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Those Sinking Medicare Margins

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Payment shifts and regulatory mandates are putting hospital Medicare margins on a downhill slope. Hospital executives say the chasm between the two has widened in recent years due to a number of factors: federal mandates to deploy expensive health information technology systems under the meaningful use program, a 2% across-the-board cut to provider Medicare payments under the Budget Control Act of 2011, reductions in Medicare disproportionate-share hospital payments and the move to alternative-payment models. Layoffs and reductions in services have been common coping mechanisms to avoid the income drop

While expanded coverage is a net positive, hospital leaders still complain that the government payment programs do not cover costs. For Medicare, hospitals received 88 cents for every dollar spent caring for beneficiaries in 2015 and 90 cents for Medicaid patients, according to the American Hospital Association. Combined underpayments from the government programs were $57.8 billion in 2015. This includes a shortfall of $41.6 billion for Medicare and $16.2 billion for Medicaid, the association reported.

Attempts to move Medicare from a fee-for-service system to a value-based model pose perhaps the most serious challenge to hospitals and health systems struggling with low Medicare margins.

In 2015, the Obama administration announced it wanted 30% of payments for traditional Medicare benefits to be tied to alternative-payment models such as accountable care organizations by the end of last year and 50% by the end of 2018.

The first goal was met, but since the Trump administration took over in January, CMS officials have been coy about their own goals for the shift beyond noting they want the move to be voluntary.

Overall, hospital leaders believe they are getting mixed messages from the Trump administration over whether it still supports the move away from fee-for service Medicare, given that it has canceled or scaled back several new pay models created under the Obama administration.

medicare margins take a dive

There are things Congress can do to stabilize and lessen the financial pressures hospitals now face. The Medicare recovery audit contractor program could be overhauled. Under the program, private companies audit the medical records of hospitals and doctors to find instances of improper billing or erroneous payment from the government.

Hospital executives argue that claims are often mistakenly flagged as being improper in some way. Of the claims that have completed the appeals process, 62% were overturned in favor of the provider, according to the AHA. The association found that 43% of all hospitals reported spending more than $10,000 managing the RAC process during the third quarter of 2016, 24% spent more than $25,000 and 4% spent over $100,000.

Despite those concerns, the program has scored big for the federal government. RACs have recouped $8 billion in improper payments since its inception in 2009, according to the CMS.

The other recurring request from hospitals is that Congress preserve the individual mandate in the Affordable Care Act. A proposal to repeal the mandate is included in the Senate version of tax reform legislation.

 

 

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Hackensack Meridian Health Invests $25M in Tech Incubator

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New Jersey-based Hackensack Meridian Health has teamed up with the New Jersey Innovation Institute (NJIT) to open a health incubator with a design similar to the reality show ”Shark Tank,” in which companies pitch healthcare innovation ideas to a panel of experts. The incubator, Agile Strategies Lab, is the first of its kind for healthcare advances in New Jersey, according to officials. The lab, located on the New Jersey Institute of Technology (NJIT) campus in Newark, is designed to help create and launch the next wave of problem-solving in healthcare through better devices, improved technology and more efficient services to provide a higher quality of care, lower costs, and an enhanced patient experience, officials said in an announcement.

Hackensack Meridian Health has committed $25 million, a new revenue stream to help companies develop trailblazing products and services. This seed money will help launch ideas to the point where they can become viable and receive financing through venture capitalists. And the organization’s vast network—13 hospitals in seven counties, and more than 100 outpatient centers and 6,000 physicians—will look to serve as a vehicle to test some of the innovations once they are advanced enough as determined by a panel of experts from multiple disciplines.

The new Thing In Mental Healthcare

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Dr Jeffrey Lieberman from Columbia University says” the new technologic innovation that is emerging and which does seem likely to impact psychiatry and mental health care in a time that is commensurate with the other specialties of medicine, is the technology that informs how we use Internet-based smartphone mobile app devices. The rudimentary ways in which this has already begun to permeate medicine and mental health care include electronic health records and telemedicine, which is ideally suited to psychiatry in terms of being able to provide consultation at a distance.“The initial idea is to have smartphone-based applications that can perform several functions. One is a monitoring function: having apps that can passively monitor the activities or biologic signals of an individual—whether it is movement, heart rate, respiratory rate, or level of activity—and have an ongoing record that can be catalogued, observed, and interpreted by clinicians. A second function is as a means of communication. Doctors already have begun to employ FaceTime, Skype, and texting to maintain contact with patients remotely in a variety of situations. Another area would be to develop apps that could provide some kind of actual therapeutic assistance, including cognitive-behavioral therapy, motivational interviewing, and supportive types of techniques or protocols when needed. All of these have great potential and can expand the reach of healthcare providers, psychiatrists, and mental health care clinicians, and provide help to a larger proportion of people when they need it.”

LightStrike Germ-Zapping Robot Can Eliminated Hospital Germs

 

Hospitals around the world are constantly for new and innovative ways to battle deadly pathogens and kill multidrug resistant organisms that can cause hospital-acquired infections (HAI).

Saint Peter’s University Hospital has implemented a LightStrike Germ-Zapping Robot that emits waves of ultraviolet (UV) light to destroy hard-to-kill bugs in hard-to-clean places.

Their goal is to prevent infection & provide a clean, safe environment for their patients,  families and employees. The latest technology provides an added level of protection in combating HAI’s caused by pathogens such as Clostridium difficile and Staphylococcus aureus.

The Xenex robot is a new technology that uses pulsed xenon, a high-intensity UV light that penetrates the cell walls of microorganisms, including bacteria, viruses, mold, fungus and spores. Their DNA is fused, rendering them unable to reproduce or mutate, effectively killing them on surfaces without contact or chemicals.

The system is effective against even the most dangerous pathogens, including Clostridium difficile (C. diff), norovirus, influenza, Ebola and methicillin-resistant Staphylococcus aureus, better known as MRSA. Over 400 hospitals, Veterans Affairs and Department of Defense facilities in the U.S., Canada, Africa, Japan and Europe are using Xenex robots, which are also in use in skilled nursing facilities, ambulatory surgery centers, and long-term acute-care facilities.

The Future Of Healthcare & What They’re Saying

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By 2019, 3D printing is expected to be a crucial tool in up to 35 per cent of surgeries.

In 2021, artificial intelligence (AI) is due to assist doctors in treating patients.

AI ‘chatbots’ are expected to outperform humans at some surgical procedures in 2030.

And in 2035, our senses will be able to be upgraded with implants that detect X-rays.

In the future, patients will still need specialists with expert knowledge but the difference is that advanced AI systems will assist healthcare practitioners by providing clinical and medical solutions; sometimes eliminating the need to see a doctor at all.

 

The Future Of Healthcare & It’s Tranformation

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The pressure to ensure accessibility, affordability, quality and sustainability, while leveraging technology in healthcare, will be on in the coming year.

As healthcare moves into the future, the quest for quality and affordability continues to be the key driver for transformation.Traditional healthcare is often said to be more “disease-care” than “healthcare”, with healthcare systems focusing on caring for the sick, expanding and improving infrastructure, and figuring out long-term financing for healthcare in an aging population. Increasingly, both medical science as well as consumers are recognizing that prevention is better than cure, especially for chronic diseases.

There has also been a overabundance of health and wellness apps – from nutrition apps to fitness trackers monitored by wearable sensors – that support this shift.Such technology not only monitors and offers insights on a person’s physiological status, but also recommends nearby healthy eateries and food selections, fitness-related events as well as exercise facilities.

This places personal health and preventative care rightfully back into the individual’s hands, shifting the outcome towards a more active and healthier community.

Health care’s resistance to transform is likely bolstered by concerns about patient data privacy, a dependence on highly specialized skills, professional ethics and a traditional emphasis on the human touch in the practice of medicine.

In Singapore, all hospitals have gone digital to a large extent, and the Government is encouraging nursing homes and GP (general practitioner) clinics across the island to follow suit.

With an Electronic Medical Record system, real-time Integrated Health Information Systems and an automated inpatient pharmacy already implemented, the next step for hospitals will be widespread tele­health services for discharged patients and the elderly in the community.

Robotics customized for the healing environment can improve patient care while relieving manpower shortages, and provide a better working environment.With everything including life-support systems hyper-connected in the Internet of Things (Io T) , cyber security will become of utmost importance.

In order to adapt to societal needs, modern healthcare professionals need to be well-educated in the management of technological capabilities and deliver patient-centric solutions.

Cameras Turned Into Health Monitors

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