January 13, 2015

HEALTHCARE & GOVERNMENT - IN BRIEF

HEALTHCARE TRENDS - IN BRIEF

UPCOMING ROUND TABLES & EVENTS FOR HEALTHCARE EXECS
  • 1/13  -  Silicon Valley Round Table
  • 1/14  -  San Francisco/ Bay Area Round Table
  • 1/16  -  Los Angeles Round Table
  • 1/20  -  San Diego Round Table
  • 2/04  -  Orange County Round Table
  • 2/12  -  East Bay/ Bay Area Round Table
     
  • 1/21  -  12th Annual Top Tech Trends - The Sixth Wave:
                 The Power of the Digital Infinite, featuring Dave "Mr. Trend"    
                 Berkus,
    Networking Lunch 12-1 p.m., Program 1-4:30 p.m., Long
                 Beach Airport Marriott

MEMBER NEWS - IN BRIEF

INSIGHTS FROM AN ADAPTIVE BUSINESS LEADER

MEMBERS ARE READING. . .

HEALTHCARE & GOVERNMENT - IN BRIEF

Some NY Nurse Practitioners to be Freed of Doc Supervision in 2015

Nurse practitioners (NPs) in New York with over 3,600 hours of clinical practice under their belt, beginning Jan. 1, will no longer be required to have a written collaborative agreement with a physician, nor will they be required to submit patient charts to a physician for review. Instead, experienced practitioners will only be required to have an established relationship with a physician or hospital for referral or consultation. The new rules mean a NP with about two years of full-time clinical practice would meet the requirement. New York joined 19 other states and the District of Columbia that have passed similar legislation creating what the American Association of Nurse Practitioners calls “full practice” environments, in which regulations do not reduce or restrict nurse practitioners' practices. (modernhealthcare.com, 12/30/14)
      Meanwhile, lawmakers in Minnesota recently passed a law, which took effect January 1, that gives Advanced Practice Registered Nurses (APRNs) the authority to diagnose and refer patients, order tests, and write prescriptions. APRNs have a bachelor's degree, plus at least three years of specialized training. (fiercehealthcare.com, 12/19; kare11.com, 12/15/14)
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Jones Releases Emergency Rule Over Narrow Provider Networks

The California Department of Insurance recently issued an emergency regulation that aims to address narrow provider networks in the state and improve residents' access to care. The regulation requires insurers to:
*Adhere to new standards for appointment wait times;
*Offer an adequate number of physicians, clinics, and hospitals to patients who live in certain areas;
*Provide an accurate list of in-network providers;
*Provide out-of-network care options for the same price as in-network care when the number of in-network providers is insufficient; and
*Report to DOI information about their networks and any changes.
The emergency regulation will go into effect after it has been reviewed by the Office of Administrative Law. (KXJZ News - Capital Public Radio, 1/5; DOI release, 1/5/15)
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No Money in Brown's Budget for Healthcare for Undocumented

Gov. Jerry Brown's (D) recently released fiscal year 2015-2016 budget proposal lacks funding to provide health coverage to undocumented immigrants in the state. When asked about providing health coverage to such residents, Brown said, "There's not a lot of money left in the budget. . . It's very tight." Further, the proposal does not include funding to expand Medi-Cal to undocumented immigrants in California who now are protected from deportation under President Obama's recent executive action on immigration According to the budget, Medi-Cal will account for two-thirds of overall health and human services spending in the coming fiscal year. ("State of Health," KQED, 1/9/15)
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CMS Revises RAC Program to Increase Transparency, Oversight

The Centers for Medicare & Medicaid Services will revise its Recovery Audit Contractors (RAC) program to sharpen agency oversight, reduce the burden on providers and increase transparency. Under the new plan, CMS will restrict the RAC program's window for patient status reviews to six months if the provider submits its claim within three months of the date of service. (fiercehealthcare.com, 1/6/15)
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Errors in Medicare Physician Fee Schedule Delay Payments

On November 13, 2014, the CY 2015 Medicare Physician Fee Schedule (MPFS) final rule was published in the Federal Register. In order to implement corrections to technical errors discovered after publication of the MPFS rule and process claims correctly, Medicare Administrative Contractors are holding claims containing 2015 services paid under the MPFS for the first 14 calendar days of January 2015 (i.e., Thursday January 1 through Wednesday January 14). The hold is expected to have minimal impact on provider cash flow as, under current law, clean electronic claims are not paid sooner than 14 calendar days (29 days for paper claims) after the date of receipt. (MLN Connects, Provider eNews, 12/29/14)
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HEALTHCARE TRENDS - IN BRIEF

Without ACA Subsidies, Premiums Will Rise 35%-45%, Rand and RWJF Find

If the U.S. Supreme Court determines federal subsidies are illegal when it rules in the King v. Burwell case, it would dramatically increase costs and lower enrollment in the individual market, according to two separate studies. In a new Rand Corp. study, researchers determined that more than 9.6 million people would lose coverage they purchased through the health insurance exchanges, dropping the enrollment down to 4.1 million from 13.7 million people. That's because they wouldn't be able to afford the annual premiums, which would rise from $3,450 to more than $5,000. Meanwhile, the Robert Wood Johnson Foundation (RWJF) determined in a separate study that eliminating subsidies would cause the number of uninsured people to increase by 44% and raise premiums by 35%. RWJF researchers added that such a large drop in enrollment would lead to adverse selection, thereby discouraging insurers from participating in many exchanges as well as individual markets. In addition, markets with higher levels of insurer competition "are likely to revert to smaller numbers of insurers, potentially increasing premium costs even further," according to the study. (fiercehealthpayer.com, 1/8/15)
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Healthcare Tech Hype, and a Warning, Surface at Consumer Electronics Show

The boom times in healthcare gadgetry and related Silicon Valley technology developments appear set to continue, if last week's International Consumer Electronics Show is a reliable harbinger. The number of "health and biotech" exhibitors at the show is up 35% year over year - and that's without Apple's participation, according to a report from NPR. When you couple that with news of increased venture enthusiasm for digital health, it's clear the sector will continue to boom in the months ahead. But the show also featured Federal Trade Commission Chair Edith Ramirez warning that devicemakers need to do a better job building in data security and making clear who they share data with. (modernhealthcare.com, 1/8/15)
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ICD-10 is Coming! Prepare for (laughing at) these codes now!

With thanks to Ed Buckley, of Select Data, and Troy Hagen, of Care Ambulance, these codes – and their "explanations" – are sure to give you a chuckle. (healthcaredive.com, 7/15/14)
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MEMBER NEWS - IN BRIEF
24Hr HomeCare Opens Office in Arizona
A ribbon-cutting ceremony hailed the recent opening of 24Hr HomeCare's new office in Scottsdale, Arizona - the company's first outside of California. (David Allerby, Los Angeles)
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ABHOW Reorganizes Affordable Housing Division as Beacon

Senior housing and healthcare provider ABHOW has reorganized its affordable housing division into a wholly owned subsidiary, called Beacon Communities. With 33 affordable housing communities serving 2,500+ residents, and 10 development/ redevelopment projects in its pipeline, Beacon Communities has acquired Beacon Development Group, a Seattle-based developer of affordable housing communities, to support its growth. (Dave Ferguson, Silicon Valley)
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AT&T Digital Life Announces Expanded Offerings

AT&T has announced plans to integrate new products and services into its AT&T Digital Life platform. Among AT&T Digital Life's partners is Qualcomm Life, which provides access to its 2net Platform and Hub, a medical-grade device connectivity platform and standalone gateway, with the goal of developing a solution to allow customers to seamlessly transmit biometric data, such as blood pressure or weight, via the Digital Life app, enabling them to better manage their own health and the care of loved ones remotely. (Judi Manis, Orange County, & Marina Younani)
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Cibola Systems Collaborates on Rinker Health Science Campus

Audiovisual consulting and integration was provided by Cibola Systems to the recently completed Chapman University Harry and Diane Rinker Health Science Campus, in Irvine, CA. The Campus features flexible, shared classroom and research spaces designed to foster interdisciplinary collaboration. The high-tech facility will be used to teach future healthcare professionals the best ways to integrate technology into practice, while focusing on a team-based approach to healthcare. Pictured below is one of the new classrooms. (Lisa Perrine, Los Angeles)

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Hospice of the East Bay Sees Program Growth

The Bridge, Hospice of the East Bay's child and adolescent bereavement program, has moved to larger meeting facilities, as, in 2015, it expects its largest participation to date. Over 20 families with more than 30 children are signed up for the program. (Cindy Hatton, Bay Area)
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Independa Announces New Products, Receives Award at CES

At last week's 2015 Consumer Electronics Show (CES), Independa announced that its TV-based social engagement and remote care solution is now available for purchase by individuals, combining the benefits of cloud-based software with the simplicity of a TV. Also, Independa launched its mobile app solution on Apple iPhones and iPads, including integration with Apple Watch and the Apple HealthKit platform. Meanwhile, Independa and LG celebrated winning the 2015 CES Innovation Award, in the "Tech for a Better World" category. Pictured below, Independa CEO, Kian Saneii (center), stands with LG colleagues. More photos and coverage are available on Facebook. (Kian Saneii, San Diego)

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Kaiser Permanente, Donate Life Present Inspiring Rose Parade Floats

"Together We Thrive," Kaiser Permanente's 2015 Rose Parade float entry (pictured below), was awarded the Judge's Special Trophy for the most spectacular in showmanship and dramatic impact. The float celebrates the 7,000 athletes from 177 countries who will take part in the Special Olympics World Games Los Angeles 2015. (Walt Meyers, Bay Area)

 

Also, the Donate Life float committee, chaired by Tom Mone, CEO of OneLegacy, built "The Never-Ending Story," (pictured below) which symbolized that an organ donor's legacy continues long after he or she dies, as donated organs and tissues help restore the lives of those who receive them. (Tom Mone, Los Angeles)

Gary Goltz, of Goltz Healthcare Sales Strategies, had the opportunity to visit the Donate Life float very early in its construction, and took the photo below, which emphasizes how much work goes into these beautiful floats. (Gary Goltz, Los Angeles)

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Kindred Acquires Centerre Healthcare

The previously announced acquisition of Centerre Healthcare Corporation by Kindred Healthcare has been completed, for approximately $195 million in cash. Centerre currently operates 11 inpatient rehabilitation hospitals with 612 beds in partnership with some of the nation's leading acute care hospital systems through joint ventures. It also has two additional hospitals with a total of 90 beds under construction and scheduled to open in 2015, and a pipeline of additional potential hospitals in various stages of development. (Adam Darvish, Orange County)
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Pathways Home Health & Hospice Highlighted

In Hospice physician crafts care plans to support patients' goals, the Palo Alto Weekly features Pathways Home Health & Hospice's chief medical director, Ellen Brown, MD, who discusses how hospice care works and its many benefits. Demand for hospice care, locally and nationally, has more than doubled in the 16 years since Brown joined Pathways. Back then, she said, about 20% of people at end of life used hospice, a figure that today approaches 45%. Also since 1998, Pathways' average daily patient count across the Bay Area has grown from about 100 to 465, adding up to thousands of patients in a given year. (Barbara Burgess, Silicon Valley)
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Select Data Examines Changes in 2015

"Case Mix Diagnoses Changes in 2015 - What does this mean for your agency?" is the title of both a paper and webinar from Select DataAlso, another webinar, Face to Face Encounter Changes in 2015, is also available. (Ed Buckley, Orange County, & Ted Schulte, Silicon Valley)
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TCG Acquires Leading RCM Services Provider

The Corridor Group (TCG) has acquired HMS Healthcare Management Solutions, a leading provider of revenue cycle management (RCM) and consulting services. With HMS, TCG will deliver to post-acute providers a full range of RCM, consulting, and education solutions, helping them optimize operations, as the healthcare market evolves from fee-for-service to value-based reimbursement. (Jeannee Parker Martin, Bay Area)
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The Health Trust Accredited by Diabetes Educators

The American Association of Diabetes Educators has awarded accreditation to The Health Trust, which will incorporate additional services, such as medical nutrition therapy and individual diabetes educational sessions with a registered dietitian, to their suite of diabetes prevention and management services currently offered throughout Santa Clara County.  Meanwhile, the eighth episode of Health Trust TV is available online, entitled "Happy Babies, Happy Toddlers." (Todd Hansen, Silicon Valley)
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VHA Acquires Assets of MDS Consulting

The assets of healthcare consulting firm Medical Development Specialists (aka MDS Consulting) have been acquired by VHA Inc. The integration will enable VHA to develop regionally based advisory teams who understand important geographic distinctions that impact member needs related to population health, network strategies, and partnership and affiliation strategies. (Andrea Coleman, Bay Area)
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Vitas Earns Reaccreditation from Jewish Hospice Organization

Select VITAS Healthcare programs in California, as well as in Alabama, Florida, Kansas, Missouri, and Texas, have been reaccredited with the National Institute for Jewish Hospice, enabling them to receive on-site training designed to deepen caregivers' knowledge and understanding of Jewish religious rituals and the unique concerns of Jews at the end of life and during mourning. (Lisa Cooper, Bay Area)
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INSIGHTS FROM AN ADAPTIVE BUSINESS LEADER

Dave Berkus on:  Being an Adaptive Business Leader

In Be an Adaptive Business Leader, Dave Berkus, the Chairman of ABL's Technology Advisory Board and an active Round Table Member since 1989, shares that he's probably attended 400+ half-day ABL Round Tables over the years. "Why would I spend so much time networking with other CEOs, discussing mutual problems and solutions?" he asks. "The answer is that I am the recipient of many insights from fellow CEOs that sometimes strike like lightning bolts when least expected. It was an Internet CEO roundtable in early 2000 where it became obvious before the public was aware, that the bubble was just beginning to burst for such tech businesses. And it happened again in early 2008, as CEOs reported the first evidence of order slowdowns and issues with customer payments – right before the 'great recession.' But most importantly, it is the constant hearing of stories by these CEOs of how they were able to adapt to changes in their environment and alter the course of their leadership, adapting to external influences that had changed in their industry or the economy."
     "The theme of these roundtables is 'adapt' – to be ready for and embrace change quickly and efficiently in the light of opportunities and changes that might be missed by other CEOs without trained antenna-like skills," Dave continues. "[ABL is] a group of fellow executives ready to share and solve your problems of the month, or share theirs with you to better inform you of those you might otherwise miss in your management life. Unlike other groups, ABL members all belong to either healthcare or technology industry-focused roundtables. There they not only discuss their business issues, but significant business-changing trends facing their industry.
     "I am the recipient of many insights from fellow CEOs that sometimes strike like lightning bolts when least expected," Dave acknowledges. "And, as an active, professional angel investor, often I can help in areas not familiar to the others, when fundraising issues are on the list." (Dave Berkus, Los Angeles Area & West Los Angeles)
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