Leaders pushing for greater tech role

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Providers see tech tools as a way to provide more efficient care.
Providers see tech tools as a way to provide more efficient care.

Members of the National Center for Assisted Living (NCAL) recently joined federal agency leaders and industry experts to push for the adoption of health information technology by senior living operators. 

Appearing at an educational session sponsored by the Capitol Hill Steering Committee on Telehealth and Healthcare Informatics were AHCA/NCAL members Rustan (Rusty) Williams, vice president and Chief Information Officer of the Evangelical Lutheran Good Samaritan Society, based in Sioux Falls, SD; and Gary Kelso, president and Chief Executive Officer of Mission Health Services, Ogden, UT.

The session, titled “Adopting Information Technologies for Post-Acute and Long Term Care: Achieving Care Continuity,” provided a forum for experts to discuss the latest in health IT potential and issues in support of rapidly evolving payment mechanisms.

“Continuity among providers and payers in the delivery of care is the key to quality and efficiency,” said Mark Parkinson, president and CEO of NCAL. “Health information technology platforms that allow providers and payers to communicate and share data are essential to ensuring continuity of care and facilitating close relationships between health care delivery partners.”

Despite the lack of government incentives, providers need to find the resources necessary to implement modern electronic information systems. Health IT will be essential for new care delivery models — such as accountable care organizations — and for value-based payment approaches,” Parkinson said. “We are pleased to see our members speaking out in support of health IT and to encourage its adoption.”

Williams referenced Good Samaritan Society's LivingWell@Home program that electronically monitors patient vitals and activities of daily living in the home. He explained that the systemic change required to implement a technology of this magnitude does not happen overnight. 

“This is not a service we started looking at one or two years ago,” Williams says. “We've been developing this for over a decade, including several years of trial and error.”

Bill covers telehealth

In a move that could greatly expand the visibility and adoption of telehealth systems, Congress is proposing that Medicare reimburse telehealth services at the same rate as in-person medical visits. 

Members of the House Energy and Commerce Committee's subcommittee on Health began circulating a draft that would expand reimbursement for telehealth services that address unmet needs, substitute for an in-person visit, reduce hospital readmissions or enable a person to move to a “lower level of care.” 

The draft leaves space for later versions to include more specific criteria for meeting these requirements.

Insurance coverage has been practically non-existent for telehealth services to date, but observers believe if Medicare starts offering coverage, private payers would follow. 

Some commercial payers are already waking up to its potential, says Aaron Carlock, managing director for Chicago-based Huron Healthcare's IT solution Vonlay.

GAO's quality push

A new report to Congress casts significant doubts on the integrity and effectiveness of information systems many state Medicaid programs use to process claims, and CMS has agreed with it in its recommendation that they verify those systems when applying for Medicaid funds.

State Medicaid agencies should be required to measure and report to the federal government how well their electronic payment-integrity tools work, the Government Accountability Office concluded in its March 2 report. 

“The effectiveness of the states' use of the systems for program integrity purposes is not known,” GAO analysts noted, adding that CMS does not require states to measure or report quantifiable benefits achieved as a result of using the systems.

The GAO analyzed Medicaid management information systems in nine states and the Virgin Islands. Inspectors found a wide variety of IT systems to prevent and detect improper payments. Three state programs were working on MMIS platforms that were more than 20 years old. Seven had performed some kind of upgrade or implemented ancillary programs with data analytics and decision support features to review multiple claims and flag potentially fraudulent billing patterns.

Telemonitoring rebuff

Once touted as a viable, emerging cost-effective care option, telemedicine may not be the savior some forecast it to be, Mayo Clinic and Purdue University researchers concluded recently.

After examining the outcomes of 205 older adults with multiple chronic conditions who used conventional in-office and telemonitoring services, researchers concluded there were very little significant savings with telemonitoring. The results were published in the January issue of Telemedicine and eHealth.

The conventional group was able to access physician offices, home healthcare services and phone consultation while the telemedicine group transmitted data from vital sign devices and other kinds of devices to monitor things such as weight, glucose and blood pressure to clinicians.

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