Federal Audits Of Medicare Advantage Reveal Widespread Overcharges

Government audits just released as the result of a lawsuit detail widespread billing errors in private Medicare Advantage health plans going back years, including overpayments of thousands of dollars a year for some patients.

Since 2004, private insurers that run Medicare Advantage plans, an increasingly popular alternative to traditional Medicare, have been paid using a risk scorecalculated for each patient who joins. Medicare expects to pay higher rates for sicker people and less for those in good health.

But the internal audits, never before made public, provide striking new evidence of billing mistakes — mostly overcharges — in the Medicare Advantage plans. Four of the audits were recently obtained by the Center for Public Integrity through a court orderin a Freedom of Information Act lawsuit.

The audits involve four health plans: an Aetna Health Inc. plan in New Jersey, Independence Blue Cross in the Philadelphia area; Lovelace Health Plan in Albuquerque, N.M, and a Care Plus plan in South Florida. Care Plus is a division of Humana, Inc.

Last month, the Center for Public Integrity reported on a fifth such audit at PacifiCare in Washington state, an arm of giant UnitedHealth Group, the nation's largest Medicare Advantage operator.

In all five audits, two sets of auditors inspected medical records for a sample of 201 patients at each plan for 2007. If the medical chart didn't document that a patient had the illnesses the plan reported, Medicare asked for a refund. Auditors also gave plans credit for underpayments they discovered.

Among the findings:

• Medicare paid the wrong amount for 654 of the 1,005 patients in the sample, an error rate of nearly two-thirds. The payments were too high for 579 patients and too low for 75 of them. The total payment error topped $3.3 million in the sample.
• Auditors concluded that risk scores were too high for more than 800 of the 1,005 patients, which in many cases, but not all, led to hefty overpayments. Medicare's annual payment for more than 200 patients was at least $5,000 higher than merited, according to the audits.
• Auditors could not confirm one-third of the 3,950 medical conditions the health plans reported, mostly because records lacked "sufficient documentation of a diagnosis." The names of the medical conditions were redacted by federal officials.

The federal Centers for Medicare and Medicaid Services, or CMS, which conducted the audits, had no comment.

None of the health plans would discuss the audit findings. Aetna, in a statement, said the company had "raised a number of questions and concerns" regarding the results and was "awaiting a response from CMS."

Clare Krusing, a spokeswoman for America's Health Insurance Plans, the insurance industry's primary trade group, said the audits "overstated" the payment errors. Health plans have since improved their record keeping and offer better care for people with chronic health conditions than traditional Medicare, Krusing said.

"The evidence is overwhelmingly clear that these programs (Medicare Advantage) deliver the right care for beneficiaries," she said.

The records are coming to light at a time of rapid expansion — and consolidation — in the Medicare Advantage market. Enrollment has neared 17 million, about 1 in 3 people eligible for Medicare. Last week, Aetna announced plans to buy competitor Humana for $37 billion.

But the industry also is drawing scrutiny over the accuracy of risk-based payments—and a penchant for secrecy.

The Center for Public Integrity first reported last year that billions of tax dollars are wasted every year due to plans that appear to exaggerate how sick their patients are, a practice known as "upcoding."

The government audits, known as Risk Adjustment Data Validation, or RADV, are the government's primary tool for catching these sorts of billing mistakes and holding the industry accountable.

Yet the process has proven unwieldly at best, partly due to a complex and lengthy appeals process and partly to indecision over how much the health plans should refund to the government.

It's not clear how the five audits were settled because CMS officials have refused to release these records.

The five RADV audits were launched in 2008, but findings weren't issued until August 2012, when CMS officials sent each plan a form letter detailing the amount of the overpayment and the plan's extensive appeal rights. CMS has refused to make public the status of the audits—or even how many total RADV audits have been conducted. CMS cites an exemption to the Freedom of Information Act that shields "trade secrets."

This stance has largely concealed Medicare Advantage billing records. It wasn't until April 15, 2011, that CMS announced it would release minimal billing data annually. Doing so would "inform the public on how their tax dollars are being spent," the agency said at the time, citing President Obama's January 2009 Memo on Transparency and Open Government.

But much to the chagrin of some researchers, CMS has never expanded on what is released, even though it has made public a huge cache of billing data and audits centering on thousands of doctors, hospitals and other medical suppliers.

"It's astonishing," said Brian Biles, a professor at George Washington University who successfully sued CMS to win release of the limited billing data now available. "They are dumping huge amounts of data in other areas. Medicare Advantage is now 30 percent of the Medicare program." (Biles assisted the Center for Public Integrity with its 2014 analysis of that data.

Timothy Layton, a Harvard Medical School researcher who recently co-authored a paper on health plan upcoding, said scholars "are definitely hindered" by the lack of data. For instance, researchers can't examine individual risk scores and the various medical conditions that raise and lower them, he said.

"Without the ability to answer these questions, we can keep pointing out how big the overpayment to MA (Medicare Advantage) is, but we can never really provide the optimal solution to the problem," Layton said.

David Himmelstein, a physician and professor in the CUNY School of Public Health at Hunter College who supports a single payer medical system, agreed.

"Medicare publishes detailed data on almost every doctor and hospital that gets paid a penny, but it leaves the public — and researchers — almost completely in the dark about the giant Medicare Advantage plans that will collect more than $150 billion from Medicare this year," he said.

Still, Medicare Advantage insurers are facing calls for closer scrutiny of their operations. In May, Senate Judiciary Committee Chairman Charles Grassley, R- Iowa,wrote to Attorney General Loretta Lynch and CMS administrator Andrew Slavitt asking how many risk score fraud investigations had been conducted over the past five years and their results. He's still waiting for an answer.

"Sen. Grassley continues to expect responses to his letters and will continue to press for responses," said Grassley spokeswoman Jill Gerber. "This is an important issue involving a large amount of taxpayer money"

In a separate letter, Sen. Clare McCaskill, the senior Democrat on the Senate Aging Committee, asked CMS officials to advise her of government efforts to curb Medicare Advantage billing abuses.

"After meeting with CMS we have continued concerns about the level of oversight taking place with respect to Medicare Advantage plans and will continue working to increase oversight and accountability in this area," said McCaskill spokesman Drew Pusateri.

This piece comes from the Center for Public Integrity, a nonpartisan, nonprofit investigative news organization.

http://www.npr.org/sections/health-shots/2015/07/10/421529105/federal-audits-of-medicare-advantage-reveal-widespread-overcharges

CMS: No ICD-10 Audit Claims for Specificity in Year One

For one year after implementation of ICD-10, CMS will not deny or audit claims just for specificity, as long as the code is from the appropriate family of ICD-10 codes. Similarly, physicians will not be penalized for the value-based payment modifier or Meaningful Use due to specificity of diagnoses.

After a vigorous, last-ditch push by the AMA for a two-year transition period after implementation to protect physicians from all ICD-CM coding errors and mistakes, CMS and AMA made a joint announcement that appears to signal a burying of the hatchet.

Steven Stack, MD, AMA's president, touts the changes in a post that begins with a concession his group has resisted stating for years: "Implementation of the ICD-10 code set is just around the corner, with a hard deadline of Oct. 1."

To gain that admission from the AMA, CMS agreed to a variety of policies involving claim denials, quality reporting, payment disruptions, and navigating the transition.

For one year after implementation, CMS will not deny or audit claims just for specificity, as long as the code is from the appropriate family of ICD-10 codes.  Even though the use of unspecified codes is allowed according to the ICD-10-CM Official Guidelines for Coding and Reporting, this clarification makes a lot more sense than absolving physicians of all coding errors and mistakes.

Similarly, CMS will not penalize physicians for the Physician Quality Reporting System, the value-based payment modifier, or meaningful use to due specificity of diagnoses as long as the provider reports a code from the appropriate family.

CMS has also authorized advance payments to physicians if Medicare contractors can't process claims due to problems related to ICD-10.

CMS will continue to offer resources to aid practices with a new ICD-10 communications and coordination center headed by an ombudsman to resolve outstanding questions about implementation.

For more information, see CMS' guidance on the changes.

The biggest benefit to the healthcare community is that the announcement has finally removed the biggest barrier to implementation: uncertainty. You can now talk to physicians confidently about the ICD-10 deadline and work with them throughout the yearlong transition to improve their documentation for you to choose the most appropriate, and specific, code.

You can forget about delays, waiting for ICD-11, and any other excuses you've heard about pushing off training for the transition. With the AMA and CMS working together, ICD-10 is certainly coming in just 86 days.

Steven Andrews is editor of Briefings on APCs and outpatient editor of JustCoding.com.

http://www.healthleadersmedia.com/content/TEC-318237/CMS-No-ICD10-Audit-Claims-for-Specificity-in-Year-One.html

CMS proposes a few clarifications to its chronic care management billing code

At the beginning of 2015, CMS began reimbursing physicians for the care they provide to a particular group of their Medicare patients remotely and between visits. This new billing code, called Chronic Care Management (CCM), required that this remote care meet a few criteria, like patients must have two or more chronic conditions; the physician must establish a comprehensive care plan for the patient; and the remote care must take up at least 20 minutes of staff time over the course of the month.

This week CMS issued a proposed rule that seeks to clarify the use of the CCM billing code based on the many inquiries the agency has received since the code first came out.

“In reviewing the questions from hospitals on billing of CCM services, we identified several issues that we believe need to be clarified. Therefore, for CY 2016 and subsequent years, we are proposing additional requirements for hospitals to bill and receive OPPS payment for CPT code 99490. These proposed requirements, discussed below, are in addition to those already required…” CMS writes. 

CMS proposes that starting next year CCM can only be billed to if patient has an already established relationship with the provider using the code. “While we have always expected the hospital furnishing the clinical staff portion of CCM services, as described by CPT code 99490, to have an established relationship with the patient and to provide care and treatment to the patient during the course of illness… we have not previously specified through notice-and-comment rule making that the hospital must have an established relationship with the patient as a requirement for billing.” This prior relationship requirement would be an “explicit condition” on billing to the code, if the proposal is adopted.

CMS also wanted to clarify that while it was previously stated that only one physician can bill for the code for a given patient, the same goes for one hospital for a given patient. “The physician or other appropriate non-physician practitioner directing the CCM services should inform the beneficiary that only one hospital can furnish and be paid for these services during the calendar month service period.”

For more on CMS’ proposed changes and clarifications to CCM and other billing codes, check out the full proposal here (PDF).

http://mobihealthnews.com/44983/cms-proposes-a-few-clarifications-to-its-chronic-care-management-billing-code/

Do your Patients Have the Knowledge to Make Good Food Choices?

Carbohydrates are your body's primary energy source! They should never be avoided, but it is important to understand that not all carbs are created equal!

Good Carb Bad Carb Trivia

Carbohydrates are an important part of a healthy diet, but there's much discussion about the good and bad carbs. So how do you know which is which? The answer is both simple and complex!

Click the picture above to launch the game!

Visit www.mhealthgames.com for more games.

CMS Issues New Telemedicine Guidelines and Approves Seven New Procedures in Move to Further Encourage Telehealth Initiatives

As the Medicare program expands telemedicine services, the opportunity may arise for sub-specialist pathologists to offer consultation services across state lines

More use of telemedicine across state borders has long been predicted as a way to improve access to care—particularly for patients in rural areas—as well as to give physicians and patients access to talented sub-specialists. Within the anatomic pathology profession, however, there are probably as many pathologists who view telemedicine across states lines to be a threat as there are pathologists who see it as an opportunity to raise the quality of care.

For its part, the Centers for Medicaid and Medicare Services (CMS) is taking a step forward in supporting the wider use of telemedicine. It is issuing new rules that expand reimbursement for remote patient services, a move that one day could benefit pathologists who provide sub-specialty pathology consultations with referring physicians across state lines.

CMS Added Seven Procedures to Its New Telehealth List

When final payment rules governing how Medicare will pay healthcare providers and suppliers in 2015 were released last October, CMS added seven procedures to the telehealth list of covered services, including annual wellness visits, psychotherapy services, and prolonged services in the office.

The American Telemedicine Association (ATA), which has long advocated for widespread use of telemedicine, praised the CMS for opening the door to greater access to telemedicine.

“It’s been a long time coming, but this ruling making signals a clear and bold step in the right direction for Medicare,” Jonathan Linkous, CEO of ATA, said in a statement. “This allows providers to use telemedicine technology to improve the cost and quality of healthcare delivery.”

What This Means for Pathologists

As the use of telemedicine becomes more common, states will be pressured to revise physician licensure laws to make it easier for out-of-state physicians to provide telemedicine services to in-state patients. For the medical laboratory profession, this might eventually make it possible for pathologists to one day be able to remotely monitor chronic patients using patient self-test devices that upload lab test results in real-time to their clinical laboratories.

For now, remote patient monitoring will continue to be available only to some Medicare patients. As Politico points out, CMS stopped short of dropping the provision requiring patients to be in a rural location to receive billable telemedicine services.

“We do not have authority to implement many of these revisions under the current statute,” Politico quoted CMS as stating. “The CMS Innovation Center is responsible for developing and testing new payment and service delivery models to lower costs and improve quality for Medicare, Medicaid, and CHIP beneficiaries. As part of that authority, the CMS Innovation Center can consider potential new payment and service delivery models to test changes to Medicare’s telehealth payment policies.”

In all, Medicare payments to telehealth are 0.8% higher in 2015.

Chronic-care Management Receives New Code: Causes Confusion

The CMS also added a new Current Procedural Terminology (CPT) code for chronic care management services. However, this change may not be as significant as first thought, because, as the ATA explained in a statement, “CMS has once again not allowed payment for data collection.”

In an iMedicalApps.com article, Perry Payne, M.D., J.D., M.P.P., Assistant Research Professor in the Department of Health Policy at the George Washington University School of Public Health and Health Services (GW), and an adjunct at Howard Law, addressed the initial confusion over the Medicare rule allowing for payment for chronic-care management.

“Some media outlets and organizations that support telemedicine are reporting that CMS is paying for remote monitoring of chronic care management patients because of a new rule that offers providers reimbursement for non-visit based services for chronic care management patients,” Payne wrote. “However, this change is not focused on telehealth or digital health services as it can include many other activities.”

Health Plans Support Telemedicine

Greater CMS reimbursement for telemedicine likely will be the impetus needed for more private payers to jump on the telemedicine bandwagon. For now, Aetna, Highmark, and Cigna are among the private insurers reimbursing for telemedicine and telehealth services, Healthcare IT News reported.

Highmark has been an early adopter of telemedicine. The private payer first offered primary care visits through Teladoc to beneficiaries in 2012. In January 2015, Highmark became the first health insurer in the country to offer teledermatology as a covered benefit.

“We need to make sure our members get the right care in the right setting, and telemedicine is a key tool to help make that setting more patient-centered,” said Donald R. Fischer, M.D., MBA, Highmark Senior Vice President and Chief Medical Officer, in a company statement. “Telemedicine is a resource that is critical to transforming the delivery of healthcare. It ensures faster access to high-quality healthcare while also helping to control costs.”

Texas Erects Barriers to Telemedicine

Telemedicine, however, still remains controversial. In April, the Texas Medical Board voted to rein in the practice of telemedicine in Texas by requiring physicians to conduct in-person visits with patients before providing diagnoses or prescribing drugs by phone or video, the Houston Chronicle reported. The only exception would be if a patient is at a healthcare facility such as a hospital, clinic, or pharmacy, and has another healthcare professional with them. Mental health visits are excluded from the rules.

“What the board is trying to do is really to keep patients safe,” Douglas W. Curran, M.D., a family physician and Vice Chair of the Texas Medical Association Board of Trustees, told the Houston Chronicle. “They want patients to be seen and evaluated so that patients can get the very best car possible. And I happen to agree with that.”

Opportunities for Pathologists

What pathologist will want to note is that CMS is taking another forward step in supporting the expanded use of telemedicine. That will put pressure on states to revise their physician licensure laws to make it easier for out-of-state physicians to provide telemedicine services to in-state patients. As that happens, this trend may open the door for more pathologists to provide sub-specialty pathology consultations with referring physicians across state lines and do patient consults as well (that are reimbursable to the consulting pathologists).

Read more: CMS Issues New Telemedicine Guidelines and Approves Seven New Procedures in Move to Further Encourage Telehealth Initiatives | Dark Daily http://www.darkdaily.com/cms-issues-new-telemedicine-guidelines-and-approves-seven-new-procedures-in-move-to-further-encourage-telehealth-initiatives-608#ixzz3ceYthMR9

Healthcare Fraud Investigations to Target Corporations and C-Suite Executives

On Thursday, May 14, 2015, at a meeting of the American Bar Association’s Healthcare Fraud Section, Leslie Caldwell, the Assistant Attorney General for the Department of Justice (DOJ) Criminal Division, declared stamping out healthcare “fraud and holding those who commit this fraud accountable are core missions of the Criminal Division and the Justice Department.” In addition to the ongoing operations of her team of more than 40 specialized healthcare prosecutors at the DOJ, Medicare Fraud Strike Force, and local United States Attorneys’ Offices, AAG Caldwell also described a renewed and intensified focus on executives and corporations:

The Strike Force will follow evidence of healthcare fraud wherever it leads, including into corporate boardrooms and executive suites. The Criminal Division has a long record of holding executives responsible for their criminal wrongdoing in cases involving financial fraud. You should expect to see us building on that record in the field of healthcare fraud.

No stranger to corporate prosecutions, as the former director of the Enron Task Force, AAG Caldwell cited the immense resources at her disposal for combating healthcare fraud across the country. Pointing to more than a dozen active corporate healthcare fraud investigations currently under way at DOJ, she made clear that the bar should expect to see more action in this area. AAG Caldwell has reason to be optimistic about the overall success of her renewed healthcare focus, as the Strike Force has made an imposing start:

In the last fiscal year alone, the Strike Force charged 353 defendants. Of those 353 defendants charged, 304 pleaded guilty and 41 were convicted at trial. The Strike Force has an overall conviction rate of 95 percent—a spectacular rate of success considering the volume and the complexity of the prosecutions—and secures prison sentences averaging more than 50 months.

AAG Caldwell further stressed the importance of cooperation for companies that have discovered healthcare fraud, noting “put simply, companies seeking credit for cooperation must conduct a thorough internal investigation and turn over all available evidence of wrongdoing to our prosecutors in a timely and complete way.” The hallmarks of cooperation, she emphasized, were candor and completeness. According to AAG Caldwell, DOJ will expand its geographic scrutiny of potential fraud hot spots to include New York, Dallas, Houston, Detroit, Chicago, and Los Angeles, meaning more companies are going to be under increased scrutiny than ever before.

With AAG Caldwell’s remarks in mind, it is incumbent on all healthcare companies and executives to implement and enforce rigorous compliance policies and programs. In many ways the vanguard of fraud prosecutions, AAG Caldwell also stressed the importance of cybersecurity measures to prevent the fraudulent acquisition or use of patient data. This latter aspect is likely to permeate all fraud prosecutions in the future, as companies face increased pressure to protect client and customer data, but it is nowhere more scrutinized at this time than in the healthcare sector.

Read more:

http://www.bakerlaw.com/alerts/justice-to-target-corporations-and-c-suite-executives-in-the-healthcare-industry?utm_source=Mondaq&utm_medium=syndication&utm_campaign=View-Original

Educating Patients on Warfarin, One Game at a Time

​Patients receiving warfarin will often need to continue taking it after discharge from the hospital, and some may require warfarin therapy for a long time. It is important that patients receive education about the drug while they are in the hospital so they can manage their therapy properly at home. Patients who are knowledgeable about their medication therapy can help to reduce the risk of adverse drug events. Education should begin with the patient’s first dose of warfarin, and all patient education needs regular reinforcement.

Tips

·        Educate patients as well as their family members or other people who live with the patients or assist with their care.

·        Use patient-directed dosing as a way to ensure that patients understand what they are taught about managing their warfarin therapy.

·        Continue education on an outpatient basis through a clinic or dosing service.

·        Use innovative tools, such as games and apps, to reach your patients post discharge.

o   Cardiac Island, from mHealth Games reinforces important objectives for patients taking Coumadin. Click the picture below to play.

Cardiac Island

Join Captain Jack on a race for treasure around Cardiac Island! Test your knowledge of Coumadin (Warfarin) and unlock treasures of health and wellness.

Exchange enrollees study by Truven Health Analytics reveals surprises

It’s only one study based on the health data of one unnamed state. But if the results of the Truven Health Analytics study are at all typical of the general U.S. population, then insurers offering coverage through health care reform exchanges should be braced for some very high utilization numbers by an unexpectedly older consumer population.

Truven said it used the data provided by “a large health plan to investigate demographics, risk, financial factors, and utilization patterns in the exchange population of its state.” The results of the analysis suggest that some of the basic predictions about those who would purchase coverage through an exchange might have been way off. Truven did not identify either the state or the health plan.

Report findings include:

• Exchange Attracted Older Enrollees: The average enrollee age in the state that was chosen for the study was 46 for the exchange population and 44 for those off the exchanges. Only one plan – the catastrophic level – had an average age under 44 (31 years).
• More Admissions, ER Visits: Exchange enrollees had a whopping 39 percent more admissions and 64 percent more emergency department visits per 1,000 enrollees than non-exchange insureds. Medical and prescription drug utilization increased as the plan design level increased.
• Higher Rate of Chronic Conditions: Exchange enrollees had 44 percent more instances of congestive heart failure and 39 percent more diabetes cases in exchange members. Additionally, exchange enrollees experienced more seizure disorders and convulsions (26 percent), asthma (21 percent), and major depressive disorder (8 percent) versus non-exchange counterparts.
• Silver Plans Dominate Exchanges: Silver plans (including both standard silver and cost-sharing reduction plans) are the preferred plan of choice for exchange enrollees, with an 82 percent market share. Bronze enrollees accounted for just 6 percent, while platinum had 4 percent of the market.
“Now, more than ever, health plan leaders need to understand details about their unique populations to create appropriate product strategies and plan designs for the future,” said Barbara Graovac, senior vice president at Truven Health Analytics. “With this snapshot of one state’s exchange population, it becomes clear how profound the differences between an exchange and off-exchange health plan population can be, and, how different reality is from initial predictions.”

http://www.benefitspro.com/2015/05/19/exchange-enrollees-study-by-truven-health-analytic

A New Mobile Tool to Assess the Need for Independent Life Skills Training

Did You Know?

Over half a million people are homeless. On any given night, there are over 600,000 homeless people in the U.S., according to the US Department of Housing and Urban Development (HUD). Most people are spending the night either in homeless shelters or in some sort of short-term transitional housing. Slightly more than a third are living in cars or under bridges or are in some other way living unsheltered.

What Can We Do?

Today, we not only know that housing ends homelessness, we also know that not everyone will need the same assistance. Some individuals will need permanent supportive housing, but others can make the transition with far less assistance. Accurate identification of those who need a higher level of services is a constant battle for mental health professionals working on the front lines.

A Call to Action

In a recent meeting with a non-profit organization who provides services to those in crisis, we were presented with this problem: How do we move beyond the traditional check boxes when evaluating an individual’s readiness for independent living? How can my outreach team effectively evaluate life skills in the field?   

Life skills are the skills that many people take for granted, like managing money, shopping, cooking, running a home and maintaining social networks. They are essential for living independently.

The Solution

Skills for a Better Life gives organizations a standard mobile tool to assess the need for life skills training.

Click on the picture below to launch:

Do you need help with a specific problem? Contact mHealth Games today for a high value, low cost solution. 

Improving Health Literacy Among Cancer Caregivers

ASCO recently published their paper on  State of Cancer Care in America 2014. In this paper, authors outline concerns and possible courses of action. The report addresses cancer costs, increasing treatment options, growing number of cancer survivors, disparities of care and the challenges of meeting these needs and concerns.

ASCO predicts that by 2030, new cancer cases in the US will rise by 45%. By 2022, there will be almost 18 million cancer survivors, about a 35% increase from today. But ASCO is also predicting a national shortage of oncology specialists by 2025. New treatment options will increase the number of cancer survivors, which is a good thing, but the shortage of specialists will result in a strain on the existing providers and a possible decrease in quality or continuum of care for some patients. Disparities of care for certain ethnic groups coupled with rising costs of medications and treatment could further result in problems with quality or access to care. Besides shortage of oncologists and disparities of care, uneven geographic distribution of physicians leave those in rural areas wanting. ASCO cites an analysis of demographics showing that nearly 90% of oncologists practice in urban areas and that more than 70% of US counties analyzed had no medical oncologist at all.

As a direct result of the above challenges, cancer patients (and their families and caregivers) will have to take a more active role in managing their health.

What tool is your organization using to educate caregivers?

How are you measuring success with specific outcomes?

Are you looking for new and improved ways to educate caregivers?

If so, mHealth Games can help!

Click the image below to launch:

Care-G Command Center

Mission Critical Care: If someone you love has been diagnosed with cancer, you've just become a very important part of their care team. Are you ready for basic training?

82% of Patients Report Unsatisfactory Education from their Primary Care Physician

What is the health literacy of patients with chronic kidney disease?

Generally, 9 out 10 adults lack the skills necessary to prevent disease or manage their health, but what about those with a chronic disease? A recent study published in the Australian Internal Medicine Journal aimed to determine patients’ understanding of chronic kidney disease when first presenting to a kidney specialist.

Two hundred and ten newly referred patients to a nephrology clinic were surveyed with open-ended questions about their understanding of CKD causes, symptoms and management. The average age of participants was 66.5 and 50.5% were female. 82% were referred by their primary care provider and 29% had previously seen a nephrologist. The results were:

• 16% of patients were unsure why they were referred
•  40% were unsure about what causes CKD
•  51% were unsure of how to manage CKD
• 82% reported unsatisfactory education from their primary care physician.

If you are struggling with ways to engage and educate your patients – mHealth Games wants to help!

Consider Fight Back, a short game to educate patients and caregivers on the basics chronic kidney disease.

Click on the picture below to play:

Fight Back

Chronic kidney disease does not have to prevent you from being a superhero! This quick training covers the basics of kidney disease and what you can do to fight back. Are you ready to join TEAM KIDNEY?

NHS England launches library for accredited mobile health apps

 

By: Jonah Comstock | Mar 24, 2015 

The National Health Service in the UK is taking steps to create a curated database of government-approved mobile health apps, starting in the area of mental health. NHS England launched a library of five approved apps on its NHS Choices website, which gets 40 million visits per month, according to the NHS.

As a large public health system, NHS struggles with waiting lists for health services including mental health. So they’ve aggressively looked to mobile health as a way to connect people to health services more efficiently. NHS began publicly evaluating mental health apps in February 2013, when they published a discussion paper on the subjecthttp://mobihealthnews.com/20154/uk-government-weighs-digital-tools-for-mental-health/.

“We want to offer people the chance to use apps and digital tools routinely to help them take control of their own healthcare,” Tim Kelsey, the National Director for Patients and Information, said in a statement. “There are online services already working for patients and we hope, by giving them our official backing, we will give clinicians, citizens and carers the confidence to use them. Digital platforms have a key role to play in improving access to psychological therapies and helping us meet our ambition of achieving parity of esteem for mental health services.”

Right now, the site has five vetted online resources: Beating the Blues, a CBT-based computer self-help course for anxiety and depression; Big White Wall, an anonymous, curated social network for people dealing with depression; FearFighter, a CBT-based self-help course for phobias; Ieso Digital Health, which offers live CBT therapy via secure instant messaging; and SilverCloud, an online platform that offers programs for different mental health conditions. The site offers descriptions of each program, instructions for accessing them, and a link to the clinical evidence that the program works.

The plan is to add additional mental health apps over time, as well as to eventually expand into other mobile health areas. NHS chose mental health to start because of a large base of evidence that these interventions are effective, they said in a press release.

“We’ve made great strides in the past few months by investing millions in talking therapies and eating disorder services. There is £1.25 billion in this year’s budget for children’s mental health, increased investment to help support veterans and new initiatives to help people on benefits get back into work,” Deputy Prime Minister Nick Clegg said in a statement. “But I know there is much left to do, which is why innovative pilots like this are so important, helping to provide treatment and support for those experiencing mental health crises. This showcases the NHS at its best — pioneering new ways of treating and supporting some of the most vulnerable in our society, harnessing innovative technology to help build a fairer society for us all.”

Source URL: http://mobihealthnews.com/41727/englands-nhs-launches-library-for-accredited-mobile-health-apps/