Consumer Power Report #503
Boston-based PatientPing has developed a new application that helps doctors monitor their patients’ activities at other health care facilities, an innovation some are saying could help lower costs and improve patient care. PatientPing notifies a patient’s primary care physician when he or she has been admitted to a hospital, emergency room, or nursing care facility that is part of the national PatientPing network. It also allows doctors to see when patients are discharged, helping them formulate effective care plans after a hospital stay.
PatientPing is currently being used in six states, and a recent agreement between the State of Vermont and PatientPing will, for the first time anywhere in the United States, make the program available across an entire state under a new pilot program. The pilot program is being funded by federal and state monies through the end of 2016, with providers covering 30 percent of the costs. The Associated Press (AP) reports after the pilot program ends – at the start of 2017 – providers will have to pay 100 percent of the costs, which are expected to range from $100 for small providers to $10,000 for very large health care systems. Every hospital in Vermont will be equipped with PatientPing under the agreement, but individual primary care facilities will not be required to join the network.
AP reports about $900,000 in federal money will be used over the life of the pilot program.
Health care providers have long spoken and written about the need for a better information-sharing system for their patients. Under the traditional health care model, primary care doctors have no way of knowing when their patients are admitted to a hospital or discharged from one, making it difficult for the health care system as a whole to provide quality care.
Currently, doctors are forced to rely on their patients informing them of important changes to their health. That “system” all too often leads to medical mistakes, missed diagnoses, and poor follow-up care once a patient leaves a hospital. Apps such as PatientPing would help resolve this problem, improving care and preventing the development of more complicated medical ailments. According to a report by the Boston Herald, “The U.S. government estimates avoidable re-admissions cost more than $17 billion in Medicare expenditures” each year.
While there are many benefits associated with using health-care-related apps, some could open the door to potential security threats for patients and health care providers. Hackers and identity thieves may be able to use these apps to steal patient information or infect health care providers’ information technology (IT) systems, an issue that has become increasingly problematic in recent years.
At the end of March, health care hackers took over parts of the IT system belonging to MedStar Health, one of the largest health care providers in the Washington, DC area. According to The Washington Post, MedStar operates 10 hospitals and 250 outpatient facilities, and its system employs more than 30,000 people.
Once hackers successfully took over the system, they made updating or adding patient records impossible, temporarily halted e-mail services, and made some computers unusable. The hackers demanded MedStar pay 45 bitcoins, about $19,000, as a ransom, and they threatened to make health care records “impossible to recover” if they weren’t paid within 10 days.
These kinds of attacks on medical facilities raise serious questions about the wisdom of centralizing medical data. A safer long-term solution may be for patients to carry medical information with them on a small, highly secure drive, which could be contained in something as small as a credit card or a key chain. The benefits of this system are fewer than the potential benefits offered by network apps, but data would be much more secure.
This is not to say all health care apps should be avoided. Because PatientPing alerts “only include admission information,” according to the Boston Herald, privacy breaches shouldn’t be a problem. PatientPing simply alerts doctors so they can better communicate with one another and share what could end up being life-saving information.
If PatientPing is successful in Vermont, it could be implemented in states across the country, a development that could save lives and billions of dollars.
— Justin Haskins
IN THIS ISSUE:
OKLAHOMA BECOMES THE FIRST ‘RIGHT TO CARE’ STATE
On Tuesday, April 12, Oklahoma Governor Mary Fallin signed SB 1148 into law and freed every Oklahoma physician from the ABMS MOC. …
“Nothing in the Oklahoma Allopathic Medical and Surgical Licensure and Supervision Act shall be construed as to require a physician to secure a Maintenance of Certification (MOC) as a condition of licensure, reimbursement, employment or admitting privileges at a hospital in this state. For the purposes of this subsection, “Maintenance of Certification (MOC)” shall mean a continuing education program measuring core competencies in the practice of medicine and surgery and approved by a nationally recognized accrediting organization.”
Wow. Even more jaw-dropping is that this landmark legislation passed through the Oklahoma house and senate unanimously. In a time when gridlock is a given, MOC is something that unites us all. The funny thing is, this law shouldn’t be revolutionary. It simply legislates exactly what ABMS says about board certification: that it is voluntary. ABMS has long claimed “board certification is a voluntary process, and one that is very different from medical licensure.” But for those of us on the ground, it’s very clear that it is NOT voluntary. We can quickly lose our jobs, our hospital privilidges [sic], and our insurance participation if we choose not to participate in any portion of MOC.
Oklahoma simply called their bluff, and now all physicians in Oklahoma are free to choose if they want to participate in ABMS MOC, if they want to certify through alternative boards like NBPAS, or if they just want to be done with the whole lot. They are free.
SOURCE: Docs4PatientCare Foundation
HEALTH CARE COALITION TARGETS PHARMACEUTICAL INDUSTRY WITH DRUG-PRICING PLAN
A national healthcare alliance aimed at reducing drug costs is rolling out a dozen proposals that it hopes will provide the framework for a major debate in Congress over the next year.
The Campaign for Sustainable Drug Pricing, which includes AARP, Wal-Mart, doctor groups and health plan groups, unveiled 12 policy proposals on Monday – nearly all targeting drugmakers.
At the top of the group’s agenda is transparency. The campaign wants drugmakers to give access to large swaths of data, from their national pricing to the “true” research and development costs for each drug.
It’s a frequently cited idea within the healthcare industry but one that remains controversial with drug manufacturers. Companies argue the data are key to retaining an edge in an already competitive market.
New requirements for drug companies to disclose data have gained traction on the campaign trail, with Democratic presidential candidates Hillary Clinton and Sen. Bernie Sanders (I-Vt.) vowing to shed light on drugmakers’ costs and profits.
“Voters are looking for solutions for this,” John Rother, the campaign’s executive director, said during a briefing on Monday. “We need more information about the costs of treatments and how the price is decided.”
Under the Campaign for Sustainable Drug Pricing plan, drugmakers would be required to disclose how much they spent to make their products and how much patients will pay. They would also have to disclose how much federal money went into each product, such as if they used grants from the National Institutes of Health.
Companies would also be required to report more clinical trial data, changing a system that members argue currently deters generic drugs from entering the market.
The campaign wants to make generic drugs more available by speeding up their approval. It calls for more resources – specifically, funding and staff – to help the Food and Drug Administration clear its massive backlog of drug applications.
Noticeably absent from the campaign’s member list are drugmakers.
SOURCE: By Sarah Ferris, The Hill
FLORIDA GOV. SCOTT SIGNS CONSUMER HEALTH CARE PRICING TRANSPARENCY BILL
Gov. Rick Scott recently signed legislation intended to ensure Florida health care consumers will have access to clear and accurate pricing information online at a website.
House Bill 1175, sponsored by state Sen. Rob Bradley, R-Fleming Island, and state Rep. Chris Sprowls, R-Palm Harbor, takes effect July 1. It is designed to create greater transparency about health care costs.
“It’s a great day for consumers in Florida. This law will empower consumers with access to real, usable information about cost and quality before they make health care decisions,” Bradley said.
The legislation creates a website enabling people to get a price projection for an episode of treatment from a hospital or ambulatory surgery center. The law also includes a provision giving consumers the right to get a written price estimate from hospitals, surgery centers, doctors and medical equipment providers within seven days.
“For the first time, consumers will be able to collect, view and compare information about the price and quality of health care,” Bradley said. “This will empower the patient to become a consumer which I believe will also drive quality in health care.”
SOURCE: By Teresa Stepzinski, The Florida Times-Union
ONE OF ARIZONA’S LARGEST HEALTH CARE INSURERS PLANS TO EXIT OBAMACARE MARKETPLACE
The nation’s largest health-care insurer, UnitedHealthcare, will exit the Affordable Care Act marketplace in Arizona next year, a move that will reduce or eliminate options for consumers to buy subsidized plans in more than half of the state’s counties.
Blue Cross Blue Shield of Arizona also said it will evaluate “all options,” including discontinuing marketplace plans, in some counties for coverage that begins Jan. 1, 2017.
UnitedHealthcare and Blue Cross Blue Shield are the only health-care insurers that sold marketplace plans in every Arizona county this year. If Blue Cross Blue Shield also drops marketplace plans in some rural counties, it could leave consumers in those counties without a way to get subsidized health-care insurance.
UnitedHealthcare said Tuesday that it will quit marketplaces in all but a “handful of states.” While the insurer did not specify in which states it will remain, the insurer told the Arizona Department of Insurance in a letter Tuesday that it won’t sell individual plans to Arizonans next year.
Blue Cross Blue Shield, meanwhile, said it lost $185 million on individual plans in 2014 and 2015, the first two years of the marketplace, as new enrollees racked up expensive claims and some consumers hopped in and out of coverage.