Health Policy News and Views
Compiled by Benita M. Dodd
Reducing office visits through mobile health: At the end of 2012, there were 2.8 million patients worldwide using a dedicated home health monitoring device with integrated connectivity, according to a report from Research and Markets. The number of these dedicated devices is expected to reach 9.4 million by 2017, according to the report. The number does not include patients using their personal mobile phone, tablet or PC ; that number rose from 0.73 million in 2011 to about 1.03 million in 2012. This remote approach “enables more efficient care delivery, decreased costs and improved sustainability of the health care system,” the report noted. “Widespread use of remote patient monitoring is still years away, but we are moving towards an age where mHealth (mobile health) solutions will become part of standard care pathways. Financial incentives are now coming into place and new mandates are formed that favorably affect the adoption of mHealth solutions.”… Time for Georgia to catch up!
Wait! Georgia is catching up: Cancer patients in Rome, Ga., are getting some new tools to help coordinate their care and access their electronic health records (EHR) information. Funded by a $1.7 million grant from the Office of the National Coordinator, the MyJourney Compass program is operated by the Georgia Department of Community Health and uses tablets and “mHealth” – mobile health – apps to foster collaboration between caregivers, help consumers navigate through the system, and provide feedback to providers about their progress and changes to their health. Source: EHR Intelligence
idea came from critical care physician Joshua Landy, who realized there was a need for an easy-to-use platform for sharing medical images to provide consultation on specific medical cases and for general educational purposes. The app, which was launched in the iTunes store May 28, allows users to take and share clinical images with other users, comment on others’ images and search through a growing image library. It has several safeguards to protect patients. When a user takes a photo including what the app identifies as a face, a gray box is put over the portion of the image containing the face. Native tools within the app also allow users to remove identifying details like tattoos with the swipe of a finger, or crop the photo down to just the area of interest. Source: Becker’s Hospital Review
Cost comparison study: Researchers have begun to recruit participants for a new study to determine whether using mobile health devices can lower health care costs. The Wired for Health study by Scripps Translational Science Institute will investigate whether the integration of wireless technologies, online social networks and medicine can have a direct effect on health care spending. Group participants being recruited have chronic conditions such as diabetes and high blood pressure and have incurred high health care costs over the past year. Half of the group of 200 will get a mobile device to manage their condition and receive other mobile interventions. These participants’ health care costs will then be compared to the control group. Source: Scripps.org
Gloomy outlook for nonprofits: Medicare’s 0.7 percent inpatient prospective payment system rate increase for 2014 isn’t enough to cover expected costs and is a credit negative for nonprofit hospitals, according to a Moody’s Investors Service report. The $1.2 billion pay raise released earlier this month is a negative because it’s lower than last year’s 2.8 percent or $2 billion increase, according to the report. Additionally, the pay boost doesn’t keep pace with hospitals’ costs, which Centers for Medicare and Medicaid Services expects to go up by 2.5 percent in 2014. Medicare pay rate increases have been equivalent to or below the rate of cost growth for several years. Source: Becker’s Hospital Review
Affordable Care Act
Who are you? The Patient Protection and Affordable Care Act is expected to result in 30 million newly insured patients. A new report from PwC paints a portrait of these individuals, who will obtain insurance through Medicaid expansion and newly created health insurance exchanges. For example, their median age is 33 compared with that of the currently insured, 31. This is largely due to children accounting for a smaller portion of the newly insured than the currently insured, according to the report. The newly insured will also have a median income at 166 percent of the federal poverty level, compared with 333 percent for the currently insured. Source: Becker’s Hospital Review
Alternatives Expanding Medicaid under existing inflexible federal regulations would be unwise and irresponsible as a long-term solution for Georgia, but that doesn’t mean there are not more effective alternatives, writes Kelly McCutchen, president of the Georgia Public Policy Foundation, in an op-ed published Aug. 16. Click to read, “Health Care Expansion: “Yes, If” Versus “No, Because.”
How to game the system: A Kaiser Health News report notes that low-income people in states that opt not to expand Medicaid under ObamaCare can still get financial assistance with coverage. Individuals and families can get federal subsidies to cover nearly all of the cost of private insurance coverage by projecting their 2014 income to at least the federal poverty level – $11,500 per person or $23,500 for a family of four – according to the report. The subsidies are available under the law on a sliding scale for those making between the poverty level and four times that level of income. In applying for subsidies, the health insurance exchanges will require more information if a person estimates an income of more than 10 percent higher than shown in electronically available data such as a tax return. If the person applying can’t provide more information such as a pay stub, however, the exchanges will rely on their self-attestation, according to the report. Individuals who lie on a government application for financial assistance face considerable fines. But guess what? Those who “miscalculate” their incomes above the poverty level for 2014 and are later found to make less than the poverty level won’t have to pay back their subsidies.
Quotes of note:
“Keep a watch also upon the faults of the patients, which also make them lie about the taking of things prescribed.” – Hippocrates
“One of the most difficult things to contend with in a hospital is the assumption on the part of the staff that because you have lost your gall bladder you have also lost your mind.” – Jean Kerr
“If you look like your passport photo, you’re too ill to travel.” – Will Kommen
The Foundation’s Criminal Justice Initiative pushed the problems to the forefront, proposed practical solutions, brought in leaders from other states to share examples, and created this nonpartisan opportunity. (At the signing of the 2012 Criminal Justice Reform bill.)