Friday, July 01, 2016


As we head into the second summer holiday weekend, we can look back at CMS's busy week:

  • Today CMS finalized a rule allowing the agency to sell Medicare data to qualified entites in an effort to improve health care quality. CMS has approved 15 qualified entities. Modern Healthcare explains that 

four of the 15 have nationwide reach. They include two for-profit companies, Amino, a startup based in San Francisco and funded by venture capital and OptumLabs, a collaborative led by Optum, the health information technology, data mining and analytics arm of health insurance giant UnitedHealth Group based in Minnetonka, Minn. 
Also serving the entire nation is the Health Care Cost Institute, a not-for-profit that is funded in part by for-profit insurers UnitedHealth Group and Aetna, as well as not-for-profit giant Kaiser Permanente. The other national organization is FairHealth, a not-for-profit insurance claims data miner  . . . .

  • Yesterday, CMS's Medicare Innovation Center launched its Oncology Care Model which engages oncologists and healthcare payers in an experiment with episodic payments for cancer care. Becker's Hospital Review provides nine interesting details about the effort here.
  • Also yesterday, CMS updated its Open Payments Program database with 2015 data.  "The Open Payments program (sometimes called the “Sunshine Act”) requires that transfers of value by manufacturers of drugs, devices, biologicals, and medical supplies that are paid to physicians and teaching hospitals will be published on a public website." There certainly is a lot of money circulating in the health care industry.  Fierce Healthcare has more details here
The Leapfrog Group reports that 80% of U.S. hospitals have adopted the organization's never events policy. Under the organization's policy, a hospital that encounter a never event, e.g., operating on the wrong body part,  will apologize, report to an outside agency, conduct a root cause assessment, waive charges, and make its policy available. Leapfrog seems to assume that if the hospital has not adopted Leapfrog's policy then it has no valid policy. The FEHBlog finds that to be a stretch. 

Finally another Becker's Hospital Review report discusses a recent nationwide survey on prices for childbirth in 30 major cities. The FEHBlog realizes tha health care is local but these survey results make no sense.  

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