Wednesday, April 17, 2013

CMS has updated ICD-10 resources to reflect October 1, 2014 DEADLINE

Updated resources are now available to reflect the October 1, 2014, deadline. The CMS implementation guides, checklists, and timelines have been adapted and provide step-by-step guidance around the transitions.

Medicare Fee-For-Service National Provider Call – Last Chance to Register

Thursday, April 18; 1:30-3pm ET

On September 5, 2012, CMS published a final rule that delays the ICD-10 compliance date from October 1, 2013 to October 1, 2014. Are you ready to transition to ICD-10? Now is the time to prepare. Join us to learn how to prepare in 2013 for the transition. CMS Subject matter experts will review basic information on the transition to ICD-10 and discuss implementation planning and preparation strategies. A question and answer session will follow the presentations. Learn more about the call on the April 18 call web page.  

ICD-10 Conferences

  • ACP Internal Medicine Conference (April 9 – 11, 2013; San Francisco)
    • ICD-10 - Are You Ready? technology briefing; Thursday, April 11 at 10:45 am; in the exhibit hall
    • ICD-10 Implementation: A Practical Roadmap; Thursday, April 11 from 2:15 pm - 3:45 pm; Room PN 033
  • The AHIMA ICD-10-CM/PCS and Computer-Assisted Coding (CAC) Summit is April 22-24 in Baltimore
    • MDCMS representatives will be at table 29. We encourage you to stop by to hear about CMS tools and resources available to help with ICD-10.  

Health Plan’s Secret Sauce is Social Media

Health Plan’s Secret Sauce is Social Media

Health Plan's Secret Sauce is Social Media

Jacqueline Fellows, for HealthLeaders Media , April 17, 2013

Every industry, including healthcare, has been trying to figure out a way to get the most out of social media in general, and Facebook, specifically. The real winners are, of course, consumers because myriad online ads, coupon sites, and Facebook posts drive prices lower.
Hospitals and health systems trying to compete in this space can't win a price war, but they may win on patient engagement. Unfortunately, the results are soft, at best, as the strategy generally revolves around hoping someone comments on a Facebook post about a wellness goal, such as losing weight, managing stress, or quitting a tobacco habit.
Magellan Health Services, a specialty managed healthcare provider, seems to have hit upon an effective way to not only engage patients, but also change the behavior that is contributing to patients' health problems. And they're doing it with social media.
In 2012, Magellan launched a pilot project with a "large health plan in the Northeast" aimed at reducing the readmission rates of members who had been admitted to a hospital for substance abuse. In addition to a phone call after being discharged from the hospital, health plan members were invited to join a social media site that looks, feels, and functions like Facebook, but is tailored specifically for them.

"The people we're engaging on this [website] we probably never would've gotten on the telephone," says Laurie Gondek, senior vice president of product innovation at Magellan. "You have people who want to engage in many different ways. Some, with their providers… and then there are those who prefer to start out online."
Though the pilot project has ended, the site is still being used by Magellan and for the company's health plan customers who buy it under a private label to brand the site how they want. Gondek says she is seeing a lot of interest from Blue Cross Blue Shield plans and others who are interested in the site's potential for bridging care gaps and for chronic conditions.
"We've started to talk to ACO's and other entities that are looking for ways to have the medical practitioners have something in their toolbox that has some behavioral components to it for those individuals who do not want to see behavioral practitioners or specialists. We've got some ACO's we're working with in California and some in the southeast," she says.
The way it works is patients sign in with their usernames (it can be whatever the patients choose) and then check in with an emoticon to indicate how they're feeling. There are 28 different emotions a user can choose from, ranging from happy to in pain. The small icons are also color coded red, yellow, or green. The color is important and can serve as an SOS signal of sorts. For example, if a user checks in as being "in pain," which is red, then everyone in that user's support group—the Facebook equivalent of friends—is notified and they can jump to offer support. Friends can then comment, and also hit the equivalent of a "like" button, except the statements are empathic, ranging from, "I relate," to "I feel like that too" (sic).
Patients can also choose which groups pertain to them, such as depression or alcoholism, and they'll be connected with other patients in a social media forum that offers what traditional support groups do not—anonymity. There are also real meetings online as well as webinars with doctors or other medical experts, explains Gondek.
"What's interesting is as these individuals start out online, they are signing up for the online meetings and the talks with the expert, so we're achieving a kind of a mixed model with them being able to enter with their preference. When we say, 'We have a national expert talking about eating disorders today at noon, would you like to join?' They join, and then they ask them questions."
In the pilot project, which included 1,000 patients, Gondek says the effort generated a 20% engagement rate.
"If you look at a traditional coaching program where we are fortunate to get engagement of 2 to 3% using a telephonic model," says Gondek. "By reaching out to these individuals with a welcome home call and an invite to the program, we achieved 20%, which, that's pretty high—double what we thought it was going to be."
Gondek also says that once patients engage with the program they're more apt to take a phone call from a coach, if needed.
And while the hard data from readmission rates is still a few months off, Gondek is optimistic.
"I had a goal of reducing it [the readmission rate] from 2 to 5%, and it's a little too soon to tell, but some of our numbers are looking very promising. We're thinking we're going to save somewhere between $1,000–$2,000 per individual, which is pretty significant."
Gondek says Magellan is running with its early success in substance abuse readmission rates and including other conditions such as eating disorders, chronic pain and autism, among others.
"It's HIPAA-compliant; it's got experts [and] we're monitoring the site. I really think that we could find something here that could be super helpful that would keep costs down. We actually see this as having tremendous power in a number of ways."

Engaged Patients Cost Less

Engaged Patients Cost Less

Marianne Aiello, for HealthLeaders Media , April 17, 2013

It's safe to say that practically everyone reading this article would be an engaged patient. It would be hard not to, being in the industry that we are. While this is beneficial to us personally, I wonder if it skews our views of how many patients are truly engaged and what the value of that engagement actually is.
This question is something I've been thinking about a lot lately as I prepare for the second surgery to repair the damage I did to my left thumb in a gruesome vegetable-chopping incident. (If you're sick of me harping on about this since November, just think of how tired I am of dealing with it.)
During my pre-op phone screen for my coming out-patient surgery, the RN rattled off a list of preparations and rules I had to follow before arriving for my procedure; track down and wash with a particular antiseptic soap three days prior, don't eat anything after midnight the day before, take this medication the morning of but not that, acetaminophen is okay for pain but no ibuprofen or aspirin, etc. 
I dutifully wrote all of this down and, of course, am following it to the T. But what about the people who don't? I can think of several happy-go-lucky (that's putting it kindly) friends and relatives who would easily brush off most of these instructions, who wouldn't bother trekking to three different pharmacies before they found the correct antiseptic.
There are also the varying levels of health literacy to consider. I had to ask the RN on the phone to clarify a few things for me, including the scientific name of the antiseptic, which she had spat out as if it were a common item for the everyday person. Had I not felt empowered to ask, I would not have understood or followed that particular instruction.
Spacey, disinterested, and low-health literate patients are out there, in abundance. Some patients do the best they can and still fall short. Others simply 'go with the flow,' essentially relinquishing responsibility for their care to others.
Improving communication with these types of patients is something healthcare marketers should focus on. And it's more than just good medicine—it can improve costs.
A study in the February issue of Health Affairs looked at the role that patients play in determining health-related outcomes. Researchers found that patients who were more knowledgeable, skilled, and confident about managing their day-to-day health had healthcare costs that were 8% lower in the base year and 21% lower in the next year compared to patients who lacked this type of confidence and skill.
These savings held true even after adjusting for patient differences, such as demographic factors and the severity of illnesses.
Furthermore, engaged patients with the same chronic illness had lower healthcare costs than their less-engaged counterparts; less-engaged asthma patients had 21% higher costs than the most engaged patients. With high blood pressure, the cost differential was 14%.
"There is ample evidence that the behaviors people engage in and the health care choices they make have a very clear effect on both health and costs, positively and negatively," the study authors wrote.
"The most innovative healthcare delivery systems recognize this and see their patients as assets who can help them achieve the goals of better health at lower costs. From this point of view, 'investing' in patients and helping them to be more effective partners in care makes good sense."
Dave deBronkart, a.k.a. e-Patient Dave, also talks about the value of engaged patients in his most recent Forbes column, says "Let patients help." In the article, he describes how being an engaged and informed patient when diagnosed with stage-IV kidney cancer improved his outcome and possibly even saved his life.
The question for marketers, then, is how can we most effectively invest in patients in a way that fosters higher levels of engagement? The Health Affairs study authors offer two suggestions:
  1. Build into every step of the care process a meaningful role for patients and their families.
  2. Tailor and customize care in a way that helps patients acquire the knowledge and skills they need to effectively manage their health.
I've seen some organizations tackle these steps by creating easy-to-understand brochures and literature for patients to take with them after their hospitalization. Some take the next step of a follow-up call to make sure patients understand the instructions and are following them. And many hospitals, like the one where I'm receiving my care, check in with patients before their procedure.
While these are all likely effective, it seems to me that hospitals need to move away from fostering incident-based engagement and toward patient-based engagement. Patients should be engaged in their health and healthcare at all times, not just when they are having surgery or contract an illness.
It's up to marketers, working with physicians, administrators, and patients, to figure out what that balance is.