voice vote.
Delegates also considered a resolution in favor of background checks for gun purchases. An earlier AMA Board of Trustees report recommended support for background checks for anyone buying firearms.
A number of delegates rose in support of this proposal. Speaking on behalf of the American Academy of Family Physicians, AAFP President Dr. Robert L. Wergin noted the recent statement of support signed by a number of medical societies and the American Bar Association.
However, the background-check provision met resistance. Some delegates said it would not do anything to stop criminals who are obtaining guns illegally, while others said it was too far-reaching to require all sales to be accompanied with a criminal background check.
The proposal does not address those who can legally own guns, such as law enforcement officials and those who recently purchased a gun and already underwent a check, cautioned Dr. Michael Greene, of Macon, Ga. Others mentioned the potential impact on situations such as nonoperative weapons that are transferred as heirlooms, as well as guns given as gifts.
In the end, delegates sent the resolution back to committee for further consideration.
Delegates did approve an electronic health records resolution that called for holding vendors accountable for system downtime and other technology disruptions, and working with the CMS to earn physicians partial credit if some meaningful use objectives are met, rather than the current all-or-none situation.
Delegates also approved provisions to increase the use of prescription drug monitoring programs (PDMP). Under those provisions, the AMA would support voluntary use of state PDMP programs, encourage states to modernize their programs, and support allowing access to PDMPs by a delegate appointed by a physician.
CHICAGO – Physicians would have a 2-year reprieve from penalties while using the new ICD-10 coding set, under a resolution easily passed June 8 by the American Medical Association’s House of Delegates.
However, two proposals related to gun violence generated more heat than consensus among the AMA delegates at their annual meeting.
The ICD-10 resolution calls for the AMA to push the Centers for Medicare & Medicaid Services and other payers for a 2-year grace period from penalties physicians would otherwise face due to coding errors, mistakes, or other issues that might arise after the Oct. 1, 2015, transition to the new coding set.
The resolution passed without any discussion, other than a request that its reference committee report be considered at the top of the voting agenda so the AMA could begin working on it immediately.
The rest of the ICD-10 resolution calls for the AMA to educate physicians on how to meet obligations to Medicare and private payers if they choose to become a cash-only practice that no longer accepts insurance. The resolution also calls for the AMA to collect data on how ICD-10 implementation affects patients and changes practice patterns.
In contrast, two resolutions on gun-related violence produced far less agreement among the delegates.
The first resolution addressed prevention of firearm-related injuries and deaths among youth by calling on the AMA to work with other organizations to identify materials that could be handed out as educational material in clinical practice.
Some delegates were concerned that the resolution could open the door to partnerships with organizations such as the National Rifle Association. However, others saw that as a good thing, because it could open the door to the organizations working together and finding common ground. Some delegates also noted that the NRA has the ability to reach people to promote gun safety whom the AMA might not be able to reach.
After discussion, delegates passed the resolution with a voice vote.
Delegates also considered a resolution in favor of background checks for gun purchases. An earlier AMA Board of Trustees report recommended support for background checks for anyone buying firearms.
A number of delegates rose in support of this proposal. Speaking on behalf of the American Academy of Family Physicians, AAFP President Dr. Robert L. Wergin noted the recent statement of support signed by a number of medical societies and the American Bar Association.
However, the background-check provision met resistance. Some delegates said it would not do anything to stop criminals who are obtaining guns illegally, while others said it was too far-reaching to require all sales to be accompanied with a criminal background check.
The proposal does not address those who can legally own guns, such as law enforcement officials and those who recently purchased a gun and already underwent a check, cautioned Dr. Michael Greene, of Macon, Ga. Others mentioned the potential impact on situations such as nonoperative weapons that are transferred as heirlooms, as well as guns given as gifts.
In the end, delegates sent the resolution back to committee for further consideration.
Delegates did approve an electronic health records resolution that called for holding vendors accountable for system downtime and other technology disruptions, and working with the CMS to earn physicians partial credit if some meaningful use objectives are met, rather than the current all-or-none situation.
Delegates also approved provisions to increase the use of prescription drug monitoring programs (PDMP). Under those provisions, the AMA would support voluntary use of state PDMP programs, encourage states to modernize their programs, and support allowing access to PDMPs by a delegate appointed by a physician.
CHICAGO – Physicians would have a 2-year reprieve from penalties while using the new ICD-10 coding set, under a resolution easily passed June 8 by the American Medical Association’s House of Delegates.
However, two proposals related to gun violence generated more heat than consensus among the AMA delegates at their annual meeting.
The ICD-10 resolution calls for the AMA to push the Centers for Medicare & Medicaid Services and other payers for a 2-year grace period from penalties physicians would otherwise face due to coding errors, mistakes, or other issues that might arise after the Oct. 1, 2015, transition to the new coding set.
The resolution passed without any discussion, other than a request that its reference committee report be considered at the top of the voting agenda so the AMA could begin working on it immediately.
The rest of the ICD-10 resolution calls for the AMA to educate physicians on how to meet obligations to Medicare and private payers if they choose to become a cash-only practice that no longer accepts insurance. The resolution also calls for the AMA to collect data on how ICD-10 implementation affects patients and changes practice patterns.
In contrast, two resolutions on gun-related violence produced far less agreement among the delegates.
The first resolution addressed prevention of firearm-related injuries and deaths among youth by calling on the AMA to work with other organizations to identify materials that could be handed out as educational material in clinical practice.
Some delegates were concerned that the resolution could open the door to partnerships with organizations such as the National Rifle Association. However, others saw that as a good thing, because it could open the door to the organizations working together and finding common ground. Some delegates also noted that the NRA has the ability to reach people to promote gun safety whom the AMA might not be able to reach.
After discussion, delegates passed the resolution with a voice vote.
Delegates also considered a resolution in favor of background checks for gun purchases. An earlier AMA Board of Trustees report recommended support for background checks for anyone buying firearms.
A number of delegates rose in support of this proposal. Speaking on behalf of the American Academy of Family Physicians, AAFP President Dr. Robert L. Wergin noted the recent statement of support signed by a number of medical societies and the American Bar Association.
However, the background-check provision met resistance. Some delegates said it would not do anything to stop criminals who are obtaining guns illegally, while others said it was too far-reaching to require all sales to be accompanied with a criminal background check.
The proposal does not address those who can legally own guns, such as law enforcement officials and those who recently purchased a gun and already underwent a check, cautioned Dr. Michael Greene, of Macon, Ga. Others mentioned the potential impact on situations such as nonoperative weapons that are transferred as heirlooms, as well as guns given as gifts.
In the end, delegates sent the resolution back to committee for further consideration.
Delegates did approve an electronic health records resolution that called for holding vendors accountable for system downtime and other technology disruptions, and working with the CMS to earn physicians partial credit if some meaningful use objectives are met, rather than the current all-or-none situation.
Delegates also approved provisions to increase the use of prescription drug monitoring programs (PDMP). Under those provisions, the AMA would support voluntary use of state PDMP programs, encourage states to modernize their programs, and support allowing access to PDMPs by a delegate appointed by a physician.
AT THE AMA HOD MEETING
AMA launches online tool to help address physician burnout
CHICAGO – The American Medical Association has launched an interactive tool to help physicians deal with burnout.
Dr. Steven Stack, who takes over as AMA president on June 9, said the organization wants “to the restore the joy to the practice of medicine. I think physicians feel besieged right now by an overburdened regulatory environment, too much paperwork, too much time doing clerical tasks that support the provision of care, and too little time actually interacting with patients.”
The “STEPS Forward” program gives physicians access to online modules to help them improve their practices. Currently, 16 modules are available addressing practice efficiency and patient care, patient health, physician health, and technology and innovation. Each module includes steps for implementation and case studies as well as downloadable tools, videos, and resources. CME credits are available for completed modules.
The modules were designed by physician teams, and all include real-world examples of how the processes that are displayed have been implemented.
We “recognize that in a complex world where everyone’s busy, giving someone a PDF outlining what to do does not get much traction,” AMA CEO Dr. James Madara said during a June 8 press conference at the annual meeting of the American Medical Association House of Delegates..
The AMA, in partnership with the Medical Group Management Association (MGMA), also are looking for solutions to add to the STEPS Forward program and plan to award several $10,000 prizes for those who propose the best solutions that help physicians adapt to the changing work environment. Entries are due Sept. 1. Dr. Madara said he hopes to give awards to at least five physicians and their practices for their ideas, but if more come in, AMA and MGMA will make more awards. He hopes those winners will be ready to be announced at MGMA’s annual meeting in October.
CHICAGO – The American Medical Association has launched an interactive tool to help physicians deal with burnout.
Dr. Steven Stack, who takes over as AMA president on June 9, said the organization wants “to the restore the joy to the practice of medicine. I think physicians feel besieged right now by an overburdened regulatory environment, too much paperwork, too much time doing clerical tasks that support the provision of care, and too little time actually interacting with patients.”
The “STEPS Forward” program gives physicians access to online modules to help them improve their practices. Currently, 16 modules are available addressing practice efficiency and patient care, patient health, physician health, and technology and innovation. Each module includes steps for implementation and case studies as well as downloadable tools, videos, and resources. CME credits are available for completed modules.
The modules were designed by physician teams, and all include real-world examples of how the processes that are displayed have been implemented.
We “recognize that in a complex world where everyone’s busy, giving someone a PDF outlining what to do does not get much traction,” AMA CEO Dr. James Madara said during a June 8 press conference at the annual meeting of the American Medical Association House of Delegates..
The AMA, in partnership with the Medical Group Management Association (MGMA), also are looking for solutions to add to the STEPS Forward program and plan to award several $10,000 prizes for those who propose the best solutions that help physicians adapt to the changing work environment. Entries are due Sept. 1. Dr. Madara said he hopes to give awards to at least five physicians and their practices for their ideas, but if more come in, AMA and MGMA will make more awards. He hopes those winners will be ready to be announced at MGMA’s annual meeting in October.
CHICAGO – The American Medical Association has launched an interactive tool to help physicians deal with burnout.
Dr. Steven Stack, who takes over as AMA president on June 9, said the organization wants “to the restore the joy to the practice of medicine. I think physicians feel besieged right now by an overburdened regulatory environment, too much paperwork, too much time doing clerical tasks that support the provision of care, and too little time actually interacting with patients.”
The “STEPS Forward” program gives physicians access to online modules to help them improve their practices. Currently, 16 modules are available addressing practice efficiency and patient care, patient health, physician health, and technology and innovation. Each module includes steps for implementation and case studies as well as downloadable tools, videos, and resources. CME credits are available for completed modules.
The modules were designed by physician teams, and all include real-world examples of how the processes that are displayed have been implemented.
We “recognize that in a complex world where everyone’s busy, giving someone a PDF outlining what to do does not get much traction,” AMA CEO Dr. James Madara said during a June 8 press conference at the annual meeting of the American Medical Association House of Delegates..
The AMA, in partnership with the Medical Group Management Association (MGMA), also are looking for solutions to add to the STEPS Forward program and plan to award several $10,000 prizes for those who propose the best solutions that help physicians adapt to the changing work environment. Entries are due Sept. 1. Dr. Madara said he hopes to give awards to at least five physicians and their practices for their ideas, but if more come in, AMA and MGMA will make more awards. He hopes those winners will be ready to be announced at MGMA’s annual meeting in October.
AT THE AMA HOD MEETING
AMA HOD: Delegates call for ICD-10 grace period
CHICAGO – With the ICD-10 transition looming, delegates to the annual meeting of the American Medical Association House of Delegates want their organization to advocate for giving some room to physicians to adjust.
A resolution submitted by the Alabama delegation calls on the AMA to push for a 2-year grace period during which physicians would not be penalized for errors, mistakes, and other system malfunctions, and payments would not be withheld due to coding errors.
Dr. W. Jeff Terry, chairman of the Alabama delegation, noted that, despite the AMA’s policies and efforts against ICD-10, the government stands firm on its Oct. 1 implementation date.
“I truly believe that we have just not educated Congress well enough as to the issues of the consequences of ICD-10,” Dr. Terry said.
“We – as our AMA, me, and all of you – just haven’t done our job well enough. … I want to stress here today what our AMA message should be from out of this meeting. Even though the American Medical Association is firm in its view that the switch to ICD-10 is a mistake, we also recognized that there are other groups that are fighting to maintain the Oct. 1 implementation date. In order to maintain patients’ access to care and protect physicians’ practices, we offer a compromise solution that will allow ICD-10 to be implemented as planned on Oct. 1, and at same time, protect physicians from suffering financial consequences as a result of coding errors and mistakes for a 2-year period,” he said.
He called for the AMA to put in motion a letter-writing campaign to advocate for the grace period. “This should be our number-one priority, at least from now until Oct. 1, when it won’t matter.”
Dr. Wanda Filer, delegate from the American Academy of Family Physicians, echoed Dr. Terry.
“At this point, we believe that the adoption of ICD-10 is inevitable and, recognizing that advocacy resources are finite, we would like to encourage our AMA to work with CMS to prepare for this and ensure a soft landing for all physicians and patients … rather than a hard start,” said Dr. Filer, who is also AAFP president-elect.
Delegates suggested that the organization focus on how ICD-10 requirements could affect small practices and their patients. They called on the AMA to track data on rejected claims, payment delays resulting from coding errors, and the impact on patient volume.
Reference Committee B, which addresses matters of federal legislation, considered a number of other issues, almost without dissent. One exception was a resolution advocating for background checks on all gun sales, which met with some resistance as being onerous for certain people in specific situations.
Resolutions will be voted on by the full House of Delegates June 8-10.
CHICAGO – With the ICD-10 transition looming, delegates to the annual meeting of the American Medical Association House of Delegates want their organization to advocate for giving some room to physicians to adjust.
A resolution submitted by the Alabama delegation calls on the AMA to push for a 2-year grace period during which physicians would not be penalized for errors, mistakes, and other system malfunctions, and payments would not be withheld due to coding errors.
Dr. W. Jeff Terry, chairman of the Alabama delegation, noted that, despite the AMA’s policies and efforts against ICD-10, the government stands firm on its Oct. 1 implementation date.
“I truly believe that we have just not educated Congress well enough as to the issues of the consequences of ICD-10,” Dr. Terry said.
“We – as our AMA, me, and all of you – just haven’t done our job well enough. … I want to stress here today what our AMA message should be from out of this meeting. Even though the American Medical Association is firm in its view that the switch to ICD-10 is a mistake, we also recognized that there are other groups that are fighting to maintain the Oct. 1 implementation date. In order to maintain patients’ access to care and protect physicians’ practices, we offer a compromise solution that will allow ICD-10 to be implemented as planned on Oct. 1, and at same time, protect physicians from suffering financial consequences as a result of coding errors and mistakes for a 2-year period,” he said.
He called for the AMA to put in motion a letter-writing campaign to advocate for the grace period. “This should be our number-one priority, at least from now until Oct. 1, when it won’t matter.”
Dr. Wanda Filer, delegate from the American Academy of Family Physicians, echoed Dr. Terry.
“At this point, we believe that the adoption of ICD-10 is inevitable and, recognizing that advocacy resources are finite, we would like to encourage our AMA to work with CMS to prepare for this and ensure a soft landing for all physicians and patients … rather than a hard start,” said Dr. Filer, who is also AAFP president-elect.
Delegates suggested that the organization focus on how ICD-10 requirements could affect small practices and their patients. They called on the AMA to track data on rejected claims, payment delays resulting from coding errors, and the impact on patient volume.
Reference Committee B, which addresses matters of federal legislation, considered a number of other issues, almost without dissent. One exception was a resolution advocating for background checks on all gun sales, which met with some resistance as being onerous for certain people in specific situations.
Resolutions will be voted on by the full House of Delegates June 8-10.
CHICAGO – With the ICD-10 transition looming, delegates to the annual meeting of the American Medical Association House of Delegates want their organization to advocate for giving some room to physicians to adjust.
A resolution submitted by the Alabama delegation calls on the AMA to push for a 2-year grace period during which physicians would not be penalized for errors, mistakes, and other system malfunctions, and payments would not be withheld due to coding errors.
Dr. W. Jeff Terry, chairman of the Alabama delegation, noted that, despite the AMA’s policies and efforts against ICD-10, the government stands firm on its Oct. 1 implementation date.
“I truly believe that we have just not educated Congress well enough as to the issues of the consequences of ICD-10,” Dr. Terry said.
“We – as our AMA, me, and all of you – just haven’t done our job well enough. … I want to stress here today what our AMA message should be from out of this meeting. Even though the American Medical Association is firm in its view that the switch to ICD-10 is a mistake, we also recognized that there are other groups that are fighting to maintain the Oct. 1 implementation date. In order to maintain patients’ access to care and protect physicians’ practices, we offer a compromise solution that will allow ICD-10 to be implemented as planned on Oct. 1, and at same time, protect physicians from suffering financial consequences as a result of coding errors and mistakes for a 2-year period,” he said.
He called for the AMA to put in motion a letter-writing campaign to advocate for the grace period. “This should be our number-one priority, at least from now until Oct. 1, when it won’t matter.”
Dr. Wanda Filer, delegate from the American Academy of Family Physicians, echoed Dr. Terry.
“At this point, we believe that the adoption of ICD-10 is inevitable and, recognizing that advocacy resources are finite, we would like to encourage our AMA to work with CMS to prepare for this and ensure a soft landing for all physicians and patients … rather than a hard start,” said Dr. Filer, who is also AAFP president-elect.
Delegates suggested that the organization focus on how ICD-10 requirements could affect small practices and their patients. They called on the AMA to track data on rejected claims, payment delays resulting from coding errors, and the impact on patient volume.
Reference Committee B, which addresses matters of federal legislation, considered a number of other issues, almost without dissent. One exception was a resolution advocating for background checks on all gun sales, which met with some resistance as being onerous for certain people in specific situations.
Resolutions will be voted on by the full House of Delegates June 8-10.
AT THE AMA HOD MEETING
Data will drive evolution to value-based care, CMS chief says
WASHINGTON – Data are so integral to the transition to value-based care that the health care industry must begin to think of itself as an information industry, according to Centers for Medicare & Medicaid Services Acting Administrator Andy Slavitt.
“Health care will either remain a series of best guesses or it will turn into an information industry,” Mr. Slavitt said during his keynote address at an annual conference on health data transparency. This “requires an enormous amount of change and it is our job to help everyone adapt and succeed. The implication for us at CMS is that we need to be more modern, more strategic, and culturally a fast-moving, responsive, and transparent agency that leads and enables change.”
Mr. Slavitt identified four key areas for focus: privacy and security, real consumer benefit, learning and productivity, and connectivity. To improve his agency’s connectivity to providers, Mr. Slavitt said that it has recently created a new email box – [email protected] – to allow doctors and others who are experiencing information blocking issues to help the agency address concerns.
“Data blocking will not be tolerated,” Mr. Slavitt said. “We don’t experience care in silos and our data can’t live in silos.”
To spur the transition to a more information-based health care industry, Mr. Slavitt announced a number of data-sharing initiatives aimed at spurring on further data transparency.
First, the agency will be releasing its data to commercial entities. “We are aiming directly at shaking up health care innovation and setting a new standard for data transparency,” Mr. Slavitt said.
Innovators will have access to granular CMS program data, including de-identified Medicare fee-for-service claims data, with the hopes that they will be able to create care management and predictive modeling tools.
“While this is a big departure, we do this with a clear expectation that you will create a new stream of tools that will improve care and personalized decision-making and we are allowing companies to combine CMS data with other data so even what were small silos of data can have enough credibility to have meaning,” he said, challenging other organizations to open up their proprietary databases and match CMS’ move to open its data to commercial interests.
Mr. Slavitt also announced that data updates will be available on a quarterly basis. “In an information age, it is just not acceptable that the most recent Medicare data available to researchers is from 2013.”
He called on innovators to build products not for just the healthiest and wealthiest, but for the sickest in the population.
WASHINGTON – Data are so integral to the transition to value-based care that the health care industry must begin to think of itself as an information industry, according to Centers for Medicare & Medicaid Services Acting Administrator Andy Slavitt.
“Health care will either remain a series of best guesses or it will turn into an information industry,” Mr. Slavitt said during his keynote address at an annual conference on health data transparency. This “requires an enormous amount of change and it is our job to help everyone adapt and succeed. The implication for us at CMS is that we need to be more modern, more strategic, and culturally a fast-moving, responsive, and transparent agency that leads and enables change.”
Mr. Slavitt identified four key areas for focus: privacy and security, real consumer benefit, learning and productivity, and connectivity. To improve his agency’s connectivity to providers, Mr. Slavitt said that it has recently created a new email box – [email protected] – to allow doctors and others who are experiencing information blocking issues to help the agency address concerns.
“Data blocking will not be tolerated,” Mr. Slavitt said. “We don’t experience care in silos and our data can’t live in silos.”
To spur the transition to a more information-based health care industry, Mr. Slavitt announced a number of data-sharing initiatives aimed at spurring on further data transparency.
First, the agency will be releasing its data to commercial entities. “We are aiming directly at shaking up health care innovation and setting a new standard for data transparency,” Mr. Slavitt said.
Innovators will have access to granular CMS program data, including de-identified Medicare fee-for-service claims data, with the hopes that they will be able to create care management and predictive modeling tools.
“While this is a big departure, we do this with a clear expectation that you will create a new stream of tools that will improve care and personalized decision-making and we are allowing companies to combine CMS data with other data so even what were small silos of data can have enough credibility to have meaning,” he said, challenging other organizations to open up their proprietary databases and match CMS’ move to open its data to commercial interests.
Mr. Slavitt also announced that data updates will be available on a quarterly basis. “In an information age, it is just not acceptable that the most recent Medicare data available to researchers is from 2013.”
He called on innovators to build products not for just the healthiest and wealthiest, but for the sickest in the population.
WASHINGTON – Data are so integral to the transition to value-based care that the health care industry must begin to think of itself as an information industry, according to Centers for Medicare & Medicaid Services Acting Administrator Andy Slavitt.
“Health care will either remain a series of best guesses or it will turn into an information industry,” Mr. Slavitt said during his keynote address at an annual conference on health data transparency. This “requires an enormous amount of change and it is our job to help everyone adapt and succeed. The implication for us at CMS is that we need to be more modern, more strategic, and culturally a fast-moving, responsive, and transparent agency that leads and enables change.”
Mr. Slavitt identified four key areas for focus: privacy and security, real consumer benefit, learning and productivity, and connectivity. To improve his agency’s connectivity to providers, Mr. Slavitt said that it has recently created a new email box – [email protected] – to allow doctors and others who are experiencing information blocking issues to help the agency address concerns.
“Data blocking will not be tolerated,” Mr. Slavitt said. “We don’t experience care in silos and our data can’t live in silos.”
To spur the transition to a more information-based health care industry, Mr. Slavitt announced a number of data-sharing initiatives aimed at spurring on further data transparency.
First, the agency will be releasing its data to commercial entities. “We are aiming directly at shaking up health care innovation and setting a new standard for data transparency,” Mr. Slavitt said.
Innovators will have access to granular CMS program data, including de-identified Medicare fee-for-service claims data, with the hopes that they will be able to create care management and predictive modeling tools.
“While this is a big departure, we do this with a clear expectation that you will create a new stream of tools that will improve care and personalized decision-making and we are allowing companies to combine CMS data with other data so even what were small silos of data can have enough credibility to have meaning,” he said, challenging other organizations to open up their proprietary databases and match CMS’ move to open its data to commercial interests.
Mr. Slavitt also announced that data updates will be available on a quarterly basis. “In an information age, it is just not acceptable that the most recent Medicare data available to researchers is from 2013.”
He called on innovators to build products not for just the healthiest and wealthiest, but for the sickest in the population.
AT HEALTH DATAPALOOZA 2015
