Jessica Davis

Many providers are at a crossroads right now: Either join an accountable care organization or be placed into Medicare’s Merit-Based Incentive Payment System. Set to begin in 2017, MIPS uses value-based modifiers to rank providers by quality and is expected to fold together with meaningful use, essentially merging the current pay-for-performance models under one umbrella. MIPS is part of the Medicare Access & CHIP Reauthorization Act of 2015, or MACRA, which repeals CMS' Medicare Part B Sustainable Growth Rate reimbursement formula and replaces it with a pay-for-performance model. Providers can choose to join an ACO or be part of MIPS. "People are waiting with bated breath for MIPS rules, just like they were for meaningful use," said Tom Lee, CEO and founder of SA Ignite, which develops analytics tools to help providers keep track of complex government programs. "The biggest thing on the horizon is there are a lot of details on this that will come to light when the rules come out." [Also: Behavioral telehealth key for ACO success] "MIPS has higher bonuses, but higher risks," Lee said."Providers don't need to choose a physician group to be a part of the program, but those providers who don't remain on top of the heap lose money.” The rules are due to be finalized by November. Although Acting CMS Administrator Andy Slavitt has hinted draft rules may come out as soon as this spring. When choosing a program, providers must assess the risk and whether they want the guaranteed 5 percent from ACOs or choose MPIS where the value-based swing between the lowest and highest reimbursement could be up to 36 precent when accounting for bonuses, Lee said.   [Also: Mostashari's ACO startup is growing] "ACOs are unproven, and most have been penalized; weigh that against costs to get the ACO up-and-running," Lee said.  The trouble is that many providers are struggling with a lack of resources, which makes it difficult to "poll through the information to meet these requirements," said Darren Barnes, director of quality and performance improvement, Southern Illinois University HealthCare. "In today's world of quality improvement, you not only have to provide quality care, but prove you can deliver," said Barnes. [Like Healthcare IT News on Facebook] Many ambulatory providers in particular are having difficulty transitioning into a quality management system, as "hospital measures are better defined than with multi-specialty ambulatory care organizations," Barnes said. "With data requirements and support, healthcare organizations are being asked to do more with less." Hospitals have a leg up on quality measure improvements, compared with physician practices. Where hospitals can assess workflows and certain measures on a daily basis, that's more challenging for small ambulatory facilities, posing a special challenge for participating in a physician reimbursement program. Moreover, data is hard to pull from the EHRs, said Barnes, and providers will continue to struggle "until we can build these systems to look at patient needs and improve the ability for patients to have access to the data for more personalized care." Twitter: @JessiefDavis

Doctor on Demand has expanded its telemedicine platform to include board-certified psychiatrists, the company announced on Tuesday. In December 2014, Doctor on Demand began offering mental health services with the addition of psychologists to its provider network. Extending the network to include psychiatrists will complete the mental health cycle, from therapy to medicine, officials said. "Mental health is a vital area, where there may be the most need for telemedicine," said Donovan Wong, MD, medical director of behavioral health at Doctor on Demand. [Also: Telehealth's biggest roadblock: physician reimbursement] "There's really a lack of access to care," he said. "Rural areas have the worst access, but even in big cities, like Los Angeles, the wait time is up to five weeks or more for 80 percent of the population. That's really our mission: increasing high quality care. With mental health, that's really what we'd like to do." Doctor on Demand's telemedicine platform connects patients with care providers. It started in 2012, with board-certified physicians, later expanding to offer consults with lactation consultants and psychologists. More than 300 mental health professionals can be found on the network in 27 states, including licensed psychologists and board-certified psychiatrists. The company plans to expand the services nationwide by mid-year. Currently, many patients pay out-of-pocket, but Wong said Doctor on Demand hopes to change that in the near future. The platform has partnered with dozens of employers and health plans, such as United Healthcare, providing 45 million Americans access. Last month, the company announced it signed its 400th corporate customer. “Many Americans don’t have access to mental health treatment, and for those that do, long wait times, distance, cost and stigma are still barriers to getting care.” Wong said in a statement. "These are all challenges telemedicine can address." [Like Healthcare IT News on Facebook] A 2013 National Survey on Drug Use and Health estimated one in five adults aged 18 or older had a mental illness, but only 45 percent of these affected parties received treatment. Furthermore, 55 percent of the nation's 3,100 counties have no practicing mental health workers and the average wait time to see a psychiatrist is two months in some cities and eight months in rural counties. "Too many people don’t know where to turn for mental health care, so they get overpriced care, the wrong care, or no care at all," said Adam Jackson, co-founder and CEO of Doctor on Demand, in a statement. "By adding psychiatrists, we're striving to meet our mission of increasing access to high-quality care.” Twitter: @JessiefDavis

Nebraska Medicine, comprising the University of Nebraska Medical Center, Bellevue Medical Center and UNMC Physicians, will be recognized at the 2016 HIMSS Annual Conference & Exhibition in Las Vegas for achieving Stage 7.

Jeff Brown has been appointed senior vice president and chief information officer of Seattle Children's, the hospital announced today. He has filled the interim CIO position since April 2015. Brown joined Seattle Children's from Lawrence General Hospital in Massachusetts in April 2015. [Also: CIOs target population health, patient engagement in 2016] "We are thrilled Jeff has assumed the permanent role of CIO," said Lisa Brandenburg, president, Seattle Children's. "Jeff brings tremendous experience, and during his time as interim CIO, he has made key improvements within our Information Services Department and will be integral in supporting our next strategic plan with the technical elements necessary to excel in an increasingly competitive healthcare market," she added. While at Lawrence General, Brown served as CIO, focusing on mobile health IT within the integrated health system and accountable care organization. Population health and digital healthcare strategies were also his focus. He previously served in senior management positions in organizations that include Partners HealthCare and Steward Health Care Network. Twitter: @JessiefDavis

ACO quality measures were enhanced by pay-for-performance programs, according to the JAMA network, but providers also need advanced technologies, interventions, and close contact with patients. 

Patricia Mechael has been appointed executive vice president, Personal Connected Health Alliance at HIMSS, effective April 15, HIMSS President and CEO Steve Lieber announced on Thursday. Mechael will serve as consultant for HIMSS until her official appointment. She'll facilitate market analysis, business planning processes and guide immediate term goals. At PCHA, she hopes to advance trends toward self-care technology as a way to address challenges such as chronic illness management and mental health. [Also: The making of an mHealth maven] Mechael most recently served as executive director of the mHealth Alliance and as Principal and Policy Lead for HealthEnabled. She also has collaborated with the mHealth Summit for more than seven years. She has 15 years of experience in field building and thought leadership. At HealthEnabled, she concentrates on global thought leadership and advocacy, research and policy work in Nigeria, South Africa and Uganda, while working with the World Health Organization to create a Global Health Index and State of the World's Digital Health Report. She was recently awarded a Rockefeller Foundation Bellagio Center fellowship for a study entitled, the Future of Health is Digital that highlighted the use of technology to improve patient outcomes and strengthen the health system. Twitter: @JessiefDavis

Despite the record number of major healthcare breaches in just the past year, 74 percent of consumers surveyed by the National Cyber Security Alliance said they trust healthcare providers the most with personal information, according to a study released Thursday to mark Data Privacy Day. The day is an annual international effort launched by the NCSA to create awareness about the importance of securing personal information, both as a consumers and as organizations. This year's theme is "Respecting Privacy, Safeguarding Data and Enabling Trust." [Also: Flint hospital hit with cyber attack] "These are the three legs of the stool for the Internet," said NCSA Executive Director Michael Kaiser. "We believe everyone needs to have respect for the information."  The findings in the TRUSTe/NCSA Consumer Privacy Index show that people have a trust-based relationship with their providers, Kaiser said. "I think the expectation is that when they provide personal information, it's protected." To keep that culture of mutual respect, healthcare providers need to better communicate with patients about how their data is treated, he said. At the same time, providers have to build a culture of privacy within their organization -- one where privacy and security aren't just occasionally mentioned but frequently talked about. After all, healthcare providers are stewards of precious information. [Like Healthcare IT News on Facebook] "The data that healthcare providers have is extremely valuable," said Kaiser. "It's valuable to several different kinds of sources in the cybersecurity arena. We've seen this with some of the insurance breaches, where nation states gathered information of citizens through private data." Kaiser said the best way to protect data is to ask: What data do you have? Where does it go? Who can access it? Where is it? And what are you doing to protect it? Data Privacy Day began in North America in January 2008. It's an extension of Europe's Data Protection Day, which commemorates the 1981 signing of the first legally binding international treaty to deal with privacy and data protection. Twitter: @JessiefDavis

Many accountable care organizations are still struggling to overcome the challenges associated with health information technology integration, patient management and drug selection to improve care outcomes, according to a new study from the Pharmacy Benefit Management Institute.  In fact, fewer than a third of ACO providers use a single electronic health record system while 59 percent are on multiple systems and find it difficult to streamline and integrate them. Remarkably, PBMI found that 23 percent of ACOs still use paper charts. [Also: Behavioral telehealth key for ACO success.] PBMI surveyed 101 ACO providers, who cover over 30 million patients, specifically to analyze current practices in pharmacy management, the use of pharmacists in ACOs, the state of care management and patient engagement, clinical integration and future goals. The study found most ACOs use support tools in their practices: 90 percent utilize quality reporting tools, and 60 percent use point-of-care decision tools. However, only 34 percent of these respondents found these tools easy to use. "ACOs represent a critical and growing part of the solution to help improve value, quality, and care in our nation's healthcare and pharmacy plays an important role in achieving those goals," Jane Lutz, PBMI executive director, said in a statement. [Also: Steward Healthcare: ACO success hinges on IT strength] Almost all ACOs, 93 percent, said managing population health is very or extremely important, while an even greater majority of 98 percent said their focus on population health will increase in the next three to five years. The role of the pharmacist will be front and center, they said. Additionally, more than 60 percent of respondents said the use of biologics and specialty products and they expect genome testing will increase in the next three to five years [Like Healthcare IT News on Facebook] But health IT utilization among ACOs needs to increase for these goals to be feasible, the report said. Additionally, the pharmacist's role needs to be more prominent to support management goals to improve adherence, reduce inappropriate utilization and drug selection for better clinical outcomes. But only 57 percent of the ACO respondents currently employ or contract clinical pharmacists. More than half of the respondents said ACOs can decrease the cost of prescription drug therapy and another 69 percent said ACOs can increase the quality of prescription drug therapy. "Pharmacists are underutilized as trusted advisors to patients, physicians and other providers," according to the report. "Their patient-facing role can be very powerful in education and motivation, providing a potential solution to the lack of patient engagement and commitment to self-care." Twitter: @JessiefDavis

Dell has signed on as an industry collaborator of HIMSS Innovation Center, joining other major health IT players at the 30,000-square-foot testing and exhibition facility in Cleveland.

Intermountain Healthcare is rolling out mobile, cloud-based rounding and audit compliance tools powered by Nashville-based ReadyPoint.