It’s Getting Hot in Here: Sunshine Act Reporting Trends, Enforcement, and Best Practices
On July 20, Abraham Gitterman of Arnold & Porter LLP joined Mark Linver and Paul Silver of Huron Life Sciences to discuss Sunshine Act updates and the technical, regulatory, and legal challenges associated with the posting of information by CMS on the Open Payments website in June 2015. As the government continues to push for transparency in many areas covering federal healthcare programs, increased attention and scrutiny may be given to Open Payments information by federal and state authorities, institutional employers, and private plaintiffs. In addition to the Civil Monetary Penalties that companies may face for non...
Source: Policy and Medicine - August 3, 2015 Category: American Health Authors: Thomas Sullivan Source Type: blogs
A State-Based Strategy For Expanding Primary Care Residency
As the health care system looks to improve overall health and reduce unnecessary spending, primary care physicians become increasingly critical. The Affordable Care Act (ACA) recognizes that primary care clinicians have the potential to “bend the cost curve” through care coordination and preventive health care for our increasingly diverse and aging population. However, there aren’t enough primary care physicians to meet this need — especially in rural or poor urban areas. Current estimates predict that by 2035, our country will face a shortage of more than 44,000 primary care physicians.
As in many other states...
Source: Health Affairs Blog - July 31, 2015 Category: Health Management Authors: Arthur Kaufman and Charlie Alfero Tags: Costs and Spending Featured Health Professionals Hospitals Medicaid and CHIP Organization and Delivery Public Health Quality Arthur Kaufman Charlie Alfero Federally Qualified Health Center GME New Mexico primary care shortage Source Type: blogs
Rise of the Machines
By SHIRIE LENG, MD
“We are convinced the machine can do better than human anesthesiologists.”
This statement was made by a doctor. Not only a doctor but an anesthesiologist. Not just an anesthesiologist but a pediatric anesthesiologist. Not just any old pediatric anesthesiologist but one in charge of pediatric anesthesia research at the University of British Columbia medical school in Vancouver.
One can only assume that this guy has a pretty low estimation of what his colleagues can do. Must make for great break room conversation.
The doctor making this statement, one JM Ansermino, is co-creator of a new automated ...
Source: The Health Care Blog - July 31, 2015 Category: Consumer Health News Authors: suchandan roy Tags: THCB Shirie Leng Source Type: blogs
The Overhyping of the July Effect and What to Do About It
By HEMANT SINDHU, MD
Filing into the auditorium, scanning the room hoping to spot a familiar face, there is a generalized sense of anxiety. Today is orientation, a day that marks the beginning of a new chapter in the lives of these bright-eyed young doctors, but also evokes an old story.
Every year around this time, there is a rash of news coverage and discussion about the “July Effect,” a term used to characterize the increased risk of medical errors as interns begin their residency training and the demands on their supervising residents and attendings increase.
While I believe the July Effect is overhyped (an...
Source: The Health Care Blog - July 28, 2015 Category: Consumer Health News Authors: suchandan roy Tags: THCB Hemant Sindhu July Effect Patient Safety Source Type: blogs
Analyzing the deficit of African-Americans in academic medicine
The number of African-American physicians in academic medicine is dismal, and this leads to an abundance of problems. Academic hospitals (teaching hospitals associated with universities) generally do not have a proportionate representation of underrepresented minority faculty as compared to the surrounding population. According to a U.S. News & World Report article, the number of African-American faculty increased by 0.2 percent in ten years from the year 2000 to 2010; yet, the growth of this group in the general population was 30 percent. This fact has been duly noted and highlighted as a discrepancy that deserves a...
Source: Kevin, M.D. - Medical Weblog - July 25, 2015 Category: Journals (General) Authors: Dr. Mary Tags: Education Medical school Source Type: blogs
Open Payments: CMS Clarifies Continuing Medical Education FAQs, Confirms CME Funding Must Meet the Definition of "Indirect Payment" To Be Reportable
On Friday, the Centers for Medicare and Medicaid Services (CMS) announced they had updated the Law and Policy page on the Open Payments website with information about the revised reporting requirements for continuing medical education. CMS also announced three FAQs for CME reporting. This information isn't necessarily "new" as CMS revised this page several months ago to correct what many felt was a misinterpretation of the Sunshine Act Final Rule regarding CME payments. This was, however, the agency's first announcement about the revision.
Under the Physician Payments Sunshine Act, pharmaceutical...
Source: Policy and Medicine - July 20, 2015 Category: American Health Authors: Thomas Sullivan Source Type: blogs
New Open Payments FAQs Shed Some Light on Year 2 Data
The Centers of Medicare and Medicaid Services (CMS) recently added several new entries to its Frequently Asked Questions (FAQs). Most of the questions relate to the new round of data that the agency published on June 30. CMS addresses the payment records and the status of disputed records among other topics, and promises “in the coming month…to present another new, very detailed search interface that will translate the large datasets into more detailed visualizations."
"NEW" How is “de-identified” 2013 data being treated?
2013 data published last year included a set of “de-identified” records which removed pa...
Source: Policy and Medicine - July 17, 2015 Category: American Health Authors: Thomas Sullivan Source Type: blogs
Open Payments 2014 Data Highlights
The 2014 Open Payments database covers 11.41 million transactions between manufacturers and covered recipients (physicians and teaching hospitals), totaling $6.49 billion. With such an immense amount of data, it can be hard to make meaningful analysis of the information. Open Payments Analytics has put together a very interesting list of insights from their dive into the database. While there are many takeaways from the data, here are three aspects that grabbed our attention:
(1) 49% of the physicians in the database received less than $100 total. Per the Sunshine Act, de minimis transfers of value are ex...
Source: Policy and Medicine - July 14, 2015 Category: American Health Authors: Thomas Sullivan Source Type: blogs
Here We Go Again: Open Payments Round 2, and Planning For Disclosure, by Seth Whitelaw
Seth Whitelaw is President and CEO of Whitelaw Compliance Group, LLC.
On the first of July, the Centers for Medicare and Medicaid Services (CMS) published the second round of Open Payments data, revealing the various transfers of value made from life sciences manufacturers to physicians and teaching hospitals in 2014.
As the initial analyses by Open Payments Analytics, Policy and Medicine, and Modern Healthcare reveal, there appear to be few surprises in the data. For example, more than 75 % of the payments were for less than $100.00, with more than half being for less than $20.00. This is hardl...
Source: Policy and Medicine - July 10, 2015 Category: American Health Authors: Thomas Sullivan Source Type: blogs
Newly Minted Doctors Begin Their First Jobs In July: Should You Be Afraid?
Today’s post first ran on Better Health on July 4.
The short answer, in my opinion, is yes.
The long answer is slightly more nuanced. As it turns out, studies suggest that one’s relative risk of death is increased in teaching hospitals by about 4-12% in July. That likely represents a small, but significant uptick in avoidable errors. It has been very difficult to quantify and document error rates related to inexperience. Intuitively we all know that professionals get better at what they do with time and practice… but how bad are doctors when they start out? Probably not equally so… and just as time is the bes...
Source: Disruptive Women in Health Care - July 9, 2015 Category: Consumer Health News Authors: dw at disruptivewomen.net Tags: Choice Consumer Health Care Health Professions Patients' Rights Source Type: blogs
HIT Newser: CMS & AMA Agree to be Odd ICD-10 Bedfellows
By MICHELLE RONAN NOTEBOOM
CMS agrees to first-year flexibility in ICD-10 claims processing
CMS releases guidance that will allow for flexibility in the claims auditing and quality reporting process for the new ICD-10 codeset. CMS will keep the October 1 deadline for the transition, but adopt four AMA-proposed steps that include: an agreement that claims lacking specificity will not be denied; an easing of quality reporting and other penalties due to improper coding; an agreement to authorize advance payments to physicians if contractors are unable to process claims; and, the addition of an ICD-10 Ombudman to navigate tran...
Source: The Health Care Blog - July 7, 2015 Category: Consumer Health News Authors: michelle Tags: THCB Source Type: blogs
What Are Reporters Writing About Open Payments 2014 Data?
Last week, the Centers for Medicare and Medicaid Services (CMS) released the second year of Open Payments data, detailing the transfers of value made from pharmaceutical and device manufacturers to physicians and teaching hospitals in 2014. While the data release did not garner quite as much attention as in 2013, articles this year did focus on the improved CMS data compared to last year and the top line totals—industry payments were $6.5 billion, with research ($3.23 billion) and royalties ($803 million) as the top payment types (See NY Times, Washington Post, Reuters, and Wall Street...
Source: Policy and Medicine - July 7, 2015 Category: American Health Authors: Thomas Sullivan Source Type: blogs
Newly Minted Doctors Begin Their First Jobs In July: Should You Be Afraid?
Photo By Danny Kim
The short answer, in my opinion, is yes.
The long answer is slightly more nuanced. As it turns out, studies suggest that one’s relative risk of death is increased in teaching hospitals by about 4-12% in July. That likely represents a small, but significant uptick in avoidable errors. It has been very difficult to quantify and document error rates related to inexperience. Intuitively we all know that professionals get better at what they do with time and practice… but how bad are doctors when they start out? Probably not equally so… and just as time is the best teacher, it is also the ...
Source: Better Health - July 4, 2015 Category: American Health Authors: Dr. Val Jones Tags: Research True Stories Communications Culture Of Carefulness Don't Get Sick In July Handoffs Interns Medical Errors Mistakes Sign out The July Effect Source Type: blogs
Inside the Open Payments Data: Two-Thirds of Transactions Worth $20 or Less; Research and Royalties Account for Majority of Total Value
Yesterday, the Centers for Medicare and Medicaid Services published the second year of Open Payments data, detailing the transfers of value made from pharmaceutical and device manufacturers to physicians and teaching hospitals in 2014. The top line total has received most of the headlines—“docs get $6.5 billion from drug and device companies.” Here, with data courtesy of Open Payments Analytics, we break down some of those payments in detail, with more to follow in subsequent articles.
Small Payments Fill the General Database:
Overall, there were 11.41 million records published, covering 607,000 physicians and ...
Source: Policy and Medicine - July 2, 2015 Category: American Health Authors: Thomas Sullivan Source Type: blogs
Physician Payments Sunshine Act: CMS posts 2014 Open Payments Data Totaling $6.49 Billion
The Centers for Medicare & Medicaid Services (CMS) today published 2014 Open Payments data about transfers of value by drug and medical device makers to health care providers. The data includes information about 11.4 million financial transactions attributed to over 600,000 physicians and more than 1,100 teaching hospitals, totaling $6.49 billion. This is compared to 4.3 million records attributed to 470,000 physicians and 1,019 teaching hospitals covering $3.43 billion dollars, according to CMS’s summary data.
Like last year, the datasets are available in three separate spreadsheets—general payme...
Source: Policy and Medicine - June 30, 2015 Category: American Health Authors: Thomas Sullivan Source Type: blogs
