Ingenix will collaborate with the Wisconsin Health Information Organization (WHIO) to create a statewide repository of health claims data in Wisconsin. WHIO will report on the quality of care, measured against evidence-based treatment guidelines enabling Wisconsin healthcare provider groups to benchmark their results against their peers. This initiative hopes to provide insight for employers and consumers on the value of healthcare services in the state.
Novo Innovations will provide electronic electronic information exchange software to Southwest Washington Medical Center (SWMC) of Vancouver, WA. Electronic delivery of laboratory results and transcribed reports through the Novo system are the first functionalities offered by SWMC. The hospital intends to expand the range of information it can exchange electronically to include radiology reports and lab orders.
An increasing number of Americans are opting to travel to other countries to save money on various medical procedures. Many have traveled to Mexico for healthcare services, although according to a recent report, medical travel to that country has been on the decline.
Aetna is providing physicians with electronic notices about patients' healthcare, such as warnings about potential drug-to-drug or drug-to-disease interactions. "Care Considerations" will now be sent through Aetna's secure provider website via NaviNet, Aetna has announced. Last year, more than 1.6 million Care Considerations were sent by phone, fax or mail to physicians who provided care for Aetna members. Care Considerations alert physicians to opportunities for improved care when care appears to have deviated from evidence-based medical best-practice standards, according to an Aetna release.
In radiology, automated worklist tools help ensure that the right study gets to the right radiologist in the least amount of time. However, most worklists lack the capability to filter exam interpretation assignments on the basis of insurance reimbursement.
Now a team of physicians from Staten Island University Hospital in New York has addressed the deficiency by developing a worklist tool that assigns studies based on a patient's insurance and a radiologist's credentialing status.
The American Medical Association's new policy on medical travel puts the rights of patients ahead of American physician protectionism. That's good news for global hospitals, payers, employers, medical travel companies, and most of all patients.
I spoke last week with J. James Rohack, MD, a cardiologist from Bryan, TX, and the new president-elect of the AMA. He says some members were concerned that employers and insurers were forcing patients into medical tourism. In fact, according to a report on the association's Web site, the New York delegation last year called on the AMA to "seek legislation to prevent insurance companies from incentivizing subscribers in this country to have to go overseas for medical treatment that could be provided locally."
With a healthy dose of common sense, the AMA didn't buy the rhetoric of medical protectionism and instead adopted a policy that respects the patient's right to choose a healthcare provider, whether it's down the block or in Bangkok.
"One of the excuses [protectionists] are using is that insurers are forcing patients to go overseas, which is an absolute lie," says Jonathan Edelheit, president of the Medical Tourism Association. Most insurers that offer patients incentives for medical travel are not drastically changing plan designs; they're simply waiving deductibles and coinsurance and then paying for travel expenses, he adds.
The irony is that the protectionists are the ones attempting to limit choice and force patients to pay the higher price for U.S. healthcare. Even if an employer or insurer offers a patient a financial incentive beyond waiving coinsurance and deductibles, it wouldn't amount to forced medical travel.
Rohack points out that the policy is meant to educate patients about things like the risks associated with traveling with a medical condition, legal rights abroad, and how to identify qualified healthcare providers. In addition, the AMA says follow-up care should be coordinated prior to travel. These are measures any right-thinking healthcare provider would want patients to take before they commit to medical travel.
Not long ago, I wrote that American providers need to get over the fact that healthcare globalization is here and decide whether medical travel is an opportunity to collaborate or a threat that they must compete against. Pushing for legislation against this emerging movement is just a wasted effort. The AMA correctly diagnosed this, but the next step remains.
If Americans continue to seek high-value healthcare from global destination hospitals, as many industry analysts predict, how can providers from across nations create incentives that promote cooperation in the best interest of these patients?
Note: You can sign up to receive HealthLeaders Media Global, a free weekly e-newsletter that provides strategic information on the business of healthcare management from around the globe.