Population health is everywhere (US)

Last week, CMS published the ominously dubbed Final Rule on MACRA (the Medicare Access and CHIP Reauthorization Act of 2015) which utterly changes how physicians are compensated by Medicare and the various monetary incentives they have in quality and patient-centered care. This Editor is not going to get into interpretation of 2,300+ pages, but her belief is that this will not be effective in 2017 as designed, as literally it is over-complex and not understood by those who implement patient care. The dizzying models include Merit-Based Incentive Payment System (MIPS) and for the daring, the Advanced Alternative Payment Model (APM). All great business for the 100 or so ‘value-based consultants’ ready to help those expensively organized ACOs which thought they’d be rich from Meaningful Use. Oh, and what about the patient and their well-being in the meantime?? Healthcare Dive, Healthcare IT News and here  Don’t hunt for CMS’ fact sheet–it’s here. Don’t look for much about telemedicine and remote monitoring, which apparently was included in the law but not in the Final Rule for MIPS but is a part of the Advanced APM. Congress may act to expand Medicare’s payment policy on telehealth, but don’t hold your breath for it happening this year. POLITICO Morning eHealth 19 Oct

But population health and the data analytics that’s needed to get a handle on both large-scale patient health trends to allocate care where it is needed, and the financial metrics that organizations need, is hot. Verily Life Sciences (Alphabet-Google’s ever versatile healthcare tech arm) is allying itself with 3M Health Information Systems. (This Editor bets that you never thought that the Post-It Notes company was in health information!) According to the article, 3M’s part has to do with its business in coding, classification and risk-stratification methodologies. Verily will bring to the party data analytics, algorithms and software development. Healthcare IT News

This Editor also noted IHS Markit’s analysis of MACRA mixed with a bit from ATA’s Fall Forum. One insight: And now CMS plans to tie 90 percent of traditional Medicare fee-for-service payments to value-based payments in 2018. A lagninappe: “MACRA will help telemedicine to simply become another modality within healthcare delivery.” The wrapup is quite illuminating.

As identified during a recent consumer survey conducted by IHS Markit on digital health trends in the US, patients are interested now more than ever in sharing their healthcare data, and provider communication is at a low:

  • Of the 405 respondents, 50% of the respondents are managing a chronic condition and 83% are using a device to monitor their health.
  • Nearly 40% are using a weight scale and 28% use a smartphone.
  • Smartwatch usage is increasing at 15%, while activity monitor uptake has edged past blood pressure monitors.

Only 14% of respondents communicate with their healthcare provider on a daily or weekly basis and 55% communicate with their provider monthly or biannually with the highest frequency of communication being once every six months. However, 70% stated that they are interested in sharing the health data they collect with their provider. The trend toward self-monitoring and interest in communicating the data with providers may prove to be advantageous for telemedicine. As consumers become more cognizant of their health data through access to patient portals, they may also find that accessing routine consultations are preferable through video rather than in-person. The challenge for the healthcare industry is to maintain a unique, personal delivery system while achieving economies of scale.

Inovalon, a data analytics company, with Quest Diagnostics testing in a joint study, admits that physicians and health plans find it all too complex and can’t get at patient data. They are crying ‘More Tools’! But again, telemedicine and telehealth may come to the rescue!  Release

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