Tacking Health Care Costs Onto California Farm Produce

Today's post was shared by WCBlog and comes from www.nytimes.com

Farm labor contractors across California, the nation’s biggest agricultural engine, are increasingly nervous about a provision of the Affordable Care Act that will require hundreds of thousands of field workers to be covered by health insurance.

While the requirement was recently delayed until 2015, the contractors, who provide farmers with armies of field workers, say they are already preparing for the potential cost the law will add to their business, which typically operates on a slender profit margin.

“I’ve been to at least a dozen seminars on the Affordable Care Act since February,” said Chuck Herrin, owner of Sunrise Farm Labor, a contractor based here. “If you don’t take the right approach, you’re wiped out.”

Proposed Medicare Payment Reductions Will Impact Workers' Compensation Costs

A government Medicare advisory panel reported on Friday that sweeping changes should be implemented to reduce increasing medical costs, including higher costs associated with hospital purchased physician practices. The impact of those proposed adjustments will significantly impact the national workers' compensation systems because of both direct and indirect links between the two programs, including medical fee schedules, and Medicare Secondary Payment reimbursements.

The Medicare Payment Advisory Commission (MedPAC)  releases its June 2013 Report to the Congress: 
Medicare and the Health Care Delivery System.

According to Commission Chair Glenn Hackbarth, “This report can inform a dialogue about future 
directions for the Medicare program, as well as about technical refinements to existing Medicare 
payment policy. Whether broad or narrow, the Commission’s work aims to balance the interests of 
Medicare beneficiaries, health care providers, and tax payers.”

Redesigning the Medicare benefit. In the report, the Commission continues its discussion of 
possible ways to redesign the Medicare benefit by focusing on the concept we refer to as competitively
determined plan contributions (CPC). Under CPC, Medicare beneficiaries could receive care through
either a private plan or traditional fee-for-service (FFS), but the premium paid by the beneficiary might
vary depending on the coverage option they choose. How much the federal government pays for a 
beneficiary’s care would be determined through a competitive process comparing the costs of available 
options for coverage. The report identifies key issues to be addressed if the Congress wishes to pursue a 
policy option like CPC. These include how benefits could be standardized for comparability, how to 
calculate the Medicare contribution, the role FFS, and the structure of subsidies for low-income 
beneficiaries.

Reducing Medicare payment differences across sites of care. Medicare’s payment rates often 
vary for similar services provided to similar patients, simply because they are provided in different sites of 
care. For example, Medicare pays 141 percent more for one type of echocardiogram when done in a
hospital outpatient department than when it is done in a freestanding physician’s office. If Medicare pays a 
higher rate for a service in one setting over another, program spending increases and beneficiaries pay 
more in cost sharing without a corresponding increase in quality of care. 

The Commission previously recommended reducing the rate Medicare pays for basic office visits from the 
payment rate in the outpatient setting to the physician office rate. Using similar criteria, this report identifies
additional services that may be eligible for equalizing or narrowing payment differences across settings. 
Bundling post-acute care services. Each year, about one-quarter of Medicare beneficiaries receive 
care following a hospitalization from a post-acute care provider, such as a skilled nursing facility, home 
health agency, or inpatient rehabilitation facility. However, nationwide the use of these services varies 
widely, for reasons not explained by differences in beneficiaries’ health status. Under traditional 
Medicare, the program pays widely varying rates for different settings and—characteristic of FFS—pays 
based on the volume of care provided, without regard to quality or resource use. 

Medicare has begun to explore the possibility of bundling services as a way to encourage providers to 
coordinate and furnish needed care more efficiently. In this report, the Commission explores the 
implications for quality and program spending for different design features of the bundles, such as the 
services included, the length of time covered by the bundle, and the method of payment.

Reducing hospital readmissions. In 2008, the Commission recommended a hospital readmissions 
reduction program to improve patient experience and reduce Medicare spending. In 2012, Medicare 
began such a program, penalizing hospitals that have high rates of Medicare beneficiaries being 
readmitted to the hospital within 30 days of discharge. The readmission penalty has given hospitals a 
strong incentive to improve care coordination across providers, and for that reason Medicare should 
continue to implement the policy. In this report, the Commission suggests further refinements to 
improve incentives for hospitals and generate program savings through reduced readmissions rather than 
higher penalties. 

Payments for hospice services. The Medicare hospice benefit provides beneficiaries an important 
option for end-of-life care. At the same time, the Commission has identified several problems in the way 
Medicare pays for hospices that may lead to inappropriate use of the benefit. The report presents 
information on the prevalence of long-stay patients and the use of hospice services among nursing home 
patients—both of which may inform policy development in the hospice payment system in the future. It 
also presents further evidence to support the Commission’s March 2009 recommendations to revise the 
hospice payment system.

Improving care for dual-eligible beneficiaries. Beneficiaries eligible for both Medicare and 
Medicaid—many of whom have complex medical and social needs—often have trouble accessing 
services and receive little care coordination, resulting in poorer health outcomes and higher spending 
relative to other beneficiaries. Programs that coordinate dual-eligible beneficiaries’ Medicare and 
Medicaid benefits have the potential to improve care for this population. In the report, the Commission 
notes that federally qualified health centers and community health centers may be uniquely positioned to 
coordinate care for dual-eligible beneficiaries because they provide primary care, behavioral health
services, and care management services, often at the same clinic site.

Mandated reports. The report includes three chapters that fulfill Congressional mandates: one on 
Medicare ambulance add-on payments, a second on geographic adjustment of fee schedule payments for 
the work effort of physicians and other health professionals, and a third on Medicare payment for 
outpatient therapy services. In each case, the Commission considers the existing policies—which are not 
permanent statutory provisions—and examines the effect of their continuation or termination on 
program spending, beneficiaries’ access to care, and the quality of care beneficiaries receive, as well as 
their potential to advance payment reform. 

The three congressionally mandated reports are described in further detail in separate fact sheets, posted 
on MedPAC’s website. The full report can be downloaded from MedPAC’s website:
http://medpac.gov/documents/Jun13_EntireReport.pdf

Read more about Medicare and Workers' Compensation

Workers' Compensation: NJ Court Approves Medicare Set-Aside ...

May 18, 2013

A NJ Superior Court deemed a proposed Medicare Set-Aside Agreement to be satisfactory to protect Medicare's interests and granted a Motion to Enforce a Pending Settlement. This action by the Court was taken after CMS ...

http://workers-compensation.blogspot.com/

CMS Publishes Brand New Reference Guide for Medicare Set-Aside

Mar 29, 2013

A new Workers' Compensation Medicare Set-Aside Arrangement (WCMSA) Reference Guide has been posted and is available to be downloaded on the CMS (Centers for Medicare & Medicad Services) website.

http://workers-compensation.blogspot.com/

Workers' Compensation: Obama signs MSP Medicare bill

Jan 11, 2013

"The legislation changes the way Medicare collects money from people whose negligence caused a patient to incur medical bills. Murphy said the new law will streamline an outdated process, making it easier to close cases ...

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CMS Health Care Workers Vaccination Deadline March 15, 2022

The Centers for Medicare and Medicaid Services (CMS) issued guidance that the full vaccination compliance deadline is March 15, 2022, for all health care workers subject to the Omnibus Health Care Staff Vaccination rule.

CDC Issues Revised Interim U.S. Guidance for Monitoring and Movement of Persons with Potential Ebola Virus Exposure

CDC Issues Revised Interim U.S. Guidance for Monitoring and Movement of Persons with Potential Ebola Virus Exposure

The Centers for Disease Control and Prevention (CDC) issued today revised Interim U.S. Guidance for Monitoring and Movement of Persons with Ebola Virus Exposure. This guidance (hyperlink to the guidance here) provides new information public health authorities and other partners can use to determine appropriate public health actions based on Ebola exposure risk factors and clinical presentation. It also includes criteria for monitoring exposed people and for when movement restrictions may be needed.

In determining the right approach, we have put the health and safety of Americans first and foremost, and our deliberations have been informed by our most knowledgeable and experienced public health and homeland security professionals. As with everything we have done to respond to the threat of Ebola both at home and abroad, we have been guided by the best science available.

Coordinated public health actions are essential to stop and reverse the spread of Ebola virus. CDC announced last week that public health authorities will begin active post-arrival monitoring of travelers whose travel originates in Liberia, Sierra Leone, or Guinea and arrive at one of the five airports in the United States doing enhanced screening. The revised interim guidance released today is intended to guide state and local health officials with decisions about managing the movement of individuals being monitored, including travelers from the countries with widespread transmission and others who may have been exposed in the United States.

Active post-arrival monitoring means that travelers without febrile illness or symptoms consistent with Ebola will be contacted daily by state and local health departments for 21 days from the date of their departure from Liberia, Sierra Leone, or Guinea. Six states (New York, Pennsylvania, Maryland, Virginia, New Jersey, and Georgia), where approximately 70% of incoming travelers are headed, will start active monitoring today, with the remainder of the states starting in the days following.

This guidance also outlines appropriate public health actions for those individuals classified as “some risk.” These include health care workers who are providing direct care to Ebola patients in West Africa or others, such as observers, who enter an Ebola treatment area where Ebola patients are being cared for. Additional precautions, such as direct active monitoring, are recommended for those classified as “some risk.” In addition, the guidance recommends public health authorities determine on an individualized case-by-case basis whether additional restrictions, such as controlled movement, workplace exclusions, or restrictions on other activities, are appropriate. This daily health consultation will give additional confidence to the community that a returning health care worker is asymptomatic and therefore not contagious.

Returning health care workers should be treated with dignity and respect. They, along with our civilian and military personnel in the region, are working tirelessly on the frontlines against Ebola, and their success is what ultimately will enable us to eliminate the threat of additional domestic Ebola cases. We must not prevent or unduly discourage them from undertaking this indispensable and selfless work.

Guidance for returning health care workers from West Africa should be distinguished from health care workers providing care for Ebola patients in the United States. There are important differences between providing care or performing public health tasks in Africa versus in a U.S. hospital. A U.S. hospital provides a more controlled setting than a field hospital in West Africa. A U.S. healthcare worker would be able to anticipate most procedures that would put them at risk of exposure and wear additional personal protective equipment as recommended. In some places in Africa, the same may not be true and workers may not have the ability to prepare for potential exposures.

This guidance is interim guidance and could be updated or changed as new information becomes available.

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Johnson & Johnson to Pay More Than $2.2 Billion to Resolve Criminal and Civil Investigatio

Today's post is shared from justice.gov

Allegations Include Off-label Marketing and Kickbacks to Doctors and Pharmacists\Global health care giant Johnson & Johnson (J&J) and its subsidiaries will pay more than $2.2 billion to resolve criminal and civil liability arising from allegations relating to the prescription drugs Risperdal, Invega and Natrecor, including promotion for uses not approved as safe and effective by the Food and Drug Administration (FDA) and payment of kickbacks to physicians and to the nation’s largest long-term care pharmacy provider. The global resolution is one of the largest health care fraud settlements in U.S. history, including criminal fines and forfeiture totaling $485 million and civil settlements with the federal government and states totaling $1.72 billion.

“The conduct at issue in this case jeopardized the health and safety of patients and damaged the public trust,” said Attorney General Eric Holder. “This multibillion-dollar resolution demonstrates the Justice Department’s firm commitment to preventing and combating all forms of health care fraud. And it proves our determination to hold accountable any corporation that breaks the law and enriches its bottom line at the expense of the American people.”

The resolution includes criminal fines and forfeiture for violations of the law and civil settlements based on the False Claims Act arising out of multiple investigations of the company and its subsidiaries.

Why Improving Access to Health Care Does Not Save Money

Today's post was shared by The New York Times and comes from www.nytimes.com

One of the oft-repeated arguments in favor of the Affordable Care Act is that it will reduce people’s need for more intensive care by increasing their access to preventive care. For example, people will use the emergency room less often because they will be able to see primary care physicians. Or, they will not develop as many chronic illnesses because they will be properly screened and treated early on. And they will not require significant and invasive care down the line because they will be better managed ahead of time. Moreover, it is often asserted that these developments will lead to reductions in health care spending. Unfortunately, a growing body of evidence makes the case that this may not be true. One of the most important facts about health care overhaul, and one that is often overlooked, is that all changes to the health care system involve trade-offs among access, quality and cost. You can improve one of these – maybe two – but it will almost always result in some other aspect getting worse. You can make the health care system achieve better outcomes. But that will usually cost more or require some change in access. You can make it cheaper, but access or quality may take a hit. And you can expand access, but that will increase cost or result in some change in quality. The A.C.A. was primarily about access: making it easier for people to get insurance and the care it allows. The law also tries to make changes that may bend the curve of spending...

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A Conservative Re-Envisioning Of The Health Care Overhaul

Today's post was shared by Kaiser Health News and comes from capsules.kaiserhealthnews.org

Tired of hearing policy experts and politicians debate the 2010 health care law?  What if you took the Affordable Care Act out of the conversation?  If you could scrap the nation’s current health care system and build a new one, what would it look like?

A group of health care experts from Stanford University, the Harvard Kennedy School of Government and the University of Southern California, among other institutions, has compiled a report with their answer to that question.  Funded by the conservative-leaning American Enterprise Institute’s National Research Initiative, the document offers a variety of ideas that its authors say would achieve universal coverage, protect the poor and the sick and restrain health care cost growth, among other priorities.

“In many ways, the ACA has been a distraction, because people think that all of the health care debate boils down to ‘do you support the ACA or do you oppose it?’ ” said Darius Lakdawalla, one of the authors and a visiting scholar at the American Enterprise Institute, as well as a  professor of pharmaceutical economics in the University of Southern California School of Pharmacy. “To us, that is really a very narrow and misleading question.”

The report’s proposals include allowing health insurers to charge premiums that reflect consumers’ health care costs and providing generous subsidies to help the poor obtain...

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OSHA announces outreach campaign to protect health care workers from hazards causing musculoskeletal disorders

The U.S. Department of Labor's Occupational Safety and Health Administration today announced a campaign to raise awareness about the hazards likely to cause musculoskeletal disorders among health care workers responsible for patient care. These disorders include sprains, strains, soft tissue and back injuries.

"The best control for MSDs is an effective prevention program," said MaryAnn Garrahan, OSHA regional administrator in Philadelphia. "Our goal is to assist nursing homes and long-term care facilities in promoting effective processes to prevent injuries."

As part of the campaign, OSHA is providing 2,500 employers, unions and associations in the health care industry in Delaware, Pennsylvania, West Virginia and the District of Columbia with information about methods used to control hazards, such as lifting excessive weight during patient transfers and handling. OSHA is also providing information about how employers can include a zero-lift program, which minimizes direct patient lifting by using specialized lifting equipment and transfer tools.

Republican Lawmakers Set To Unveil Health Law Replacement Plan

Health care is a known unknown in the future of workers' compensation. If the Scott Walker's Wisconsin plan to dismantle workers' compensation is implemented, will that lead to more uninsured workers, or a merger into a universal health care program? Will it be a step backward to the 1994 Contract With America and the Newt Gingrich plan to eliminate workers' altogether? The debate continues as the 2016 national election cycle continues to frame the issues. Today's post was shared by Kaiser Health News and comes from kaiserhealthnews.org

House Energy and Commerce Committee Chairman Fred Upton declined to give details on the plan. Some Republicans are pushing tax credits and deductions for health care, and others are pushing the idea of "portable" health coverage -- the ability to take your insurance from job to job. The Associated Press: GOP Lawmakers Ready A Plan To Replace Obama Health Care Law A Republican House committee chairman says he and two GOP senators are preparing to release a plan for replacing President Barack Obama's health care law. House Energy and Commerce Committee Chairman Fred Upton declined to discuss details Tuesday, but said the proposal will give Republicans a proposal that they can stand behind. The Michigan Republican said he, Senate Finance Committee Chairman Orrin Hatch of Utah and Sen. Richard Burr of North Carolina will unveil their proposal Thursday. (2/3) The Fiscal Times: New GOP Congress Develops Alternate Health Plans House lawmakers are planning to vote for a 60th time today to repeal the president’s health care law – a vote that’s legislatively pointless but politically symbolic. Many of the 47 GOP freshmen who were elected last November won at least in part because their constituents were anti-Obamacare. (Ehley, 2/3)

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Health and Compensation Programs Passed Into Law After Almost Decade Long Fight Set to Expire This Year – Participants in 9/11 Health Program Living in All 50 States and 429 of 435 Congressional Districts

After nearly a decade long fight to stand by our first responders who answered the call of duty on September 11th, Congress finally fulfilled its moral obligation in late 2010 and provided our 9/11 heroes with the health care and financial compensation they deserved by passing the James Zadroga 9/11 Health and Compensation Act. With the Zadroga bill’s two critical programs – the World Trade Center (WTC) Health Program and the September 11th Victim Compensation Fund – set to expire in October 2015 and October 2016 respectively a bipartisan group of lawmakers from across the country today introduced the James Zadroga 9/11 Health and Compensation Reauthorization Act to permanently extend these programs. Last month, the U.S. Senate unanimously passed an amendment to the Senate budget resolution that will facilitate future legislation to renew and extend the Zadroga Act.

Denial Rates: An Insurance Company Tactic That Compounds the Health Care Delivery Problem

As Congress considers changes in the nation’s health care program, US health insurance companies continue to be scrutinized. The methodologies of how insurance companies deny claims are being investigated.

A certified nurse assistant, Amelia Mendoza, age 52, of West Covina, California, was attacked twice in the same week by a patient while working at Huntington Hospital in Pasadena earlier this year. Amelia suffered injuries that resulted in her suffering a stroke in April, falling into a vegetative state and contracting pneumonia. The hospital insurance carrier cut off medical care for her, forcing her from the hospital, and leaving her family responsible for medical care for Amelia’s work-related injury that is the hospital’s responsibility.

Her husband, Ralph Mendoza, who met with reporters and supporters outside the hospital, commented, “I am shocked and extremely disappointed that Huntington Hospital would treat Amelia this way. Amelia gave her all to her job for more than six years, and she deserves better….Amelia was injured doing her job, and the hospital has avoided its responsibility for months. I watch my wonderful wife, a mother of four children, slip away in a vegetative state and I wonder whether she would be healthy today if the hospital had met its responsibility. I want the medical care that my wife deserves.”

After an attack by a violent patient, Amelia was examined in the hospital’s Emergency Room and told to return to work. After a second attack just two days later, Amelia went to the Emergency Room and was told to go to Huntington Hospital’s in-house workers’ compensation clinic. The hospital was aware that Amelia’s blood pressure was dangerously high after the attack, and that the patient had infectious diseases. The hospital even called Amelia and her husband to warn of the health dangers Amelia faced. Yet the hospital’s clinic turned Amelia away, saying they were too busy to see her. Amelia suffered a stroke less than three hours later. The attacks had caused bleeding in her brain.

“The workers’ compensation carrier, Sedgwick, has denied liability for Amelia’s medical care, claiming that their investigation did not support a claim of injury and no medical evidence supports the claim either,” said Amelia’s attorney, Chelsea Glauber of the Glauber/Berenson Law Firm. “Medical evidence does in fact exist which states in no uncertain terms that Amelia’s condition was caused by these attacks at work. Amelia is trapped in a horrible hell, between two insurance companies trying to avoid responsibility. So Huntington Hospital let Amelia go home, in a vegetative state, to be taken care of by her husband, who no matter how loving and well intentioned, is not qualified to provide the critical care that Amelia needs and deserves. What does it say about these insurance companies and a hospital that they would treat a hard-working human being in this awful manner?”

A recent report on insurance companies denial rates reveals that, “When it comes to claim denials, insurers may be putting profits ahead of patients’ best interests. Most major insurance companies have reassigned their medical directors—the doctors who approve or deny claims for medical reasons—to report to their business managers, whose main responsibility is to boost profits.”


An inefficient system is not helpful to anyone, including injured workers, insurance companies, and employers. Wasteful administration should be curbed. The U.S. healthcare system wastes between $505 billion and $850 billion every year, recently reported Robert Kelley, vice president of healthcare analytics at Thomson Reuters.

Lawmakers must concentrate the U.S. health debate on how the delivery of medical care can be more efficient and effective. Delays and denials presently occurring in the workers’ compensation system continue to highlight the fact that injured workers need a universal health care system.

To read more about "health care" and "workers' compensation" click here.

Avoidable Deaths from Heart Disease, Stroke, and Hypertensive Disease — United States, 2001–2010

The US CDC reports that deaths attributed to lack of preventive health care or timely and effective medical care can be considered avoidable. In this report, avoidable causes of death are either preventable, as in preventing cardiovascular events by addressing risk factors, or treatable, as in treating conditions once they have occurred. Although various definitions for avoidable deaths exist, studies have consistently demonstrated high rates in the United States. Cardiovascular disease is the leading cause of U.S. deaths (approximately 800,000 per year) and many of them (e.g., heart disease, stroke, and hypertensive deaths among persons aged <75 years) are potentially avoidable.

New Fee Rules for Obtaining Medical Records

A new law has been enacted that amends the current law concerning the fees that may be charged for copies of medical and billing records by hospitals and by health care professionals licensed by the Board of Medical Examiners. Obtaining medical records in Workers’ Compensation actions is a standard claim and litigation procedure.

Shifting the Blame: Doctors Look To Others To Play Biggest Role In Curbing Health Costs

Blame for increased medical costs is getting tossed around like a political football. Those deeply entrenched into the system are pointing their finger at "the other" party to shift responsibility. This reminds one of when CMS in 1980 urged the passage of the Medical Secondary Payer Act. 

As this process continues, ultimately the US Government will be the final authority as Medicare ultimately rules the medical billing field and outcome based medicine seems to be the new goal.

Workers' Compensation system will ultimate adapt or be subsumed by the Medicare protocols in one fashion or another.  Special interests  will have little opportunity to cut out their specialized markets.

Today's post was shared by Kaiser Health News and comes from capsules.kaiserhealthnews.org

In a study, published Tuesday in the Journal of the American Medical Association, Mayo Clinic researchers surveyed more than 2,500 doctors to assess their views of different approaches to rein in the nation’s health care costs. The doctors were randomly selected from an American Medical Association database.

When it comes to controlling the country’s health care costs, doctors point their fingers at lawyers, insurance companies, drug makers and hospitals. But well over half acknowledge they have at least some responsibility as stewards of health care resources.

Based on their findings, 59 percent of doctors believed they have some responsibility in holding down  health care costs. Only 36 percent thought they have a major role.

Look Who Is Prescribing What

As part of the Administration’s goals of better, care, smarter spending, and healthier people, the Centers for Medicare & Medicaid Services announced the availability of new, privacy-protected data on Medicare Part D prescription drugs prescribed by physicians and other health care professionals in 2013. This data shows which prescription drugs were prescribed to Medicare Part D beneficiaries by which practitioners.

“This transparency will give patients, researchers, and providers access to information that will help shape the future of our nation’s health for the better,” said acting CMS Administrator Andy Slavitt. “Beneficiaries’ personal information is not available; however, it’s important for consumers, their providers, researchers, and other stakeholders to know how many prescription drugs are prescribed and how much they cost the health care system, so that they can better understand how the Medicare Part D program delivers care.”

The new data set contains information from over one million distinct health care providers who collectively prescribed approximately $103 billion in prescription drugs and supplies paid under the Part D program. The data characterizes the individual prescribing patterns of health providers that participate in Medicare Part D for over 3,000 distinct drug products. For each prescriber and drug, the dataset includes the total number of prescriptions that were dispensed, which include original prescriptions and any refills, and the total drug cost paid by beneficiaries, Part D plans, and other sources.

CMS created the new data set using drug claim information submitted by Medicare Advantage Prescription Drug plans and stand-alone Prescription Drug Plans. With this data, it will be possible to conduct a wide array of prescription drug analyses that compare drug use and costs for specific providers, brand versus generic drug prescribing rates, and to make geographic comparisons at the state level.

The Administration has set measurable goals and a timeline to move Medicare toward paying providers based on the quality, rather than the quantity, of care they give patients. This is part of a wide set of initiatives to achieve better care, smarter spending and healthier people through our health care system. Open sharing of data securely, timely and more broadly supports insight and innovation in health care delivery.

Today’s Part D prescriber data availability adds to the unprecedented information previously released on services and procedures provided to Medicare beneficiaries, including hospital charge data on common impatient and outpatient services as well as utilization and payment information for physicians and other healthcare professionals. In addition, under the Qualified Entity (QE) program, CMS releases Medicare data to approved entities for the purposes of producing public performance reports on physicians, hospitals, and other providers. To date, CMS has certified 11 regional QEs and one national QE.

To view a fact sheet on the Medicare Part D prescriber data, visit: http://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/Medicare-Provider-Charge-Data/Part-D-Prescriber.html

Updated: May 15, 2015

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Doctors and hospitals’ use of health IT more than doubles since 2012

More than half of America’s doctors have adopted electronic health records

HHS Secretary Kathleen Sebelius today announced that more than half of all doctors and other eligible providers have received Medicare or Medicaid incentive payments for adopting or meaningfully using electronic health records (EHRs).

HHS has met and exceeded its goal for 50 percent of doctor offices and 80 percent of eligible hospitals to have EHRs by the end of 2013.

Since the Obama administration started encouraging providers to adopt EHRs, usage has increased dramatically. According to the Centers for Disease Control and Prevention survey in 2012, the percent of physicians using an advanced EHR system was just 17 percent in 2008. Today, more than 50 percent of eligible professionals (mostly physicians) have demonstrated meaningful use and received an incentive payment. For hospitals, just nine percent had adopted EHRs in 2008, but today, more than 80 percent have demonstrated meaningful use of EHRs.

“We have reached a tipping point in adoption of electronic health records,” said Secretary Sebelius. “More than half of eligible professionals and 80 percent of eligible hospitals have adopted these systems, which are critical to modernizing our health care system. Health IT helps providers better coordinate care, which can improve patients’ health and save money at the same time.”

The Obama administration has encouraged the adoption of health IT starting with the passage of the Recovery Act in 2009 because it is an integral element of health care quality and efficiency improvements. Doctors, hospitals, and other eligible providers that adopt and meaningfully use certified electronic health records receive incentive payments through the Medicare and Medicaid EHR Incentive Programs. Part of the Recovery Act, these programs began in 2011 and are administered by the Centers for Medicare & Medicaid Services and the Office of the National Coordinator of Health Information Technology.

Adoption of EHRs is also critical to the broader health care improvement efforts that have started as a result of the Affordable Care Act. These efforts – improving care coordination, reducing duplicative tests and procedures, and rewarding hospitals for keeping patients healthier – all made possible by widespread use of EHRs. Health IT systems give doctors, hospitals, and other providers the ability to better coordinate care and reduce errors and readmissions that can cost more money and leave patients less healthy. In turn, efforts to improve care coordination and efficiency create further incentive for providers to adopt health IT.

As of the end of April 2013:

• More than 291,000 eligible professionals and over 3,800 eligible hospitals have received incentive payments from the Medicare and Medicaid EHR Incentive Programs.
• Approximately 80 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.
• More than half of physicians and other eligible professionals in the U.S. have received an incentive payment for adopting, implementing, upgrading, or meaningfully using an EHR.

For more information about the Administration’s efforts to promote implementation, adoption and meaningful use of EHRs and health IT systems, please visit: http://www.cms.gov/EHRIncentivePrograms and http://www.healthit.gov.

......

For over 4 decades the Law Offices of Jon L. Gelman  1.973.696.7900  jon@gelmans.com have been representing injured workers and their families who have suffered occupational accidents and illnesses.  Click here now to submit a case inquiry.

Read more about "Medical Records" and workers' compensation

Major California Medical Record Privacy Breach Disclosed

Aug 23, 2011

The lack privacy of medical records in workers' compensation claims has perpetually been a huge concern for workers since Congress ignored requests to protect their dissemination. A recent disclosure in California that the ...

http://workers-compensation.blogspot.com/

The Scarlet Letter - Workers' Compensation Style

May 16, 2013

The lack privacy of medical records in workers' compensation claims has perpetually been a huge concern for workers since Congress ignored requests to protect their dissemination. A recent disclosure in California that the .

http://workers-compensation.blogspot.com/

The Need to Incorporate Occupational Histories Into Electronic

Oct 04, 2011

The Need to Incorporate Occupational Histories Into Electronic Medical Records. Each year in the United States, more than 4,000 occupational fatalities and more than 3 million occupational injuries occur along with more ...

http://workers-compensation.blogspot.com/

Workers' Compensation: Private Investigators in Workers ...

Mar 11, 2013

They can pour over your medical records, pre- and post-injury, looking for any piece of evidence to deny your claim. They can send your file to lawyers who review medical records and recorded statements to potentially attack ...

http://workers-compensation.blogspot.com/

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Labor and Industry Join Forces to Change the Path of Health Care Delivery

The United States is now facing a crucial change, necessitated by economics, to the health care delivery system. Not since the movement initiated in the early 1900’s to embrace a national workers’ compensation system, has the nation faced such a critical turning point in health care and the identical parties expressed such a keen interest in change.

The nation’s largest private employer, Walmart (non-union), and the nation’s largest union representing health care workers, SEIU, as well as the influential policy think-tank, the Center for American Progress, delivered a letter to President Obama today, endorsing a mandate for employer and employee contribution for a health care plan.

Citing the Senate Finance Committee (Max Bacus (D-Montana, Chairman) that “health care expenditures are expected to consume nearly 20 percent of the GDP” by 2017, the collation seek, “…an employer mandate which is fair and broad in its coverage.”

While the debate is being to flow in the direction of the adoption a “public plan” option, the “single payer system” has not yet been ruled out entirely. Funding continues to remain a concern.

It is anticipated that if a “public plan” is adopted, the workers’ compensation system will probably be targeted as an economic engine to contribute generated revenue through various reimbursement mechanisms in addition to outright payment reform including incentive based medicine. It is estimated that the plan's cost may amount to a $2 Trillion cost.

Cost shifting enforcement could be more strictly pursued. Additional fines, penalties and user fees, maybe assessed under the Medicare Secondary Payer Act. Even taxing workers’ compensation benefits may become an option if other employer provided health care benefits are also subject to tax.

AMA Urges Trump Administration to Clarify Immigration Executive Order

A major element of workers' compensation benefits is medical treatment and that will be impacted the Donald Trump's recent ban on immigration. An adequate number of physicians must be available to provide medical care to cure and relieve  a work related medical condition. The American Medical Association (AMA) sent the following letter today to the U.S. Department of Homeland Security regarding the Administration’s executive order issued last week,“Protecting the Nation from Foreign Terrorist Entry into the United States:”

The 10 Highest Medical Cost Jurisdictions for Medicare

A recent study highlights the nation's disparity on the cost of medicine. The study also recommends that Medicare continue to pay varying medical fees by jurisdiction. In many states, workers' compensation medical fees are based upon Medicare guidelines.

"For over three decades, researchers have documented large, systematic variation in Medicare fee-for-service spending and service use across geographic regions, seemingly unrelated to health outcomes. This variation has been interpreted by many to imply that high spending areas are overusing or misusing medical care. Policymakers, seeking strategies to reduce Medicare costs, naturally wonder if cutting payment rates to high cost areas would save money without adversely affecting Medicare beneficiary health care quality and outcomes.

Health Care Workers Are at a Heightened COVID Risk - Updated 5/5/2020

A report published today by the Centers for Disease Control [CDC] highlights the increased risk of health care workers who are working so diligently on the frontlines in the effort to battle the COVID pandemic.