Beaumont Hospitals has announced it has formed a nationally designated Children's Hospital, housed within its Royal Oak, MI, flagship facility. Beaumont Children's Hospital, as it is named, offers 36 pediatric subspecialty services, from endocrinology to urology, with more than 200 pediatricians.
Majority Leader Harry Reid indicated he's willing to move sweeping healthcare legislation through the Senate with a procedural maneuver that would block a GOP filibuster. The prospect of the controversial tactic has already ignited Republicans' ire, and key Senate Democratic chairmen have said they don't want to do it.
Chicago-based Rush University Medical Center has landed a $10 million gift from a Lake Forest foundation for an orthopedic joint replacement surgery center at its new hospital. The gift from The Grainger Foundation will help Rush's effort to redevelop the entire medical center complex on Chicago's West Side. That 10-year plan, which began in 2005 and will cost more than $900 million, includes the hospital under construction, a new parking garage, power plant, and emergency center.
Newton-Wellesley Hospital's bid to expand into Framingham, MA, has reignited an old debate: whether a nonprofit facility's services to the community outweigh the loss in property tax dollars. A Newton alderman is urging city officials to compare the value of the hospital's services with the taxes it would pay were it not exempt. Also, a Framingham planning official has told Newton-Wellesley to return with a "grown-up" offer of compensation if it wants to build an outpatient surgical facility in Framingham.
After months of meetings, a diverse collection of healthcare groups plans to issue recommendations March 30 for Congress as it works on legislation revamping the U.S. healthcare system. The proposal is consistent with plans outlined by President Obama and key congressional Democrats, said three people familiar with the report, who spoke on condition of anonymity. But the effort shows just how difficult it will be to overhaul the healthcare system, according to the Wall Street Journal Health Blog.
New York Gov. David A. Paterson and legislative leaders have reached tentative agreements on major cuts to healthcare spending. Lawmakers and healthcare industry officials said the leaders had agreed to freeze the so-called trend factor, the cost-of-living adjustment made to Medicaid reimbursements for nursing homes, hospitals, and home care providers. The freeze, which would be partly retroactive, would save the state about $300 million, according to industry officials.
Jeff Levin-Scherz, MD, assistant professor at Harvard Medical School and Harvard School of Public Health, talks about how health plans can add value in this difficult time.
The $787 billion American Recovery and Reinvestment Act of 2009 pushed healthcare into a new era of personal health information regulation and enforcement—and companies need to deal with these changes now.
As part of the stimulus law, President Barack Obama and Congress infused billions into the country's struggling economy. Not stopping there, they also set aside $19 billion for healthcare information technology and created new HIPAA regulations through the Health Information Technology for Economic and Clinical Health Act (HITECH). Much of what has been written about HITECH has focused on Medicare reimbursement incentives for healthcare providers who use "certified" electronic health records in a "meaningful way."
There is another piece of HITECH that will have a larger impact on health plans and companies working in the managed care arena—changes to the HIPAA law.
Much of the new healthcare security and privacy requirements created through HITECH will go into effect February 18, 2010, one year after Congress passed the stimulus bill. Over the next year, the feds will issue many new regulations in the area of health IT to resolve questions that remain following the legislation's passage, but companies shouldn't wait to get started.
"This has a profound impact on disease management organizations as well as the healthcare industry," says Reece Hirsch, CIPP, partner at Sonnenschein Nath & Rosenthal LLP in San Francisco, who spoke during a members-only DMAA: The Care Continuum Webinar this week.
Here are the five things you need to know as a health plan, disease management, or population health company executive about the HITECH Act:
1. Federal leaders used stimulus as a way to make HIPAA changes
Washington leaders have debated revising HIPAA for the past decade and legislators used the stimulus bill as a way to finally revamp HIPAA's privacy and security provisions.
David C. Kibbe, MD, MBA, principal of the Kibbe Group and senior advisor for the American Academy of Family Physicians, says these changes are an attempt to protect individual health information while also trying to create better, cheaper, and faster technology. It also places patients in greater control of their health information. He says HITECH stops short of a European-type policy that requires any entity that handles personally identifiable health information to comply with the same privacy and security rules, but it does move the U.S. a step closer to that.
"That day is a little nearer as a result of these changes, but I don't think [lawmakers] wanted to take the time to do that and didn't feel it was actually necessary," says Kibbe.
2. HITECH extends privacy and security rules
The new legislation protects patient information from unauthorized acquisition, access, use, or disclosure.
As so-called covered entities, health insurers will need to work with their multiple vendors to make changes to business associate agreements. For instance, health insurers must incorporate the new privacy and security requirements into agreements and remove amendments from contracts that are no longer necessary under HITECH. They may also need to amend "notice of privacy" practices to reflect new patient rights to their health information under HITECH, says Hirsch.
Business associates, such as disease management companies, will need to perform those duties and incorporate changes to comply with the same obligations as covered entities.
3. HITECH imposes breach notification requirements on HIPAA covered entities AND business associates
HITECH requires business associates to comply with the same obligations and face the same potential penalties as covered entities.
This means violations are not merely a problem that will be handled through the business associate agreement, but the feds could take action, too.
Covered entities and business associates will have to notify the proper people/entities within 60 days of discovering security breaches. They will also need to provide detailed information about breaches and what steps individuals should take to protect themselves.
4. HITECH increases enforcement of and penalties for HIPAA violations. Business associates who violate the new regulations will not merely need to deal with covered entities, but may face hefty fines from the feds and states, too.
Critics, including the Office of Inspector General, have charged that Health and Human Services enforcement of HIPAA regulations has been lax. HITECH tackles both the limited enforcement issue and speeding-ticket sized HIPAA fines.
HITECH created a tiered penalty that stretches to as much as $1.5 million for violations. All civil money penalties will go to the Office of Civil Rights to fund future investigations.
HITECH requires HHS to formally investigate any complaint of a HIPAA violation if preliminary investigation shows possible violations. The new law also allows state attorneys general to bring civil actions in federal court on behalf of state residents (and state AGs love to take on large healthcare companies).
"A security breach can be a disastrous event for many organizations because the adverse consequences can be enormous, from class action lawsuits to regulatory action. One of the major components of HITECH is to really create new stringent security breach obligations for HIPAA-covered entities," says Hirsch.
5. Prepare for the changes now
Hirsch says business associates will need to:
Revise business associate agreements to incorporate the new privacy and security requirements and remove amendments from contracts that are no longer necessary under HITECH
Implement written policies and procedures that address each HITECH security rule standard
Create a security awareness and training program for employees
Designate a security official
Conduct a security risk analysis
As part of this process, the business associates will need to track, store, and compile information so there is an audit trail in case of breaches.
"Because the security standards are fairly broad and general, the security risk analysis is key because that's how an organization decides how to prioritize and justify the decision they make in implementing all of these broad and general standards. A formal, thorough security risk analysis is critical to that process," says Hirsch.
While many large business associates already have a comprehensive security compliance program, smaller companies will need to create their own. This may force some companies to decide the added work and regulations are too much. Hirsch suggested smaller business associates, especially those that work in areas beyond healthcare, may bow out of the industry rather than invest the money, time, and manpower to create procedures to follow HITECH regulations.
As the above action points show, managed care companies need to prepare for these changes—and realize that more revisions are coming. HHS will issue clarifications over the next year before HITECH goes into effect next February.
This is an exciting time for healthcare, but with that excitement comes many changes. Instead of waiting to get started, managed care companies should start work on its game plan now.
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With the federal government offering about $36 billion over the next seven years to incentivize healthcare providers to install electronic medical records and other health IT, several strategies are emerging among hospitals grappling with how to undertake the daunting task.
Some hospitals are taking it very slow and waiting to see what guidelines and standards emerge from the federal bureaucracy, waiting to see other providers succeed or fail with EHR, and waiting to see if EHR actually works.
Don't count Parkview Hospital in Wheeler, TX, among the wait-and-see crowd. The 16-bed critical access hospital, located on the gas and oil fields 120 miles east of Amarillo, is in full installation mode for its EHR, an effort that started last year, before the federal reimbursement program for health IT was even on the table.
CEO Ann Fagan-Cook says Parkview was going to have to make the technological leap anyway, because of the much-anticipated government push and the reduction of Medicare/Medicaid reimbursements for providers who don't. So the feeling was they might as well do it now, avoid the rush, and exert more control over the process.
"I don't like to have somebody from the government come along and tell me I should have done these things three years ago and now it's going to cost me more money than ever," Fagan-Cook says. "I like to be on the edge and have it done when they come, they say 'great,' and they don't write any deficiencies, and they go away."
Software is being installed this month, so Parkview can begin to enter medication data on vulnerable patients from nearby nursing homes who frequent the hospital, many of whom take up to 20 medications a day. "If we can get them preloaded before we start using the record fully, that will save a lot of time," Fagan-Cook says.
The plan now is to go EHR live in late August or early September, and Fagan-Cook is already anticipating the benefits. "It will allow our staff more time to do direct patient care instead of shuffling papers or looking for papers from lab and X-ray," Fagan-Cook says. "We are going to start with nursing and integrate the business office first. Then we will go to the pharmacy and X-ray and lab will be last."
Like most hospital administrators, Fagan-Cook is reluctant to talk about the cost of her EHR system. "I'm not supposed to discuss it. I am what is called a project site. So, we give tours and help educate people who haven't made a decision yet about what this system will do," she says. "Part of the contract is that I probably got a better deal than other people."
Fagan-Cook didn't pick the vendor. She created a steering committee of physicians and from among the 80 staff to weed through the sales pitches before selecting an EMR system. Fagan-Cook says giving staff a decisive role in EHR is critical. "It helps when you have steering committees and groups that work on things so it's not just my idea. They have input. They can say yes or no. That changes the culture more than anything," she says.
It takes moxie for a small, remote hospital to aggressively pursue EHR, especially because of the complexity of the technology, the tough economic times, and the high stakes for both success and failure.
If EHR delivers on its promise, it will greatly enhance Parkview ability to delivery quality care and measure success. If it fails, lives may be at stake. God help the EHR vendor who doesn't have an answer when feisty and focused CEOs like Fagan-Cook want explanations for why what they bought hasn't delivered. "I'm in the middle of nowhere," she says. "I don't want to spend my money and be told in a year from now that what I bought isn't going to work."
John Commins is the human resources and community and rural hospitals editor withHealthLeaders Media. He can be reached atjcommins@healthleadersmedia.com.
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At the bottom of a print ad promoting breast cancer awareness and the Clarian West Breast Care and Research Center—a Best in Show 2008 HealthLeaders Media Marketing Awards winner among small hospitals—there is a clue.
It reads: "If you want to get in shape, this is the place to go. Recognize the state bird and you're in the know. Stop by the desk in Avon. Let the hunt begin. The game is now on."
The marketing campaign, called "The Hunt for Pink October," featured a scavenger hunt. The Indianapolis hospital's marketers integrated the game into the advertising in an attempt to have its Breast Care and Research Center marketing stand out in October, a competitive month for breast centers.
"We knew we didn't want to be lost in the sea of pink messaging around Breast Cancer Awareness Month, so it just got our wheels turning on how could we be out there, how could we reinforce some of the messages that we've started to build, how could we participate in educating women and stand out and have a little fun," says Cathy Stoll, director of marketing, communications, and public relations. "We wanted to find a way to engage the community in a different way."
Stoll says the three-year-old hospital worked with local businesses to be the secret locations hinted at in the ads. The first person to the correct spot collected a pink medallion and was eligible to win a prize. Runner-up medallions were also available so that the less speedy participants could still participate in the next round. Based on the number of runner-up medallions given out, Stoll estimates that at least 500 people participated.
"It's been a nice way to make relationships with women in a unique way and make relationships with other businesses in the community in a unique way and generate a little bit of buzz," she says. "I haven't seen people get engaged in a marketing campaign like this in a while."
And after local women participated in the hunt, many of them scheduled mammograms at Clarian West. Before the campaign launched, the breast center performed 290 to 320 mammograms per month. In October 2007, the month the campaign launched, 390 mammograms were performed.
Stoll says the breast center has sustained that number and recently saw an increase in mammograms this fall—even before new marketing was released—when women who participated last year came in for a second screening. In fact, Stoll says Clarian West plans to buy an additional mammography machine and open a second screening suite this spring.
Marianne Aiello is an editor with HealthLeaders Media. Send her Campaign Spotlight ideas at maiello@healthleadersmedia.com If you are a marketer submitting a campaign on behalf of your facility or client, please ensure you have permission before doing so.
