Impact Insights

Week in Review 9/18/15

THE MEANINGFUL USE STAGE 3 SAGA CONTINUES… Earlier this week, the chairman of the Senate HELP Committee (Sen. Lamar Alexander), called on CMS to hold off publishing the MU Stage 3 Final Rule until January 1, 2017.  According to Health Data Management, Sen. Alexander “hopes to persuade [CMS] to make the change administratively but will look at legislative options if necessary.”  For context, the proposed Stage 3 rule was originally released in March 2015, and CMS recently sent the final Stage 3 requirements (along with the long-awaited modifications to Stage 2 in 2015-17) to the Office of Management and Budget for review – which is usually the last step before publication.  Under the proposed rule, Stage 3 would be required for all providers beginning January 1, 2018.

Impact Advisors’ ThoughtsWe continue think the most likely scenario is that CMS sticks with its plan to publish the Stage 3 Final Rule “early this fall.”  Regardless of when the rule is officially released though, the fact that so many lawmakers are now expressing interest in getting involved means it is increasingly likely that Stage 3 will end up starting later than the proposed date of January 1, 2018.  (For an overview and analysis of the proposed Stage 3 requirements, see our recent white paper.)

DATA ISSUES REMAIN SIGNIFICANT BARRIERS FOR ACOs… A new survey from the eHealth Initiative finds the top challenge cited by ACOs is accessing data outside their organization (mentioned by 78% of the 69 ACOs surveyed).  The specific types of data most often analyzed are “claims data” (cited by 96% of responding ACOs) and “clinical data” (79%). “Disease registry data” was only mentioned by 39% of ACOs though.  The top reasons that ACOs cited for using analytics were to “identify gaps in care” (mentioned by 84%) and to “identify outliers in cost / utilization” (80%).

Impact Advisors’ ThoughtsThe results serve as a good reminder that exchange of actionable data between non-affiliated organizations remains a huge problem (especially for hospitals and physician practices participating in an ACO-like arrangement).  We think it is also worth noting that the authors found that traditional fee-for-service and “upside-only shared savings” ACO models are “still dominant.”  In other words, most ACOs are still not taking on financial risk for their performance.

USE OF TELEHEALTH BY PROVIDERS UP SLIGHTLY IN 2015… A new HIMSS Analytics survey finds that almost 58% of provider organizations currently use telehealth tools and services (up slightly from 54.5% in 2014).  The most common type of product currently in use is two-way video Web cameras, cited by roughly 70% of respondents who use telehealth.  FierceHealthIT reports that HIMSS Analytics also asked respondents about their organization’s adoption of four different telehealth models:

  • The “hub-and-spoke” model (i.e., audio and visual communication between an originating site and outside sites)
  • Concierge services (i.e., e-visits and online consults)
  • “Patient portals or application-focused patient engagement” (i.e. “services delivered via portal with mobile or desktop access”); and
  • Remote patient monitoring

According to HIMSS, the primary telehealth model in use by respondents was the “hub-and-spoke” approach.  Overall, just under one quarter (23%) said they use two of the four models, while only 3% said they use all four.

Impact Advisors’ Thoughts It will be particularly interesting to see how providers’ adoption and use of telehealth changes over the next few years as stakeholders like CVS Health and UnitedHealth aggressively roll out direct-to-consumer telehealth options.  Do health delivery organizations see these offerings as threats?  If so, will hospitals and health systems try and compete directly, or focus on alternative models and approaches?

IN CASE YOU MISSED IT… A new report from Gemalto finds the healthcare sector accounted for more than 20% of all data breaches worldwide in the first half of 2015.  More details available in this article from FierceHealthIT.