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Medicaid Acceptance by Healthcare Providers Drops in 2015

Medicaid Acceptance by Healthcare Providers Drops in 2015 | Healthcare and Technology news |

Given the size of the Medicaid program and its importance to America’s low-income population, HealthPocket examined government records on Medicaid acceptance for a broad cross-section of healthcare providers. HealthPocket’s review of over one million records found that in 2015 only 34% of the healthcare providers examined were listed as accepting Medicaid insurance. The 2015 results represent a 21% decrease from the listings of Medicaid acceptance as compared to 2013 data for the same categories of healthcare providers.

Since both the 2013 and 2015 analyses relied upon the same government data source and provider categories, the marked decline in Medicaid acceptance is significant. In particular, the data calls into question whether the temporary two-year increase in Medicaid payments to primary care physicians effected any lasting improvements to Medicaid acceptance.

Healthcare provider reluctance to accept Medicaid has numerous reasons, most notably the level of reimbursement from Medicaid for healthcare services. Medicaid typically pays 61% of what Medicare pays for the same outpatient physician services. Medicare itself typically pays 80% of what commercial health insurers pay. Consequently, in comparison to commercial health insurance from private insurance companies, Medicaid payments represent a reduction on a reduction.

“HealthPocket has stressed many times that health insurance is only as good as the doctors and hospitals that accept it,” said Kev Coleman, Head of Research & Data at HealthPocket, “In the case of Medicaid, there is an overwhelming number of healthcare providers who do not accept the insurance which, in turn, undermines the value of the insurance provided.”

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Experts warn 2015 could be 'Year of the Healthcare Hack'

Experts warn 2015 could be 'Year of the Healthcare Hack' | Healthcare and Technology news |

Security experts are warning healthcare and insurance companies that 2015 will be the "Year of the Healthcare Hack," as cybercriminals are increasingly attracted to troves of personal information held by U.S. insurers and hospitals that command high prices on the underground market.

    Anthem Inc, the No. 2 U.S. health insurer, last week disclosed a massive breach of its database containing nearly 80 million records, prompting investigations by state and federal authorities. That hack followed a breach last year at hospital operator Community Health Systems, which compromised some 4.5 million records.

    "People feel that this will be the year of medical industry breaches," said Dave Kennedy, chief executive of TrustedSEC LLC.

    In the past decade, cybercriminals focused their efforts on attacking banks and retailers to steal financial data including online banking credentials and payment card numbers. But as those companies boost security, using stolen credit card numbers has become more difficult.

Their prices on criminal exchanges have also dropped, prompting hackers to turn to the less-secure medical sector, just as the amount of digital healthcare data is growing dramatically, Kennedy said.

Stolen healthcare data can be used to fraudulently obtain medical services and prescriptions as well as to commit identity theft and other financial crimes, according to security experts. Criminals can also use stolen data to build more convincing profiles of users, boosting the success of scams.

"All of these factors are making healthcare information more attractive to criminals," said Rob Sadowski, marketing director at RSA, the security division of EMC Corp.


RSA Executive Chairman Art Coviello recently wrote in a letter to customers that he expected well-organized cybercriminals to turn their attention to stealing personal information from healthcare providers.

"A name, address, social and a medical identity ... That's incredibly easy to monetize fairly quickly," said Bob Gregg, CEO of ID Experts, which sells identity protection software and services. Identities can sell for $20 apiece, or more, he said.

    Insurers, medical equipment makers and other companies say they have been preparing for breaches after seeing the waves of attacks on other industries. 

    Cigna Corp has looked to financial and defense companies for best practices, including hiring hackers to break into its systems, said Chief Executive David Cordani. Attempts to break into corporate systems to probe for information are a constant, he said in an interview. 

St Jude Medical Inc CEO Daniel Starks said the company increased investment in cybersecurity significantly over the last few years, to protect both patient data and the medical devices it manufactures.

"You may see from time to time law enforcement briefings on nation-based (intellectual property) issues, espionage," he said. "Those are things that we take very seriously and have been briefed on and that we work to guard against."

    The FBI is investigating the Anthem breach alongside security experts from FireEye Inc.

The insurers UnitedHealth Group Inc and Aetna Inc have warned investors about the risks of cyber crime in their annual reports since 2011.

UnitedHealth has said the costs to eliminate or address the threats could be significant and that remediation may not be successful, resulting in lost customers.

    In response to the Anthem attack, UnitedHealth spokesman Tyler Mason said in an emailed statement: "We are in close contact with our peers in ... the industry cybersecurity organization, and are monitoring our systems and the situation closely."

Aetna has cited the automated attempts to gain access to public-facing networks, denial of service attacks that seek to disrupt websites, attempted virus infections, phishing and efforts to infect websites with malicious content.

Aetna spokeswoman Cynthia Michener said in a statement: "We closely follow the technical details of every breach that's reported to look for opportunities to continually improve our own IT security program and the health sector's information protection practices broadly."

Adrián Toscano's curator insight, February 12, 2015 3:02 PM

Tendencia de los crímenes en la web. Importante.!

Digital health in 2015: What's hot and what's not?

Digital health in 2015: What's hot and what's not? | Healthcare and Technology news |

I think it’s fair to say that digital health is warming up. And not just in one area. The sheer number and variety of trends are almost as impressive as the heat trajectory itself. The scientist in me can’t help but make the connection to water molecules in a glass — there may be many of them, but not all have enough kinetic energy to ascend beyond their liquid state. The majority are doomed to sit tight and get consumed by a thirsty guy with little regard for subtle temperature changes.

With this in mind, let’s take a look at which digital health trends seem poised to break out in 2015, and which may be fated to stay cold in the glass. As you read, keep in mind that this assessment is filtered through my perspective of science, medicine, and innovation. In other words, a “cold” idea could still be hot in other ways.

Collaboration is hot, silos are not. Empowerment for patients and consumers is at the heart of digital health. As a result, the role of the doctor will shift from control to collaboration. The good news for physicians is that the new and evolved clinician role that emerges will be hot as heck. The same applies to the nature of innovation in digital health and pharma. The lone wolf is doomed to fail, and eclectic thinking from mixed and varied sources will be the basis for innovation and superior care.

Scanners are hot, trackers are not. Yes, the tricorder will help redefine the hand-held tool for care. From ultrasound to spectrometry, the rapid and comprehensive assimilation of data will create a new “tool of trade” that will change the way people think about diagnosis and treatment. Trackers are yesterday’s news stories (and they’ll continue to be written) but scanners are tomorrow headlines.

Rapid and bold innovation is hot, slow and cautious approaches are not. Innovators are often found in basements and garages where they tinker with the brilliance of what might be possible. Traditionally, pharmaceutical companies have worked off of a different model, one that offers access and validation with less of the freewheeling spirit that thrives in places like Silicon Valley. Looking ahead, these two styles need to come together. The result, I predict, will be a digital health collaboration in which varied and conflicting voices build a new health reality.

Tiny is hot, small is not. Nanotechnology is a game-changer in digital health. Nanobots, among other micro-innovations, can now be used to continuously survey our bodies to detect (and even treat) disease. The profound ability for this technology to impact care will drive patients to a new generation of wearables (scanners) that will offer more of a clinical imperative to keep using them.

Early is hot, on-time is not. Tomorrow’s technology will fuel both rapid detection and the notion of “stage zero disease.” Health care is no longer about the early recognition of overt signs and symptoms, but rather about microscopic markers that may preempt disease at the very earliest cellular and biochemical stages.

Genomics are hot, empirics are not. Specificity — from genomics to antimicrobial therapy — will help improve outcomes and drive costs down. Therapy will be guided less and less by statistical means and population-based data and more and more by individualized insights and agents.

AI is hot, data is not. Data, data, data. The tsunami of information has often done more to paralyze us than provide solutions to big and complex problems. From wearables to genomics, that part isn’t slowing down, so to help us manage it, we’ll increasingly rely on artificial intelligence systems. Keeping in mind some of the inherent problems with artificial intelligence, perhaps the solution is less about AI in the purest sense and more around IA — intelligence augmented. Either way, it’s inevitable and essential.

Cybersecurity is hot, passwords are not. As intimate and specific data sets increasingly define our reality, protection becomes an inexorable part of the equation. Biometric and other more personalized and protected solutions can offer something that passwords just can’t.

Staying connected is hot, one-time consults are not. Medicine at a distance will empower patients, caregivers, and clinicians to provide outstanding care and will create significant cost reductions. Telemedicine and other online engagement tools will emerge as a tool for everything from peer-to-peer consultation in the ICU to first-line interventions.

In-home care is hot, hospital stays are not. “Get home and stay home” has always been the driving care plan for the hospitalized patient. Today’s technology will help provide real-time and proactive patient management that can put hospital-quality monitoring and analytics right in the home. Connectivity among stakeholders (family, EMS, and care providers) offers both practical and effective solutions to care.

Cost is hot, deductibles are not. Cost will be part of the “innovation equation” that will be a critical driver for market penetration. Payers will drive trial (if not adoption) by simply nodding yes for reimbursement. And as patients are forced to manage higher insurance deductibles, options to help drive down costs will compete more and more with efficacy and novelty.

Putting it all together: What it will take to break away in 2015?

Beyond speed lies velocity, a vector that has both magnitude and direction. Smart innovators realize that their work must be driven by a range of issues from compatibility to communications. Only then can they harness the speed and establish a market trajectory that moves a great idea in the right direction. Simply put, a great idea that doesn’t get noticed by the right audience at the right time is a bit like winking to someone in the dark. You know what you’re doing, but no one else does.

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Think Filing Taxes Was Tough Before Obamacare? Just Wait

Think Filing Taxes Was Tough Before Obamacare? Just Wait | Healthcare and Technology news |

The Affordable Care Act, aka Obamacare, is part health law, part tax law. Some feel benefited by the law, some burdened by it. And one’s perceptions about that can change over time. Either way, you may be annoyed by the extra forms and extra tax compliance, even if your tax bill doesn’t go up. The IRS has a far more important role in the law than you might think.

This year for the first time, the Affordable Care Act has created a trickier tax season. It is more expensive too, as virtually all Americans filing tax returns will have to consider the law’s impact on them and their taxes. There is likely to be considerable confusion this first year, and probably many mistakes. Yet many expect the IRS to be lax for a time. The agency is already stretched thin, and tax season looms large, especially this year.

A major feature of the law is a mandate requiring that most Americans must carry health insurance. In its simplest, that means you must state on your tax forms whether you have coverage. You also must say whether you got tax credits to help pay for it. If you did not have coverage in 2014 as required—and you are honest and say you didn’t—there’s a fine. Yet if you fail to pay it, many in the tax filing business think you may slide by without incident.

On the other hand, if you are entitled to subsidies, your tax refund is likely to go down. In fact, your refund may go down so much that you may even owe the IRS money. The subsidy process is confused and many people who received subsidies are likely to owe the IRS. Why? Because there is estimating involved, the tax credits they received to offset their insurance premiums may have been too large.

In fact, H&R Block estimates that up to one half of the approximately 6.8 million taxpayers who got subsidies in 2014 may have to send money back to the government. Tax preparation firms are trying to gear up to provide the kind of hybrid health insurance tax law advice that consumers are needing this year. But like any new system, there are likely to be some hiccups. It will also be one more reason taxpayers may need tax professionals, even if their situations seem simple.

In that sense, this could be a pivotal tax filing season. Obamacare was enacted in 2010, eventually rolled out, and repeatedly delayed. As enacted, employers were supposed to send in to the IRS lists of employees with health coverage through their employment. After delays, though, it’s now clear that there will be more self-reporting than originally envisioned.

Given that the IRS is administering the massive health care/tax law, you might assume that there would be something like a Form W-2 or Form 1099 that would reveal key data. For now, though, the IRS says it has to trust tax filers to answer truthfully whether they had health insurance or need to pay a penalty. In some sense, it might be similar to answering the question whether you have a foreign bank account. That too is a yes or no question.

Some taxpayers are likely to just skip the question about health insurance, just as some skip the foreign bank account question. If you don’t say yes or no, the reasoning goes, how can they penalize you? Tax return preparation software may or may not default to yes or no for health insurance. Remember, though, that you must sign your tax return under penalties of perjury.

If you must pay a fine, you pay it as part of your tax bill. That will make some people unhappy. Still, the flak from people who got subsidies and then are getting smaller refunds than they thought–or even owing money–may be greater.

Finally, a major impact on many higher income taxpayers is likely to be the 3.8% net investment income tax. It was enacted in 2010 expressly to fund the health law. It first took effect in 2013, and 2014 is likely to be a big year. If you need guidance, the IRS has released these questions and answers on the net investment income tax.

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5 digital trends to watch in 2015 | Healthcare IT News

5 digital trends to watch in 2015 | Healthcare IT News | Healthcare and Technology news |

The year 2014 goes down in history as a breakout year for digital healthcare, according to a recent report from StartUp Health, whose stated mission is to help 1,000 health startups reimagine and transform healthcare over the next 10 years.

StartUp Health's calculations show that some $6.5 billion was invested in digital health in 2014, a 125 percent increase over the $2.9 billion invested in 2013.

"Signs of a maturing market continue as investors place larger bets on fewer companies," according to the report, which lists the market's top deals and investors.

StartUp Health executives also reveal the five trends they will be watching closely in 2015:

  • Healthcare reform continues to spur innovation: As incentive structures change and new penalties come into effect in 2015, providers and payors look to entrepreneurs to create effective solutions. The unmet need is evidenced as big data and analytics ($1.5 billion); population health ($1.1 billion); and healthcare system navigation ($975 million) net the largest amounts of private funding in 2014.
  • Acceleration of chronic disease & aging population leads to increased consumerism: Rising costs continue to be the second largest catalyst for innovation in healthcare. Patients are not only encouraged, but enabled through mobile technology, to manage their health through preventive measures. Consumer health companies raised $880M in 2014.
  • Clinical decision support & personalized medicine gain traction: With the advent of the $1,000 genome, truly personalized medicine is in our reach. Genomic companies raised $632 million and diagnostics $962 million this year. This data, coupled with $624 million that went into clinical research companies will revolutionize the way that diseases are treated.
  • Convergence of technology in clinical settings: Mobile and wireless technology has permeated not only our daily lives, but those of professionals in clinical settings. Practice management tools allowing physicians to focus on treatment, rather than admin tasks, raised $783 million, while those focusing on improving workflows raised $681 million. Payor-related toolkits raised $699 million.
  • Innovation globalization: More than 7,500 startups around the world are developing new solutions in digital health, based on data from the StartUp Health Network. Even within the U.S., areas outside of the Bay Area, New York and Boston are seeing an uptick in the number of companies obtaining funding.

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Last Chance to Enroll in Obamacare for 2015

Last Chance to Enroll in Obamacare for 2015 | Healthcare and Technology news |

Americans eligible for health insurance under the Affordable Care Act (ACA) are facing an important deadline. This year's sign-up period ends Sunday, Feb. 15.

For most people, it will be the last chance to select an ACA marketplace health plan or switch plans for 2015. That's why health advocates are urging uninsured Americans to take advantage of this final window of opportunity.

The 2015 open enrollment period kicked off on Nov. 15, 2014, with barely a hiccup compared with the online problems that dogged sign-ups for 2014, the inaugural year of the new insurance marketplaces, or exchanges.

The ACA, or Obamacare, requires most citizens and U.S. nationals to have health insurance coverage or pay a fine. Some people may qualify for exemptions due to religious beliefs, financial hardship or other extenuating circumstances.

If you are enrolled in a qualified health plan for 2015, you are considered covered under the law. The list of qualified plans includes Medicare, Medicaid, the Children's Health Insurance Program, job-based health insurance, military or veterans' health coverage and health insurance purchased on or off the Affordable Care Act marketplaces.

Penalties for not having health insurance in 2015 jump to 2 percent of household income or $325 per adult (and $162.50 per child) -- whichever is higher.

Close to 10 million people have already signed up for marketplace coverage for 2015, federal health officials reported earlier this month. That figure includes some 7.5 million who selected a health plan or re-enrolled in coverage through, the federal enrollment website serving people in 37 states. Others have secured coverage through state-operated health insurance exchanges.

Although the Congressional Budget Office had previously projected 13 million enrollees in 2015, federal health officials last November revised projected enrollment to between 9 million and 10 million for the year.

The ACA was designed to expand affordable coverage to people who cannot afford health insurance on their own. It does that, in part, by subsidizing insurance premiums for people of modest means.

If you make up to 400 percent of the federal poverty level (as much as $95,400 for a family of four), you may qualify for federal tax credits to defray your monthly health insurance premium. People with very low incomes will pay little or nothing for coverage.

The amount of the subsidy depends on your household income and the number of people in your household.

Many low-income people may qualify for reduced out-of-pocket costs as well.

Americans who choose a health plan before this year's cutoff date could have coverage as soon as March 1. After Feb. 15, the federal and state ACA marketplaces will only enroll people in health coverage for 2015 under special circumstances, such as a birth, death or move.

There's no deadline for enrolling in Medicaid or the Children's Health Insurance Programs.

The next ACA open enrollment period begins Oct. 1, 2015, for coverage that would kick in no earlier than Jan. 1, 2016.

For those hoping to squeak in under the wire for 2015, can tell you whether you live in a state with a state- or federally operated health marketplace. You can also find local experts to help you enroll.

Consumers can call the government's 24/7 hotline at 1-800-318-2596 for assistance.

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How hospitals are tackling costs in 2015

How hospitals are tackling costs in 2015 | Healthcare and Technology news |

It's no secret that Americans pay a pretty penny for their healthcare – the highest in the developed world, in fact. What's more, by many reports, they're not even getting the quality outcomes to match that hefty price tag.

As providers face pressure to reduce costs on the front end – for their patients – they're also feeling the pinch on the back end: their bottom lines. For hospitals and health systems, especially, 2015 is a landmark year for everything related to costs.

In 2013, national health expenditures approached $3 trillion, representing $9,255 per person and accounting for a whopping 17.44 percent of the gross domestic product. In the wake of the Affordable Care Act, the industry now more than ever is facing pressure to be accountable and value based. That's often a struggle for many.

So as the industry works to comply with myriad regulatory changes that have been implemented, what’s top of mind this year for the healthcare finance folks?
For Karen Mihalik, executive director of revenue cycle managementat the Cleveland Clinic, there are several things that come to mind.
For one? This year, risk-based contracting is going to be tough, said Mihalik, who works with an RCM team comprising 1,700 FTEs. Also, ACOs and handling bundled paymentswill pose big challenges.
"This year is different in that we really need to make sure that we align again with the clinical component, and that we're building the right business model and administrative model to manage that risk-based population," she said.
One risk-based model, the Medicare ACO, has been a serious challenge for many provider groups. The federal government's Pioneer ACOprogram, for instance, which originally started with 32 participants has whittled down to 19 organizations as of September 2014. 
For the folks at the Denver-based Physician Health Partners, one of the groups that dropped out of the Pioneer model back in 2013, the benchmark setting process within the Pioneer model needed some serious re-working.
We can't take that much risk when the game keeps changing a little bit," Kenneth Nielsen, president and CEO of Physician Health Partners, told Healthcare IT News back in 2013, especially when these adjustments aren’t geographically based. "The Denver market, where our benchmark was $8,000 per beneficiary, per year is a lot different than an East Coast market where their benchmark was twice that."
For PHP, it wasn't all bad news, however. It was able to decrease its readmissions and hospitalizations rates and met all the quality metrics. But, financially, it wasn’t viable. It reported shared losses for fiscal year one, which was anticipated, Nielsen said, but another two years before reaping the supposed financial benefits? It proved just too risky. "We just weren't able to take enough time to take the risk over three years at this point," Nielsen added. Right now, he said, "We're between bleeding edge and cutting edge."
Cleveland Clinic passed on the Medicare ACOs in the first round, with its CEO Toby Cosgrove saying the organization was "disappointed" with the Centers for Medicare and MedicaidServices ACO proposal, claiming they requirements weren’t outcomes based and had other reporting requirements that were burdensome to healthcare organizations. 
Another item on the to-do list this year, aside from risk-based contracts? Payers have some work to do with the insurance verification process.
Specifically, Cleveland Clinicneeds to be able to identify patients enrolled in an ACA-related plan and gather crucial information related to their coverage, said Mihalik. Having the ability to know who these specific patients are and how they are doing in digesting this "new world" is essential, she added. 
For year two, Cleveland Clinic is really focused on making sure payers are able to specifically identify those patients as being in an ACA-related plan and subsequently providing that data to the clinic as part of the registration verification process. 
"We want to be able to take a look at that population, and we really can't effectively do that right now because the payers haven't built the right models," said Mihalik, "so the system changes really aren't needed on our side; they're needed on the payer side."
Mihalik isn't alone. In fact, 62 percent of MGMAmembers said they had moderate or extreme difficulty with identifying patients with ACA coverage, according to a 2014 MGMA survey. "We are going to have to hire additional staff just to manage the insurance verification process," one MGMA practice manager reported in the survey. 
As far as the IT goes, the payers are the ones with the work to do, Mihalik added. 

ICD-10 confusion not helping

Hospitals and health systems are businesses. Sure, their purpose is to provide patients with quality care at lower costs, but at the end of the day if they're not financially viable and their bottom lines are consistently in the red, there's a big problem.
For Arnette Marbella, director of HIM and CDM revenue cycle at Tufts Medical Center, it's the ICD-10limbo that's concerning from a financial perspective. There's talk that ICD-10 will be delayed yet again, pushing its go-live data of October 2015, even further down the road. The revenue implications in that is that most hospitals have already started at least a year or a year and a half ago on preparing for the transition," said Marbella. 
This preparation, of course, means systems are tested, making sure that the systems are upgraded to be able to accept the news codes, physicians are trained on documenting. That part – clinical documentation is integral, she added. If you think about it, she said, the industry is going from some 14,000 diagnosis codes to nearly 70,000 codes, so "there's no one-to-one match for the codes."
Ultimately, clinical documentation translates to "we have to be more specific on the codes that we assign, and that in turn translates to the reimbursement that we get or the bill that we submit to the payers and they reimburse and then we get," she said. A loss of revenue due to coding errors or administrative/procedural issues is a "concern in every hospital," Marbella added. 
Mihalik has her own concerns about ICD-10. 
It impacts really nearly every system," she said. "Most of our systems work off of diagnosis data, so the work we're doing around remediation and cross walks and testing is significant but very, very necessary," she added. The other area we're really focused on has to do with our coding and clinical documentation so that we are prepared now as we can be prior to go-live in making sure that we have quality training and audits going on to help make sure that we're there to the level that we need to be."
Investments in technology that they’re leveraging with computer assisted coding is also key, she said. 
With all of these items on providers to-do lists, it's difficult to focus on much else. But there is more, said Mihalik. Patients and their engagement are absolutely key. Our focus is really on what's still to come," she said, "because there are significant changes still in front of us related to primarily patient engagement so our world is really focused on first and foremost patients and being able to provide them timely and integrated information."

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Hospital Impact - 7 digital resolutions for hospitals

Hospital Impact - 7 digital resolutions for hospitals | Healthcare and Technology news |

It's the beginning of 2015 and time for people to take a closer look at their lives and make resolutions for the coming year. It's also a good time for hospitals to take another look at their social media and digital initiatives and determine what's working and what's not.

The good news is that U.S. hospitals have embraced social media. In fact, 99.41 percent of the 3,371 U.S. hospitals have ongoing social media initiatives, according to a recent report from the Journal of Medical Internet Research. But are they using the right channels and achieving the results they want?
Here are some social media resolutions for hospital marketers for the coming year:

  • Make your website work for you: Your website is your most important digital property because it's the first place people go to learn about your organization and the services you provide. However, websites are no longer the online brochures they were in the 1990s. They need to be searchable and updated on a regular basis to remove stale and outdated content. A good resource to help you know where to focus your efforts is your site's Google Analytics, which will tell you which pages get the most views and how long site visitors spend on each page.
  • Make your content easier to find: It's not enough to create compelling content, people need to be able to find it. You may have a beautiful, informative website, but are you making the most out of Search Engine Optimization (SEO)? This is important, but can be a time-intensive task. Or have you spent a lot of time creating compelling videos and posting them on YouTube, but wonder why they may not attract viewers? A simple way to fix this is by not just posting key words, but by posting the entire video transcript.
  • Reach the right people: Research shows that hospitals tend to post generic content or information about employee-related issues and achievements. While this approach helps build critical mass by engaging hospital employees (which is especially important when launching social media programs), it won't help turn people into patients. It's important to know your audience and know what topics interest them, which will help increase followers and stimulate engagement.
  • Give the people what they want: Not only is this the name of a great album by the Kinks, it's a good social media mantra for hospitals. Your site's Google Analytics will help you identify whether people are coming to your site to learn about your heart and vascular program or maternity services, or simply want directions to your hospital. This information will help you identify topics for future blogs and social media posts and will help ensure that you continue to provide content that interests people.
  • Focus on what works: Hospital marketing departments are stretched thin and it's often difficult for staff to find enough hours in the day to do their work and manage all of their organization's social media properties. Rather than having a mediocre presence in multiple social media channels, focus your efforts on a couple of major channels. Or create an educational social media campaign that encourages people to take control of their own health, such as getting a mammogram or having a colon cancer screening.
  • Listen to what people say: One of the most important parts of social media engagement is listening to what people say. The challenge is to keep up with the channels as they evolve. For example, Yelp is where people go to get restaurant reviews--but patients also use it to review the care they receive at their local hospital. It's important to hear what people say and respond to their concerns. It's amazing how listening to people and addressing their concerns can help turn a detractor into an advocate.
  • Be part of the bigger conversation: In addition to listening to patient comments, hospitals should listen to the issues and concerns that other organizations in their community, including other hospitals, talk about. Listening to others allows you to be more relevant and become part of the bigger conversation.
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HIM, Patient Monitoring, Health IT Markets to Grow Quickly |

HIM, Patient Monitoring, Health IT Markets to Grow Quickly | | Healthcare and Technology news |
Health IT markets will continue to expand as providers invest in new technologies to meet health information management and patient monitoring needs, a number of reports predict.

The purchasing markets for health information management, patient monitoring, and healthcare analytics technologies are slated to see significant growth as provider organizations continue to invest in new health IT infrastructure to meet upcoming clinical and reimbursement challenges.  As meaningful use, the Affordable Care Act, and the expansion of accountable care principles continue to demand utilization of sophisticated health IT systems, healthcare organizations will drive market growth in pursuit of high quality patient care.

The healthcare analytics outsourcing market is slated to see almost 9% compound annual growth over the next four years, predicts research from Reportstack, as healthcare organizations seek to implement the benefits of clinical, financial, and administrative analytics without bearing the entirety of the costs themselves.  The 8.60% CAGR will be driven by large, recognizable vendors as providers turn to trusted names for their most sensitive data needs.

Meanwhile, on the payer side, the global healthcare administrative systems market will see a 5.7% CAGR over the same time period, MicroMarket Monitor reports, as payers attempt to leverage health IT to meet the challenges of accountable care.  The market for payer administrative systems was valued at more than $2.2 billion in 2013, with billing systems accounting for greater than 40% of the segment.  North American markets will be responsible for the majority of the sector’s continued expansion.

Behavioral health software purchasing will explode at a 14.7% CAGR from now until 2019, says a prognostication by RnR Market Research as ongoing reforms in the healthcare industry pressure behavioral healthcare providers to implement electronic health records and administrative systems alongside their primary care peers.  The $752 million market may reach nearly $1.5 billion globally over the next four years, the report says, as healthcare providers focus on integrating behavioral health with other aspects of patient care.

The market for wireless portable medical devices may reach $2.83 billion by the end of the decade, MarketsandMarkets says, as wearable devices gain in popularity and home monitoring equipment becomes an essential tool for chronic disease management and elder care.  Continued innovation in therapeutic devices and patient monitoring technology, coupled with strong commitment to population health management from federal agencies will be key drivers of growth for these technologies.

Vendors of inpatient pharmacy information systems will also enjoy significant interest in their wares as the North American market grows as a CAGR of 7.5% over the next three years.  Led by familiar EHR developers such as athenahealth, Cerner Corporation, Allscripts, Practice Fusion, and NextGen, the global pharmacy health information management market may reach $2.5 billion by 2018.  As EHR vendors seek to expand their portfolios of product options to offset slowing growth in the EHR purchasing markets, providers may choose to select offerings that compliment their existing health IT infrastructure to ensure interoperability and health information exchange.

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Healthcare Predictions For 2015

Healthcare Predictions For 2015 | Healthcare and Technology news |

Next year will be big for healthcare. We felt small tremors in 2014 of the seismic changes underway. In 2015, I predict five changes to the core of the U.S. healthcare system: insurance, pharmaceuticals, supplies, medical services and payments. Let’s take a look at each of these trends, what they mean for the healthcare sector, and what they mean for you.

Walmart becomes your healthcare insurer

This October, Walmart tipped its hand by launching a healthcare insurance exchange online. However, the insurance products currently sold on its exchange do not have Walmart as the carrier, which will change in 2015.

Walmart’s public announcements thus far provide a clear preview of the insurance plan’s future design. Primary care through retail clinics and $4 generic drugs at the pharmacy will drive traffic into stores. For specialty care, the plan will leverage the Centers of Excellence program that Walmart already offers to its 1.2 million insured employees. In this program, consumers pay little to nothing out-of-pocket for knee, hip surgery, and cancer treatment if they go to a short list of high-quality medical centers like Mayo, the Cleveland Clinic, Mercy and Geisinger.

With a store within five miles of 95 percent of all Americans and retail transactional data from its consumers, Walmart can provided tailored population health services and incentivize healthier shopping decisions to prevent diabetes and heart disease.

Startups sell into big pharma and become profitable

Despite a 5x increase in venture investments, most digital health companies are not profitable.  Digital health CEOs should look at pharma as its paying customer. Despite their vast differences, pharmaceutical manufacturers are starting to pay tech startups to solve their complicated problems.

One major issue pharma wants your help with is accessing and selling to physicians. In person detailing by trained sales representatives has been the core of pharma’s sale strategy for decades.

Yet, one-fourth of all MD’s offices and two-fifths of all offices with 10 or more MDs refuse to see pharmaceutical sales reps in their offices. The Sunshine Act, which compelled every pharma company to disclose what it spends on each MD, accelerated the problem. The problem of customer awareness and engagement is ripe for tech companies, particularly those focused on social media, mobile advertising and video, to capitalize on.

Next year is going to be a tipping point, because spending and hiring within pharma’s commercial organizations are changing fast. Plus, the FDA published draft guidance on social media in July 2014. Suddenly, these corporations have large eMarketing teams and VPs of digital health. We are seeing CIOs from companies like Dell working at Merck. These indicators tell me that 2015 will be the year when pharma is willing to shop for best-in-breed companies that address their business problems.

Amazon undercuts the medical supply chain

Amazon sells a dizzying array of products. Catheters and surgical gloves are not on the market yet, but they will be soon. Doctors and practice managers are just like the rest of us — they love Amazon Prime for their homes, so why not for their practices?

Amazon will first target small practices and cutout group-purchasing organizations that take an undeserved cut of savings that could be passed on to physicians. If Amazon can ship you toilet paper in two hours, it can supply a small practice with gloves and gowns. The volume from these accounts will justify free shipping, especially when Amazon moves upstream into higher-margin products such as sutures, syringes and other commoditized supplies.

While medical professionals and business managers will be driven by price and convenience, Amazon’s motivations will be financial. General surgical supply company Owens & Minor generated $9 billion in annual revenue last year. Amazon isn’t known for letting glaring business opportunities go untouched, especially those that can move its stock price.

Hospitals become a channel for peer-to-peer lending

If you understand the flow of payments in healthcare, you can predict the trends. Consumers and employers are purchasing insurance plans with high deductibles. As a result, the first dollar that hospitals earn is now coming from consumers. Actually, the first $17,000 is coming from consumers. With an average income of $55,000, most American consumers simply can’t pay their medical bills.

When they don’t pay, it hurts providers financially. What consumers don’t pay shows up as accounts receivable on hospital balance sheets and eventually turns into bad debt. Since many hospitals are financed by debt and their credit worthiness is partially determined by the health of their balance sheet, the problem of getting patients to pay is urgent.

This raises the question — how can we find the money to help consumers finance their health care payments? Many consumers are able and willing to pay their medical bills, they just can’t do it all at once. Peer-to-peer lending companies have paved the way for unsecured structure notes, where an individual’s loan can be financed by others. These have shown impressive growth. Peer-to-peer lending is already being used to finance plastic surgery and other cash-pay procedures. Now it could be used for the majority of medical expenses in the U.S.

Latinos become the most desired healthcare segment in the U.S.

There are 54 million Latinos living in the United States, constituting 17 percent of the population. Politicians have taken notice and are paying attention to Latinos as an important voting demographic. Healthcare providers are beginning to do so, too.

Latinos have been disenfranchised by the U.S. healthcare system because of legal status, English language skills and financial constraints. Fewer than 4 percent of healthcare providers speak Spanish and most do not know how to approach the cultural and economic diversity within the Latino population. Even native English speakers can’t make sense of PPOs vs. HMOs.  As a result, Latinos are 1 out of every 5 uninsured individuals in the U.S. and leverage healthcare services differently than other demographic cohorts

As hospitals compete for volume, they cannot ignore 1 out of 5 Americans. In order to win the loyalty of this untapped customer segment, we will see Latino-branded services with evening and weekend hours to serve dual-income families. Since these services will be built from scratch to provide high-quality care at low prices, they might leap frog the care that the rest of the population currently receives.

Change has historically come slowly and reluctantly to the healthcare industry, but thanks to widespread demand from the government, payers, and consumers for improvement in coverage and care, it seems to be speeding up.

These five predictions represent a power shift in the world of healthcare, where new players emerge as forces to be reckoned with, and consumers gain greater control over their care. I predict, and hope, that 2015 will be the year when leaders across the healthcare spectrum will welcome innovation and embrace much-needed change.

Connected Digital Health & Life's curator insight, May 24, 2015 3:33 PM

This is the business insight for digital health in the years ahead. Solve business problems and make money! A tad beyond just keeping people well!