Patient advocates, payers, industry and academic stakeholders gathered at the Massachusetts Institute of Technology to map out a strategy for designing and piloting innovative financing and reimbursement models for promising, and possibly curative, new medicines. The project, Financing and Reimbursement of Cures in the US (FoCUS) will initially target three urgent medical areas - Curative Gene Therapies, Durable Oncology Treatments and Antibiotics for Multi-Drug Resistant Infections.
The Center for Health Care Strategies produced a brief looking at how multi-stakeholder groups are using a new model - Accountable Communities for Health (ACH) - to achieve the goals of a Triple Aim. ACHs bring together partners from health, social service, and other sectors to improve population health and clinical-community linkages within a geographic area.
One of the dilemmas Medicaid managed care plans find themselves in when they are trying to integrate physical and behavioral health care, is that due to confidentiality and consent laws, a physician can't disclose that a patient is on an anti-psychotic without getting all the required permissions, speakers said at a meeting on Medicare, Medicaid, and Dual Eligibles sponsored by America's Health Insurance Plans. Getting primary care physicians comfortable with mental health diagnoses is another barrier to integra
As ACOs continue to progress, they are seeking to expand population health management capabilities, including their relationships with community organizations and patients, according to research from Premier. The report, with support from the Robert Wood Johnson Foundation, found
Former Maryland health Secretary Dr. Joshua M. Sharfstein will oversee an initiative at the Johns Hopkins Bloomberg School of Public Health aimed at solving issues such as addiction, adolescent health, environmental challenges and violence. The Bloomberg Health Initiative is being launched with a $300-million gift from Michael Bloomberg, the former New York governor and Hopkins graduate. Michelle L. Spencer, director of the Prevention & Health Promotion Administration at the Maryland Department of Health and Mental Hygiene, will be deputy director of the initiative.
David Chou, VP and chief information and digital officer at Children's Mercy Kansas City, believes health care CIOs can help their organizations remain competitive following the implementation of MACRA's Merit-Based Incentive Payment System (MIPS). Chou says CIOs should also coordinate with physician leaders in sponsoring trainings on the EHR workflow process. He outlines three strategies to remain competitive under MACRA:
The University of New Mexico Health System is partnering with Genesis HealthCare to create clinical programs to improve care access and reduce hospital readmissions among nursing facility residents. The clinical programs will take place in the Albuquerque area, where Genesis operates 10 facilities, and other parts of the state to address issues that arise during transitions of care between hospitals and long-term care facilities.
A report in JAMA Pediatrics found children's hospitals lose more money than other facilities treating children covered by Medicaid. It also found they may be under pressure in 2018 when federal payments compensating for this loss are lowered. According to the study, Medicaid often pays less than actual hospital costs for services, adding hospitals lost $14.4 billion in 2014 from Medicaid underpayment.
The task force Gov. Charlie Baker formed to tackle the state's opioid problem is reassembling for the first time in 15 months to confront hepatitis C. The meeting of Baker's opioid working group is intended to address "new areas of focus," including the rise in hepatitis C cases, which went unaddressed in the group's initial report but experts say is largely tied to the heroin scourge, according to Marylou Sudders, the state's HHS secretary.
Changing Medicaid into a program with per-capita spending caps would require consideration of what benefits would be covered, how the money would be allocated and how states would be held accountable for spending the funds, according to a GAO report, which identified four areas of key policy considerations:
CMS finalized a rule to bolster emergency preparedness of certain providers participating in Medicare and Medicaid. The emergency preparedness requirements aim to increase patient safety during emergencies and establish a more coordinated response to natural and man-made disasters. Some providers and suppliers will be required to plan for disasters and coordinate with federal, state tribal, regional, and local emergency preparedness systems by meeting four best practice standards:
The Greater Buffalo United Accountable Care Organization is the first ACO in New York State to serve Medicaid and commercial insurance patients. The roughly 320 primary care physicians and specialists in the organization handle about 65,000 patients. The first commercial insurer to join the local organization is YourCare Health Plan, the regional, not-for-profit health plan that serves Western New Yorkers who are eligible for government-sponsored coverage.
Two UMass Amherst researchers received a three-year, $425,000 grant from the National Science Foundation to study cancer that has metastasized into bones from other organs in the body. The research team from the department of mechanical and industrial engineering will focus on breast cancer since approximately three in four patients with advanced breast cancer develop incurable bone metastases. Their goal is to define the functional relationship between mechanical signals and bone metastatic cell function.
Inmates in Delaware who leave prison in poor health can have trouble getting immediate access to health care when released, but Christiana Care Health System has an idea for how to solve that problem. Following the model of six states, Christiana Care is looking at establishing a transitions care clinic - a clinic that would provide primary care to patients who were previously in jail. Christiana Care is seeking ways to make sure those leaving prison keep seeing doctors, and it has a $28-million grant sponsored by the National Institutes of Health and others to help them.
Massachusetts' state government rolled out a new version of its prescription monitoring program, which will be easier for doctors to use and will allow data sharing between states. Gov. Charlie Baker also announced a new partnership among the state's teaching programs for nurses and physician assistants and with community health centers to teach medical practitioners about safe prescribing strategies for prescription drugs. The new prescription monitoring program is a revamped version of an old program, with easier-to-use technology.