HIE PROGRESS – OR LACK THEREOF? … A survey presented at a recent HIT Policy Committee meeting suggests an increase in the number of hospitals that are electronically exchanging information with outside providers. However, the details also reveal there is still a lot of work that needs to be done. For example, almost 25% of hospitals in 2014 said they had not electronically exchanged either lab results, radiology reports, clinical summaries, or med lists with any physician practice or hospital outside their organization. The top technical HIE challenge cited by hospitals was that exchange partners do not have an EHR (mentioned by 59% of respondents), followed closely by concerns that exchange partners have an EHR that can’t receive data (58%). The most common operational barriers to HIE mentioned by hospitals were the “cumbersome workflows” associated with sending information from the EHR (cited by 30% of respondents) and the fact that “many recipients report the summary of care record” that hospitals send is “not useful” (26%).
Impact Advisors’ Thoughts: The chart summarizing the increase in HIE activity (see slide 4 of the presentation) received a considerable amount of media attention this week. However, while interesting, we think it only tells part of the story. Another essential aspect to measuring progress with HIE (especially in today’s market) is how often hospitals electronically exchange information with outside providers.
MANY PROVIDERS SIGN UP FOR VOLUNTARY BUNDLED PAYMENT PROGRAM; MANY MORE OPT OUT… Modern Healthcare reports that participation in Medicare’s voluntary bundled payment program has increased considerably, with more than 2,100 provider organizations entering into contracts of July 1, 2015. However, almost 7,000 providers initially signed up to “formally review” what it would take for their organization to participate in the voluntary program. In other words, roughly two-thirds of those who were interested enough to evaluate the specifics ultimately opted out. As the article points out, the announcement about increased participation in the voluntary bundled payment program comes after CMS proposed a rule last month that would require roughly 800 hospitals in 75 markets to accept bundled payments for hip and knee replacements.
Impact Advisors’ Thoughts: The fact that so many provider organizations were initially interested in the idea of receiving bundled payments is encouraging. The fact that two-thirds ultimately dropped out after studying the specifics underscores just how complicated it can be to actually succeed with bundled payments in practice though. It is also important to note that these types of programs (bundled payment pilots, ACO-type initiatives, etc.) will not be “voluntary” indefinitely, as evidenced by the recently proposed rule mentioned above from CMS.