Sunday, July 7, 2013

More than Half of Doctors Now Use Electronic Health Records Thanks to Administration Policies

From / The Obama Administration has made improving the quality and efficiency of the health care system a priority. Already we have put in place new payment and care models that reward doctors and hospitals for providing high quality and efficient care to their patients. We are working with hospitals to identify gaps in patient safety and ways to reduce preventable readmissions that are harmful and expensive. Health information technology (IT) is critical to making these new models work.

Until the President made investments in health information technology by signing the American Recovery and Reinvestment Act, our health care system ran largely on paper. In 2008, only 17 percent of physicians were using advanced electronic health records and just 9 percent of hospitals had adopted electronic health records. Information is the lifeblood of modern medicine, but information can’t get where it needs to go when it’s on paper. That means doctors didn’t have the best information at their fingertips when making diagnosis and treatment decisions; that patients didn’t have easy access to their medical records; and that information is dropped when patients leaving a hospital transition to a nursing home or home care.
That’s why the President put in place a series of policies to promote adoption of electronic health records as well as their deployment in ways that improve care quality while reducing costs.  This includes:
  • Medicare and Medicaid incentives for the adoption and use of electronic health records;
  • Technical assistance and direct support for primary care practices and rural practitioners to help them overcome barriers to adoption;
  • Creation of certification standards that give providers confidence in what they’re buying and to ensure Medicare and Medicaid dollars are well-spent.
Equally important, the Affordable Care Act has created an environment where providers feel they need to invest in health IT to improve the value of the services that they provide.  
This week, HHS announced that we have reached new milestones in wiring the health care system. More than half of eligible providers – doctors, dentists and other eligible providers – have qualified for and received incentive payments for adoption of certified electronic health records, exceeding the Department’s target for the end of 2013. Moreover, nearly 80 percent of eligible hospitals have reached this milestone.
The increase has been rapid; adoption of electronic health records doubled among office based physicians from 2008 to 2012 and quadrupled in hospitals. Incredible progress has been made, thanks to the hard work of our health care providers and public policies that support their efforts, like the Recovery Act and the Affordable Care Act.
READ MORE - More than Half of Doctors Now Use Electronic Health Records Thanks to Administration Policies

A Data-Powered Revolution in Health Care

From / Thomas Friedman’s New York Times column, Obamacare’s Other Surprise, highlights a rising tide of innovation that has been unleashed by the Affordable Care Act and the Administration’s health IT and data initiatives. Supported by digital data, new data-driven tools, and payment policies that reward improving the quality and value of care, doctors, hospitals, patients, and entrepreneurs across the nation are demonstrating that smarter, better, more accessible, and more proactive care is the best way to improve quality and control health care costs. 

We are witnessing the emergence of a data-powered revolution in health care. Catalyzed by the Recovery Act, adoption of electronic health records is increasing dramatically. More than half of all doctors and other eligible providers and nearly 80 percent of hospitals are using electronic health records to improve care, an increase of more than 200 percent since 2008. In addition, the Administration’s Health Data Initiative is making a growing supply of key government data on everything from hospital charges and quality to regional health care system performance statistics freely available in computer-readable, downloadable form, as fuel for innovation, entrepreneurship, and discovery.

As Friedman describes, these trends, combined with efforts under the Affordable Care Act to change how we pay health care providers to better reward improving the quality and value of care, are creating a “new marketplace and platform for innovation.” Entrepreneurs and innovators across the country are developing and deploying new data-powered IT tools to help clinicians succeed at delivering better care at lower cost.

These tools are giving clinicians the ability to measure how they are doing, compare how they are doing relative to others, and set and meet goals. They are enabling clinicians to analyze their patient population, understand who needs help (including and especially patients who haven’t been able to come into their office), and proactively reach out and give those patients the care they need. They are helping clinicians and patients get the latest and greatest evidence-based, life-saving best practices at their fingertips. And much more.

Many of the entrepreneurs and innovators who are driving this revolution will be joining us and leaders from across the health care system next week at the fourth annual Health Datapalooza, a national celebration of data-powered innovation in health care.

We are beginning to see what happens when you unleash the power of American innovators and data to transform health care for the better from the ground up.  It’s no surprise to the doctors, hospitals, patients and entrepreneurs who have been working so hard to improve health care. But it is, indeed, great news for the nation.
READ MORE - A Data-Powered Revolution in Health Care

Good News on Innovation and Health Care

WhiteHouse Gov / A recent New York Times column, Obamacare’s Other Surprise, by Thomas L. Friedman echoes what we’ve been hearing from health care providers and innovators: Data that support medical decision-making and collaboration, dovetailing with new tools in the Affordable Care Act, are spurring the innovation necessary to deliver improved health care for more people at affordable prices.

Today, we are focused on driving a smarter health care system focused on the quality – not quantity – of care. The health care law includes many tools to increase transparency, avoid costly mistakes and hospital readmissions, keep patients healthy, and encourage new payment and care delivery models, like Accountable Care Organizations. Health information technology is a critical underpinning to this larger strategy.  

Policies like these are already driving improvements. Prior to the law, nearly one in five Medicare patients discharged from a hospital was readmitted within 30 days, at a cost of over $26 billion every year. After implementing policies to incentivize better care coordination after a hospital discharge, the 30-day, all-cause readmission rate is estimated to have dropped during 2012 to a low of 18 percent in October, after averaging 19 percent for the previous five years. This downward trend translates to about 70,000 fewer admissions in 2012.

Insurance companies are also now required to publicly justify their actions if they want to raise rates by 10% or more. Since the passage of the Affordable Care Act, the proportion of requests for double-digit rate increases fell from 75 percent in 2010 to 14 percent so far in 2013.

Reforms like these have helped slow Medicare and Medicaid spending per beneficiary to historically low rates of growth.

Mobilizing Use of Health Information Technology

Last week, we reached an important milestone in the adoption of health information technology. More than half of all doctors and other eligible providers and nearly 80 percent of hospitals are using electronic health records (EHRs) to improve care, an increase of at least 200 percent since 2008.

Friedman wrote of Dr. Jennifer Brull, a small-town Kansas family doctor, as an example of how health IT is making a difference in real patients. One of our “physician champions,” Dr. Brull installed alerts in her EHRs to improve the rate of colon cancer screenings for her patients. She found colon cancer early in three patients as a result – so early that they did not need chemotherapy or radiation.

Friedman also cited several companies, like Lumeris of St. Louis, that are using health IT and “mountains” of  HHS data now in electronic form to improve health outcomes. Mike Long, the CEO of Lumeris, says his company is analyzing hospital, insurance and HHS data and getting the information to physicians in real time. “ [W]e wind up delivering better care. …And it’s lower cost,” Long said.

Government Data as Fuel for Innovation

Since the early days of the Administration, we have provided the public with high quality health data. Making our data more accurate, available and secure brings transparency to a traditionally opaque health care market and allows innovators and entrepreneurs to use it for discovering innovative applications, products, and services to benefit the public.

Earlier this month, the Administration released unprecedented data about what hospitals across the country charge for the 100 most common Medicare inpatient stays, which can vary widely. For example, average inpatient charges for hospital services in connection with a joint replacement range from $5,300 at a hospital in Ada, Okla., to $223,000 at a hospital in Monterey Park, Calif.

In May, we announced a $1 billion challenge to help jump start innovative projects that test creative ways to deliver high quality medical care and lower costs to people enrolled in Medicare and Medicaid.

There is much work yet to be done to change the habits of the health care system. But by encouraging transparency and market-based innovation around health data, we are playing to America's greatest strength to solve our most pressing problems.
READ MORE - Good News on Innovation and Health Care

Wednesday, July 3, 2013

Introducing the Health Insurance Marketplace

If you’re uninsured, there’s a new way for you to buy health insurance for 2014. It’s called the Health Insurance Marketplace.

You’ll also see if you qualify to save money on monthly premiums or out-of-pocket costs—or for free or low-cost health coverage options.

Here are the key dates you need to know:

  1.     October 1, 2013: Open enrollment in the Marketplace starts
  2.     January 1, 2014: Coverage for Marketplace insurance plans can start
  3.     March 31, 2014: Open enrollment ends

We can help you get ready & apply

Right now, you can use to:

  1.     Find out about the Health Insurance Marketplace in your state
  2.     See if you are eligible for Marketplace coverage
  3.     See if you qualify for Medicaid or CHIP
  4.     Learn how to get ready for open enrollment

In October, you’ll be able to:

  •     Compare coverage options and choose a plan that works for you
  •     See if you can save on your monthly premiums or out-of-pocket costs
  •     Start an online application and enroll in a Marketplace coverage plan

In the meantime, answer a few quick questions to get a personalized list of programs you may be eligible for, content you’ll want to read, and a checklist to help you get ready.

Comments or questions about the Marketplace? Leave a comment below.
READ MORE - Introducing the Health Insurance Marketplace

Tuesday, June 25, 2013

What is the Health Insurance Marketplace

When you use the Health Insurance Marketplace, you'll fill out an application and find out if you can get lower costs on your monthly premiums for private insurance plans. The Marketplace will also tell you if you qualify for free or low-cost coverage available through Medicaid or (CHIP) the Children's Health Insurance Program.

The Health Insurance Marketplace is sometimes known as the health insurance "exchange."

Compare options in the Health Insurance Marketplace

Insurance plans in the Marketplace are offered by private companies, and they cover the same core set of benefits called essential health benefits. No plan can turn you away or charge you more because you have an illness or medical condition. Plans can't charge women more than men.

Learn about the Marketplace that serves you

While all insurance plans are offered by private companies, the Marketplace is run by either your state or the federal government. Find out if your state is operating the Marketplace by using the menu at the bottom of this page. If your state runs the Marketplace, you'll get health coverage through your state’s website, not this one.

The Marketplace simplifies getting health coverage

The Marketplace simplifies your search for health coverage by gathering the options available in your area in one place. With one application you can compare plans based on price, benefits, quality, and other features important to you before you make a choice. You can also get help online, by phone, by chat, or in person.

Find a plan that fits your needs and budget

In the Marketplace information about prices and benefits is written in simple language. You get a clear picture of what premiums you'd pay and what benefits and protections you'd get before you enroll. Compare plans based on what's important to you, and choose the combination of price and coverage that fits your needs and budget.
READ MORE - What is the Health Insurance Marketplace

Why should I have health coverage?

Health insurance covers these costs and protects you from very high expenses.

Health coverage when you need care

Health insurance is a contract between you and your insurance company. Plans available in the Marketplace (and most other plans) provide free preventive care, like vaccines, screenings, and check-ups.

Health insurance protects you from high, unexpected costs
Did you know the average cost of a 3-day hospital stay is $30,000? Or that fixing a broken leg can cost up to $7500? Having health coverage can help protect you from high, unexpected costs like these.

How health insurance coverage works

When you have insurance, you pay some costs and your insurance plan pays some:

  1.     Premium A premium is a fixed amount you pay to your insurance plan, usually every month. You pay this even if you don't use medical care that month.
  2.     Deductible If you need medical care, a deductible is the amount you pay for care before the insurance company starts to pay its share. Once you meet your deductible, your insurance company begins to cover some costs of your care. Some plans have lower deductibles, like $250. Some have higher deductibles, like $2000. Many plans provide preventive services, and sometimes other care, before you've met your deductible.
  3.     Copayment A copayment is a fixed amount you'll pay for a medical service after you've met your deductible. For example, after meeting your deductible you may pay $25 for a visit to the doctor's office that would cost $150 if you didn't have coverage. The health plan pays the rest.
  4.     Coinsurance Coinsurance is similar to copayment, except it's a percentage of costs you pay. For instance, you may pay 20% of the cost of a $100 medical bill. So you would pay $20 and the health plan would pay the rest.

How insurance protects you

Insurance coverage protects you from high medical costs 2 ways:

  1.     Out-of-pocket maximum This is the total amount you'll have to pay if you get sick. For example, if your plan has a $3000 out-of-pocket maximum, once you pay $3000 in deductibles, coinsurance, and copayments the plan will pay for any covered care above that amount for the rest of the year.
  2.     No yearly or lifetime limits Health plans in the Marketplace can't put dollar limits on how much they will spend each year or over your lifetime to cover essential health benefits. After you've reached your out-of-pocket maximum, your insurance company must pay for all of your covered medical care with no limit.

People without health coverage are exposed to these costs. This can sometimes lead people without coverage into deep debt or even into bankruptcy.
READ MORE - Why should I have health coverage?

Two meals a day may be better for weight loss than 'grazing'

We’ve heard for years that a key to weight loss is swapping a few square meals a day for many mini-meals throughout the day. A small study presented this weekend at the American Diabetes Association conference found that people with type 2 diabetes who ate two large meals a day lost more weight than when they consumed six smaller meals with the same amount of calories.

The researchers, led by Hana Kahleova of the Institute for Clinical and Experimental Medicine in Prague, instructed the 54 study participants to follow two types of eating plans for 12 weeks each: either six mini-meals or two larger meals – just breakfast and lunch. The volunteers lost weight under both eating plans. But eating a big breakfast and big lunch resulted in more weight loss – 1.23 points of their body mass index, or BMI. Eating the six smaller meals resulted in a loss of 0.82 BMI points. BMI uses a person’s height and weight to provide a measure of body fat. Although eating just two times a day resulted in more weight loss, is skipping dinner really feasible or sustainable for the average American -- with or without diabetes? “National surveys suggest that most Americans, including those with diabetes, eat five or six times a day, so to curb eating to only two times a day would be a change that would be drastic and dramatic -- and unrealistic for many people,” says Elisa Zied, a registered dietitian from New York.

Toby Smithson, a spokesman for the Academy of Nutrition and Dietetics, adds that eating two large meals a day is impractical because for many, dinner is the one meal that they're able to reliably fit into their schedule. "An earlier study showed that if you ate three times a day, you got the same thing. So it's really cutting down how often you eat, because you'll tend to eat less," Fernstrom told Savannah Guthrie this morning on TODAY.

"Three meals a day is going to be more workable," Fernstrom says. "A lot of people think, if I want to lose weight better, I'd better spread my meals out, eat constantly. But the more you graze, the more you tend to eat, for many people."

"These six mini meals turn into six major meals, and people wonder why they're not losing weight," she told TODAY. "So this is really good documentation, even though it's a small study, that eating less often can really help promote the same weight loss."

For long-term weight management, it’s important to learn to listen to your body. Zied’s rule: Eat when you’re hungry, stop when you’re satisfied, and plan ahead.

"One of the take home messages here -- a 500-calorie reduction in intake, regardless of how you do it, results in weight loss," Ratner says, adding that "both groups lost weight. This shows that calorie reduction matters."

READ MORE - Two meals a day may be better for weight loss than 'grazing'

5 ways pets can ease your stress

A pet prescription can remedy all sorts of problems, says animal expert Arden Moore. "There's something about the animal kingdom that possesses the ability for us to enjoy life a little better," says Moore, author of more than 20 pet books and radio host of Oh Behave, an online Pet Life Radio show.

1. They relax you

Moore suggests petting with a purpose to increase the release of feel-good hormones in animals and humans. "Give your dog or cat a head-to-tail therapeutic massage by running hand over hand through the body," she says. Your touch relaxes the animal and releases feel-good endorphins in you, reducing your heart rate.

2. They may reduce blood pressure

Communicating with animals may lower your blood pressure and improve your overall health. Moore suggests engaging animals in "happy talk," or speaking in an upbeat tone. "Happy talk or laughter around animals releases hormones in humans that lower blood pressure, and make animals feel better too," she says.

3. They're therapeutic

Animals from dogs to rabbits are often used for therapy in hospitals and nursing homes.  Moore suggests that the strong human-to-animal bond could be related to fond childhood memories. Even if it's a just a spider, people often feel more comfortable being themselves around animals, says Moore.

4. They can improve human nutrition

Eating alongside bad company may decrease your appetite, but eating in the company of an animal may improve your eating habits. "In nursing homes, if there's a fish tank where people are eating, seeing those fish actually motivates some residents to eat," says Moore.

5. They improve your relationships

According to a 1997 study at the University of Michigan School of Nursing, observing animals in nature can teach valuable characteristics like patience, and help restore mental energy. Taking care of an animal can also teach responsibility and stimulate feelings of trust, openness, and companionship.
READ MORE - 5 ways pets can ease your stress

Girl, 6, critical after long-awaited heart transplant

Teresa Bartlinski, the 6-year-old adopted from China who literally had a broken heart, received a transplant after waiting for more than two years for a matching organ.

But a few hours after the surgery last Monday Teresa went into cardiac arrest. Teresa was born with a shortened arm and heart damage that resulted from a congenital defect named hypoplastic left heart syndrome. In Teresa’s case, that also led to permanently damaged lungs, which made the little girl frail.

Doctors feared that Teresa would never be well enough for a transplant, but the little girl thrived with the Bartlinski family. Last Monday when the family was at the beach, the call they were all waiting for finally came from the Children’s Hospital of Philadelphia: Doctors said they had a donor heart for Teresa.

Teresa’s new heart started to beat once it was connected up and shocked into action. Doctors performed CPR for 30 minutes, before finally putting her on a heart-lung machine.

On Monday, surgeons will try repairs to help Teresa's new heart function properly.

Because Teresa’s atrium was so tiny, the blood vessels were too narrow to handle the increased blood flow required by the donor heart, her family reported. "Surgery will start around 12 on Monday" to repair Teresa's left atrium, according to the family's website. “We know Teresa’s a fighter,” Ed told Costello.

READ MORE - Girl, 6, critical after long-awaited heart transplant