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How bill awaiting congressional OK achieves Medicare savings

How bill awaiting congressional OK achieves Medicare savings | Healthcare and Technology news |

Details of how the bipartisan bill rewriting Medicare reimbursement of doctors, awaiting congressional approval this month, would squeeze savings from the health care program for the elderly:


Current law: Most people pay $105 monthly for medical coverage, which is 25 percent of the program's cost. The prescription drug premium varies widely, according to plan and region.

People earning at least $85,000 annually pay higher premiums, which grow as income increases. Top-earning individuals making more than $214,000 pay 80 percent of the program's costs, or $336 monthly for medical coverage. The income thresholds double for couples.

Medicare legislation: Starting in 2018, some top earners would pay higher premiums, starting with people making over $133,500. The highest 80 percent bracket would start for people earning over $160,000.


Current law: Income levels that trigger higher premiums have been frozen since 2011. In 2020, they are scheduled to increase by an amount equaling all the inflation that will have occurred between 2011 and 2020.

Medicare legislation: Unchanged except in 2020, the income levels will grow by the inflation that occurs only in 2019. This means the thresholds would be lower than otherwise and more people will breach them and owe larger premiums.


Current law: People can purchase policies that insure virtually all costs not covered by Medicare.

Medicare legislation: Starting with people buying new policies in 2020, coverage would be limited to costs above Medicare's deductible for medical costs, which is currently $147 monthly but could be higher by then.

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Supreme Court Rules that Providers Cannot Sue States Over Medicaid Payment

Supreme Court Rules that Providers Cannot Sue States Over Medicaid Payment | Healthcare and Technology news |

On Tuesday morning, March 31, the U.S. Supreme Court ruled in Armstrong et al v. Exceptional Child Center, Inc., et al, that private healthcare providers cannot sue states over low Medicaid reimbursement rates, in a 5-4 ruling, reversing a lower court’s ruling. Providers had argued that suing over low rates is sometimes the only way to enforce federal payment requirements.  But their opponents asserted that a ruling in favor of providers could lead to unending litigation that would slow the system.

The Supreme Court took up the case after Idaho residential providers for disabled patients sued state officials over that state’s failure to implement higher reimbursement rates, after the Idaho Legislature failed to sufficiently fund such reimbursement. A federal district court ruled that Idaho’s rates did not align with requirements in federal law requiring adequate reimbursement, and the distrct court was upheld by the 9th U.S. Circuit Court of Appeals.

A report in the online news service NewsMax reported that  “State officials recommended increases in reimbursement rates in the late 2000s but they were never implemented because the Idaho legislature declined to appropriate funds, according to court papers.Writing on behalf of the majority,” the NewsMax report said, “Justice Antonin Scalia said that the providers have no right to sue the state under the so-called Supremacy Clause of the U.S. Constitution, which holds that federal law generally trumps state law. The clause ‘instructs courts what to do when state and federal law clash, but is silent regarding who may enforce federal laws in court,’ Scalia wrote.”

The report further said that “Scalia noted that the providers have another option: they can ask the federal government to intervene on their behalf. In a dissenting opinion, Justice Sonia Sotomayor said there was nothing in the Medicaid law to suggest that Congress intended to prevent private lawsuits.”

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House Republican Budget Overhauls Medicare and Repeals the Health Law

House Republican Budget Overhauls Medicare and Repeals the Health Law | Healthcare and Technology news |

House Republicans on Tuesday will unveil a proposed budget for 2016 that partly privatizes Medicare, turns Medicaid into block grants to the states, repeals the Affordable Care Act and reaches balance in 10 years, challenging Republicans in Congress to make good on their promises to deeply cut federal spending.

The House proposal leans heavily on the policy prescriptions that Representative Paul D. Ryan of Wisconsin outlined when he was budget chairman, according to senior House Republican aides and members of Congress who were not authorized to speak in advance of the official release.

With the Senate now also in Republican hands, this year’s proposal is more politically salient than in years past, especially for Republican senators facing re-election in Democratic or swing states like Pennsylvania, Wisconsin, Illinois and New Hampshire, and for potential Republican presidential candidates.

Mr. Ryan’s successor, Representative Tom Price, Republican of Georgia, promised on Monday “a plan to get Washington’s fiscal house in order, promote a healthy economy, protect our nation and save and strengthen vital programs like Medicare.”

Democrats — and those Republicans who support robust military spending — will not see Mr. Price’s “Balanced Budget for a Stronger America” in those terms. Opponents plan to hammer Republican priorities this week, as the House and Senate budget committees officially begin drafting their plans on Wednesday, and then try to pass them through their chambers this month.

On Monday, President Obama tried to get ahead of the debate by criticizing Republican plans to abide by strict domestic and military spending caps.

“I can tell you that if the budget maintains sequester-level funding, then we would actually be spending less on pre-K to 12th grade in America’s schools in terms of federal support than we were back in 2000,” the president said in a speech to the Council of the Great City Schools. “The notion that we would be going backward instead of forwards in how we’re devoting resources to educating our kids makes absolutely no sense.”

But Republican aides said they have weathered those attacks ever since Mr. Ryan released his first budget plan in 2011. They said the easiest way to prevail in the House, at least, is to put forward the budget plan most House members have voted on multiple times.

“We’ve had House people vote on these four years in a row. We’ve held on to our majority and even expanded it,” said Representative Tom Cole, Republican of Oklahoma and a Budget Committee member. “The idea you’re going to lose an election on this is more political theater than political reality.”

Congressional budgets do not have the force of law and are largely advisory documents, but they represent the broadest statement of governing philosophy each year and set overall spending levels for the coming fiscal year. And in coming months, this one may contain language easing passage of taxation and entitlement legislation.
Continue reading the main story

Under congressional rules, a budget cannot be filibustered in the Senate, so Republicans would bear most of the responsibility if they failed to pass one.

House Budget Committee members previewed their plans in an unusual, campaign-style video on Monday. The plan envisions a remaking of the federal government. Future recipients of Medicare would be offered voucherlike “premium support” to pay for private insurance rather than government-provided health care.

Spending on Medicaid would be cut substantially over 10 years, with the money turned into block grants to state governments, which in turn would have much more flexibility in deciding how it is allocated.

The budget “repeals all of Obamacare,” Representative Diane Black, Republican of Tennessee, said the same day the Obama administration announced that the law had provided coverage to 16.4 million previously uninsured people.

To placate advocates of the military who say strict budget caps are hurting national defense, the House budget adds “emergency” war spending through the “overseas contingency operations” account, which does not count against the spending limits.

The budget will also include language that orders members of the tax-writing Ways and Means Committee to draft a “fairer, simpler tax code,” said Representative Todd Rokita, Republican of Indiana.

And it will include parliamentary language — called “reconciliation” — aimed at allowing legislation to repeal the Affordable Care Act to pass the Senate with a simple majority. If that bill is passed, it will still be subject to a presidential veto.

Conservative groups insist Republicans must keep their promise and repeal the Affordable Care Act.

“Republicans owe their majorities to their unwavering opposition to Obamacare, a reality that must be reflected in the budget,” declared Heritage Action, the political arm of the conservative Heritage Foundation. “A throwaway line that the budget ‘repeals Obamacare in its entirety’ is not enough.”

House Republicans conceded on Monday that the Senate was not likely to propose such extensive cuts. Even before the Senate plan is unveiled, deep rifts are appearing. Senator John McCain of Arizona, chairman of the Senate Armed Services Committee, reiterated his demand on Monday that any budget raise military spending well above the statutory caps. And he said he would not accept an approach that raised spending through the war-fighting emergency account or by shifting money from already squeezed domestic programs.

Last year, Mr. Ryan called “emergency spending” increases “a backdoor loophole that undermines the integrity of the budget process.”

Republican leaders worry that the Republican senators making moves to run for president — Ted Cruz of Texas, Rand Paul of Kentucky, Marco Rubio of Florida and Lindsey Graham of South Carolina — will never find a budget to their liking. At the same time, Republican senators from Democratic states, such as Mark S. Kirk of Illinois, will be hard-pressed to agree to the House’s conservative vision.

In 2013, when the Senate was presented an amendment to prohibit replacing Medicare’s guaranteed benefits “with the House passed budget plan to turn Medicare into a voucher program,” 96 senators agreed. Only three, Mr. Cruz, Mr. Paul and Senator Mike Lee, Republican of Utah, supported the House’s vision.

“Historically, the Senate has been less willing to take on the tough issues, and the early sounds are they’re not going to do a Ryan-type Medicare-Medicaid plan,” Mr. Cole said. “They face a very difficult election atmosphere next year.”

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Is Healthcare Spending About To Accelerate?

Is Healthcare Spending About To Accelerate? | Healthcare and Technology news |

Bend a resilient object and it will spring back with a vengeance once released from your grip. Is that what is about to happen to healthcare spending?

For years now, experts have been debating ways to “bend the cost curve ” – take the sharp rise in healthcare costs, picture a rapidly ascending line on a XY axis, and slow it down, bend it so it moves horizontally to the X axis.

In the last few years, we seem to have bent the curve as we’ve hoped to. Healthcare spending is growing more slowly than it has in decades. The federal government recently reported that: “The Congressional Budget Office now estimates that Federal spending on Medicare and Medicaid in 2020 will be $188 billion below what it projected as recently as August 2010.”

But this good economic news may soon come to an end, and the pent-up energy of the healthcare economy could snap back and break our budgets if we are not vigilant.

Experts are still debating why healthcare costs have slowed down of late. Some people think the Affordable Care Act, aka Obamacare, has helped to bend the cost curve. Some posit that the rise of high deductible health insurance plans accounts for a good deal of the savings.  But almost everyone agrees that the great recession of 2008 has played a leading role in reducing the growth of healthcare expenditures. When people don’t have money to spend on healthcare, they (surprise, surprise) spend less money on healthcare.

In a New England Journal of Medicine article, Charles Roehrig from the Altarum Institute mapped out what healthcare spending would have looked like if the great recession hadn’t happened, and what it would have looked like if healthcare spending had dropped in accordance with the size and depth of the recession. The picture shows that actual spending lies right between these two extremes:

The recession reduced healthcare spending. But not as much as you would think, because other factors are driving costs up, such as raising healthcare prices and the aging of our population.

Moreover, Roehrig warns that when we experience a stronger economic recovery, healthcare spending could rebound. Thanks to the ACA, more people have health insurance, and health insurance is well-known to increase the demand for healthcare services.

Pharmaceutical companies continue to bring out expensive “specialty drugs,” which Roehrig believes on their own could contribute a half percentage point per year to healthcare expenditures.

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Medicare bill helps doctors and kids, but deficit foes cool

Medicare bill helps doctors and kids, but deficit foes cool | Healthcare and Technology news |

Republicans say bipartisan legislation reworking how Medicare pays doctors is a milestone toward curbing the huge, growing benefit program.

It's "the first real entitlement reform in decades," says House Speaker John Boehner, R-Ohio, using Washington jargon for programs that automatically pay people who qualify.

Many deficit foes are less impressed.

A look at the debate over how significantly the legislation, which is nearing congressional approval, would bolster Medicare's finances:



Nothing a few trillion bucks wouldn't fix. The program, which helps pay medical bills for more than 50 million elderly people, is expected to spend more than $600 billion this year. That's one-sixth of the entire federal budget. The nonpartisan Congressional Budget Office expects that price tag to nearly double by 2025 as more baby boomers retire.



The budget office says the Medicare legislation would cost $214 billion over the coming decade. The House approved it overwhelmingly March 26, and Senate passage seems likely this month.

Besides helping physicians, the bill finances health care for children and low-income people. Most of its cost is for replacing a law that has threatened repeated, steep reductions in physician reimbursements for treating Medicare patients. Doctors say such cuts, which Congress usually prevents, could make them stop seeing Medicare recipients.

Most costs over the next decade - $141 billion - would be financed by making federal deficits even larger. To pay for around half the rest, federal payments would be reduced to hospitals, home health care companies and other providers.

The bill would also squeeze $35 billion from beneficiaries.

Most - $34 billion - would come from raising monthly premiums for medical care and prescription drugs for top-earning Medicare recipients beginning in 2018, and making additional higher-income recipients pay larger premiums starting in 2020.

An additional $1 billion would come from requiring people buying Medigap insurance, which covers costs Medicare doesn't pay, to incur out-of-pocket expenses before Medigap coverage begins. This would start for people buying new policies in 2020. Currently, some Medigap policies protect purchasers from virtually any out-of-pocket costs.

It's these beneficiary changes Republicans are crowing about.



To a degree, yes.

They modestly curbed Medicare without raising taxes, which Democrats normally demand in exchange for squeezing benefit programs.

There's true savings because the more Medicare recipients pay in premiums, the less the program needs government money. And making Medigap policy holders pay more for their own care should encourage them to watch their medical spending, easing some Medicare expenses.

Republicans say the initial $35 billion in savings would escalate the second decade from now as the number of Medicare recipients and medical costs grow.

They cite an estimate by Douglas Holtz-Eakin, a Republican-appointed former Congressional Budget Office director, that those changes would reduce Medicare spending by $230 billion from 2026 through 2035. This helped win votes for the bill from House conservatives unhappy over its projected deficit increases between now and 2025.



Critics say saving $35 billion over a decade pales compared to the nearly $9 trillion Medicare is expected to spend over that period. That's a saving of about one-third of 1 percent.

They say President Barack Obama, House Republicans and the 2010 bipartisan commission headed by former Democratic White House chief of staff Erskine Bowles and former Sen. Alan Simpson, R-Wyo., have all proposed more robust plans for bolstering Medicare than what's in the bill.

"These are wimpy forms of important policies," said Maya MacGuineas, president of the bipartisan Committee for a Responsible Federal Budget.

The critics say Holtz-Eakins' estimate covered only potential savings during the decade he examined, not the Medicare bill's net expenditures. They note that the budget office, Holtz-Eakin's old employer, warned of "considerable uncertainty" over such long-range predictions and said the bill might save or cost money two decades from now, with small savings in the middle of their estimate range.



That's debatable.

Under President George W. Bush, Congress increased Medicare medical premiums for higher-earning recipients for the first time, as part of the 2003 law creating the program's prescription drug coverage. The higher premiums started in 2007, and around 5 percent of recipients pay them today.

Obama's 2010 health care law required upper-income people to pay higher prescription drug premiums, too.

That law also froze the income levels above which people pay higher premiums through 2019, instead of increasing those thresholds annually with inflation. This meant more people owed the bigger premiums each year as their incomes grew.

Republicans don't consider those savings true reform because they came packaged with new, expensive benefit programs - Medicare's prescription drug coverage and Obama's health care overhaul.

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Crossing the Threshold Into a New Healthcare Policy Era

Jeff Smith, vice president of public policy at the Ann Arbor, Mich.-based College of Healthcare Information Management Executives (CHIME), is helping the healthcare IT executive leaders’ national association to make major waves on Capitol Hill and at federal agencies these days. The Washington, D.C.-based Smith sees the present moment as a time of great opportunity for CHIME and other healthcare professional associations to have a real impact on federal policymakers in Congress, the administration, and federal agencies, as healthcare IT becomes ever more critical to healthcare system reform efforts.

Last week, Smith sat down with HCI Editor-in-Chief Mark Hagland at the CHIME Washington, D.C. offices, to converse about some of the policy and political currents that CHIME and the other healthcare professional associations are working through these days. Below are excerpts from their interview.

When you look at the legislative and regulatory landscape in Washington, D.C. right now, how would you characterize that landscape overall?

To use a maturity analogy, over the past five years, we’ve gained enough experience with health IT policy to know that there are areas for improvement [with regard to policy development]. And I think when you look at the legislative and regulatory landscape, you see a lot of people in Congress and in the federal agencies who want to help. And when multiple parties want to help, multiple parties have different solutions. So for those of us who work in health IT policy, the real challenge is understanding which policies will jibe together, and which will be detrimental. So whether you’re talking about the Ellmers bill that would shorten the meaningful use reporting period to 90 days [the Flexibility in Health IT Reporting Act of 2015, or “Flex-IT Act,” introduced in mid-January by Rep. Renee Ellmers (R-N.C.)], or the SOFTWARE [Sensible Oversight for Technology which Advances Regulatory Efficiency] Act, which would essentially prohibit the FDA [Food and Drug Administration] from regulating health IT in the same way that agency regulates medical devices; what you see is people trying to be helpful.

The challenge for us is trying to figure out which bills are going to be helpful, which bills are going to be a complement to what the federal agencies are doing, and which bills are going to be the opposite. Health IT is now very much on the policy radar in the last year and a half. And for the most part, that’s a very positive development, because it means that people are paying attention; but it also means they could mess things up. So it’s a very busy space, a very active time for health IT policymaking.

Do you think there’s a level of understanding now on the Hill regarding what’s actually going on in the healthcare industry?

Yes, I would say that the degree of understanding on the Hill is actually higher than it was five years ago. But there’s a constant turnover of members and staffers; so there’s always going to be a need to educate, and to help to flatten the learning curve.

What are the biggest issues for you right now as an association, with regard to policy initiatives on the Hill?

In comparison to other years, the SOFTWARE Act, trans-industry cybersecurity legislation that might affect healthcare as one of other industries, as well as other pieces of legislation, are all out there and in play on the Hill. Meanwhile, meaningful use is still a very big deal for us. We are trying to make that program sustainable, trying to figure out if there is a gap between what the federal agencies want to do with meaningful use, and what’s going to make it most pragmatic for those who have to implement it.

So right now, that’s where there’s a lot of focus for us. And having the Stage 3 rule proposed now will help, as we’ll be able to see where the federal agencies are at mentally; so we can go back and see where they’re on track and where they need help. I would be surprised if there were additional pieces of legislation coming out this year relative to meaningful use, depending on how the industry internalize the proposed rules, and depending on how HHS [the Department of Health and Human Services] articulates final rules, you could see legislation being devised. But a lot of it goes back to macro-dynamics. And by that, I mean is, are more than 50 percent of physicians being successful with meaningful use? I think if that number gets closer to 75 percent, policymakers will be put more at ease. If hospital participation remains at the level it is now, they’ll be OK. But if Stage 3 is seen as a problem, then we’ll have to figure out what to do.

Tell me more about CHIME’s initiative around the national patient identifier issue?

With regard to our efforts around the concept of a national patient identifier, essentially, CHIME, through a host of partner organizations, decided that we needed to take steps in the private sector to really raise the profile of the safety and cost implications of misidentification. And we were lucky enough to have a well-timed meeting with Peter Diamandis, CEO of the XPrize Foundation. And essentially, we were able to convince him that accurate patient identification is a national imperative. We do not currently have the cultural, political, social, cultural, or technical climate to achieve 100-percent accuracy on patient identification through legislation or regulation; but we believe that it is time that the private sector take bold steps in this area.

We’re still very much in the scoping phase, and are looking at a relatively length process; this is not going to happen in the next few months. But we’re hoping that after we scope out the criteria and open up the challenge to anybody and everybody who think they have the solution, we can develop something that sits in the public trust, is not a for-profit or proprietary solution, but which will lead to positive identification, and is scalable across the industry. And we’ve already got some buy-in from some vendors and other organizations. We’ve got some important players on board. You’ll be hearing a lot more about it in the coming weeks.

What’s different about this is it’s not going to e a governmental solution. We think there’s plenty of opportunity for a non-governmental actor to be the honest broker. We think there’s a lot of room for a non-profit organization to come in to be the organization that could be that honest broker and broker solutions. And honestly, Russ [CHIME president and CEO Russell P. Branzell] is much closer to this than I am, but he and others have had conversations with some of the folks who have pushed back on this in the past, and they’re not pushing back on this idea; they want to make sure it’s private and that it’s secure. There will always be a contingent of tinfoil-hat people. But we’re hoping that if we can get the commonsensical people and even some people who haven’t been that commonsensical, to partner with us, those on the fringe will remain on the fringe, and those 25 people who are crazy and loud will stay on the fringe, and we’ll say, OK, we acknowledge you’re out of 300 million people.

What should CIOs be thinking now, with regard to the current waves of healthcare policy trends, and what could happen in the next few years?

In their minds, they should be dispelling any rumor that things are ever going to be the way they used to be. We’ve crossed the threshold into a new era where the government is involved in health IT, and healthcare IT leaders need to know that we have to start acting like partners to healthcare policy leaders in Washington.


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What Do Women Know About Obamacare That Men Don’t?

What Do Women Know About Obamacare That Men Don’t? | Healthcare and Technology news |

For the second year running, more women than men have signed up for coverage in health insurance marketplaces during open enrollment under the Affordable Care Act. According to the Department of Health and Human Services, enrollment ran 56 percent female, 44 percent male, during last year’s open enrollment season; preliminary data from this year shows enrollment at 55 percent female, 45 percent male – a 10 percentage point difference.

What gives? An HHS spokeswoman says the department can’t explain most of the differential. Females make up about 51 percent of the U.S. population, but there is no real evidence that, prior to ACA implementation, they were disproportionately more likely to be uninsured than men – and in fact, some evidence indicates that they were less likely to be uninsured than males .

What is clear that many women were highly motivated to obtain coverage under the health reform law – most likely because they want it, and need it.

It’s widely accepted that women tend to be highly concerned about health and health care; they use more of it than men, in part due to reproductive services, and make 80 percent of health care decisions for their families . The early evidence also suggests that women who obtained coverage during open enrollment season last year actively used it.  According to Inovalon, a company that tracks and analyzes data for health plans and providers, people who used the coverage they bought through the marketplaces last year tended to be older, sicker, and more female than the general commercially insured population. As of June 2014, 41 percent of females who purchased coverage through exchanges had face-to-face visits with health care professionals, versus 32 percent of males.

Those numbers are consistent with the notion that many women who signed up for coverage under the ACA had preexisting conditions or other health issues that led them to seek treatment.  In some cases, their pre-ACA insurance may have excluded those conditions, or the preexisting conditions may have prevented them from obtaining coverage at all.

What’s more, as HHS points out in a recent report, there are plenty of benefits in the ACA’s qualified health plans that are especially attractive to women. These include coverage at no out of pocket cost for many preventive measures, such as mammograms or screening for gestational diabetes.  An estimated 48.5 million are benefitting from that provision of the law alone.

Other data support the notion that many U.S. women are in disproportionately higher medical need, relative to men – even adjusting for the fact that they typically live longer.  According to an analysis of Medical Expenditure Panel Survey data from the Agency for Healthcare Research and Quality, women constitute nearly 60 percent of people in the top tenth of medical expenditures in 2011 and 2012.  Most of those in the top tenth of spending are either ages 45 to 64, or 65 and older.

One obvious conclusion is that many, and perhaps most, of those who’ve benefited from coverage under the Affordable Care Act are female – and especially women in middle age and beyond. Another is that, if the Supreme Court rules in King v. Burwell that subsidized coverage can’t be obtained through the federal marketplace, women will be disproportionately harmed.

A case in point: Rosemary Forrest, 63, who lives in Augusta, Georgia.  Laid off from her job at a university science lab at age 55, she spent five years unemployed and without health insurance.   She now works as a contractor to a small nonprofit agency; battling painful osteoporosis, she sometimes earns less than $400 a month.  Last year, when the federal health insurance marketplace went live, she signed up for coverage.  This year, she re-enrolled, and after federal tax credits, pays $86 per month in premiums.

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How Big Data Will Transform Our Economy And Our Lives In 2015

How Big Data Will Transform Our Economy And Our Lives In 2015 | Healthcare and Technology news |

The great Danish physicist Niels Bohr once observed that “prediction is very difficult, especially if it’s about the future.” Particularly in the ever-changing world of technology, today’s bold prediction is liable to prove tomorrow’s historical artifact. But thinking ahead about wide-ranging technology and market trends is a useful exercise for those of us engaged in the business of partnering with entrepreneurs and executives that are building the next great company.

Moreover, let’s face it: gazing into the crystal ball is a time-honored, end-of-year parlor game. And it’s fun.

So in the spirit of the season, I have identified five big data themes to watch in 2015. As a marketing term or industry description, big data is so omnipresent these days that it doesn’t mean much. But it is pretty clear that we are at a tipping point. The global scale of the Internet, the ubiquity of mobile devices, the ever-declining costs of cloud computing and storage, and an increasingly networked physical word create an explosion of data unlike anything we’ve seen before.

The creation of all of this data isn’t as interesting as the possible uses of it. I think 2015 may well be the year we start to see the true potential (and real risks) of how big data can transform our economy and our lives.

Big Data Terrorism

The recent Sony hacking case is notable because it appears to potentially be the first state-sponsored act of cyber-terrorism where a company has been successfully threatened under the glare of the national media. I’ll leave it to the pundits to argue whether Sony’s decision to postpone releasing an inane farce was prudent or cowardly. What’s interesting is that the cyber terrorists caused real fear to Sony by publicly releasing internal enterprise data — including salaries, email conversations and information about actual movies.

Every Fortune 2000 management team is now thinking: Is my data safe? What could happen if my company’s data is made public and how could my data be used against me? And of course, security software companies are investing in big data analytics to help companies better protect against future attacks.

Big Data Becomes a Civil Liberties Issue

Data-driven decision tools are not only the domain of businesses but are now helping Americans make better decisions about the school, doctor or employer that is best for them. Similarly, companies are using data-driven software to find and hire the best employees or choose which customers to focus on.

But what happens when algorithms encroach on people’s privacy, their lifestyle choices and their health, and get used to make decisions based on their race, gender or age — even inadvertently? Our schools, companies and public institutions all have rules about privacy, fairness and anti-discrimination, with government enforcement as the backstop. Will privacy and consumer protection keep up with the fast-moving world of big data’s reach, especially as people become more aware of the potential encroachment on their privacy and civil liberties?

Open Government Data

Expect the government to continue to make government data more “liquid” and useful – and for companies to put the data to creative use. The public sector is an important source of data that private companies use in their products and services.

Take Climate Corporation, for instance. Open access to weather data powers the company’s insurance products and Internet software, which helps farmers manage risk and optimize their fields. Or take Zillow as another example. The successful real estate media site uses federal and local government data, including satellite photography, tax assessment data and economic statistics to  provide potential buyers a more dynamic and informed view of the housing market.

Personalized Medicine

Even as we engage in a vibrant discussion about the need for personal privacy, “big data” pushes the boundaries of what is possible in health care. Whether we label it “precision medicine” or “personalized medicine,” these two aligned trends — the digitization of the health care system and the introduction of wearable devices — are quietly revolutionizing health and wellness.

In the not-too-distant future, doctors will be able to create customized drugs and treatments tailored for your genome, your activity level, and your actual health. After all, how the average patient reacts to a particular treatment regime generically isn’t that relevant; I want the single best course of treatment (and outcome) for me.

Health IT is already a booming space for investment, but clinical decisions are still mostly based on guidelines, not on hard data. Big data analytics has the potential to disrupt the way we practice health care and change the way we think about our wellness.

Digital Learning, Everywhere

With over $1.2 trillion spent annually on public K-12 and higher education, and with student performance failing to meet the expectations of policy makers, educators and employers are still debating how to fix American education. Some reformers hope to apply market-based models, with an emphasis on testing, accountability and performance; others hope to elevate the teaching profession and trigger a renewed investment in schools and resources.

Both sides recognize that digital learning, inside and outside the classroom, is an unavoidable trend. From Massive Open Online Courses (MOOCs) to adaptive learning technologies that personalize the delivery of instructional material to the individual student, educational technology thrives on data. From names that you grew up with (McGraw Hill, Houghton Mifflin, Pearson) to some you didn’t (Cengage, Amplify), companies are making bold investments in digital products that do more than just push content online; they’re touting products that fundamentally change how and when students learn and how instructors evaluate individual student progress and aid their development. Expect more from this sector in 2015.

Now that we’ve moved past mere adoption to implementation and utilization, 2015 will undoubtedly be big data’s break-out year.

Irina Donciu's curator insight, 15 January 2015, 09:33

The great Danish physicist Niels Bohr once observed that “prediction is very difficult, especially if it's about the future.”

Maryruth Hicks's curator insight, 8 September 2015, 16:27

Digital learning and big data in education might lead to educational reform!