It is well documented how doctors and other medical practitioners have been slow to adopt social media, and there is next to no following available for those that do. A recent poll revealed that only 11% of those interviewed would participate in social network interaction with their doctor if it was offered. Unlike the compliance issues that are holding health plans back, the only thing keeping physicians out of social media is a lack of interest. Many argue, however, that a lack of interest does not create a lack of responsibility. More and more patients are turning to social networks for advice on medical treatment, pharmaceuticals, and diagnoses. As a result, it is the responsibility of medical professionals to ensure that the information they find is accurate and up to date.
Thursday, May 12, 2011
HIPAA Regulations and New Technology: May 2011
It is well documented how doctors and other medical practitioners have been slow to adopt social media, and there is next to no following available for those that do. A recent poll revealed that only 11% of those interviewed would participate in social network interaction with their doctor if it was offered. Unlike the compliance issues that are holding health plans back, the only thing keeping physicians out of social media is a lack of interest. Many argue, however, that a lack of interest does not create a lack of responsibility. More and more patients are turning to social networks for advice on medical treatment, pharmaceuticals, and diagnoses. As a result, it is the responsibility of medical professionals to ensure that the information they find is accurate and up to date.
Friday, April 8, 2011
Census Says Life Expectancy is Up, But Why?
Wednesday, February 23, 2011
Cignet Fined for HIPAA Violation.
“Ensuring that Americans’ health information privacy is protected is vital to our health care system and a priority of this Administration. The U.S. Department of Health and Human Services is serious about enforcing individual rights guaranteed by the HIPAA Privacy Rule,” said HHS Secretary Kathleen Sebelius.
In a Notice of Proposed Determination issued Oct. 20, 2010, OCR found that Cignet violated 41 patients’ rights by denying them access to their medical records when requested between September 2008 and October 2009. These patients individually filed complaints with OCR, initiating investigations of each complaint. The HIPAA Privacy Rule requires that a covered entity provide a patient with a copy of their medical records within 30 (and no later than 60) days of the patient’s request. The CMP for these violations is $1.3 million.
During the investigations, Cignet refused to respond to OCR’s demands to produce the records. Additionally, Cignet failed to cooperate with OCR’s investigations of the complaints and produce the records in response to OCR’s subpoena. OCR filed a petition to enforce its subpoena in United States District Court and obtained a default judgment against Cignet on March 30, 2010. On April 7, 2010, Cignet produced the medical records to OCR, but otherwise made no efforts to resolve the complaints through informal means.
OCR also found that Cignet failed to cooperate with OCR’s investigations on a continuing daily basis from March 17, 2009, to April 7, 2010, and that the failure to cooperate was due to Cignet’s willful neglect to comply with the Privacy Rule. Covered entities are required under law to cooperate with the Department’s investigations. The CMP for these violations is $3 million.
Thursday, March 4, 2010
The Real Debate in D.C. (Part 2)
As a follow-up, let's talk about some of the outcomes. There has been a great deal of coverage on the event with elected officials, but none on the other. So, here is first-hand account on some of the key topics discussed:
Health Reform: The discussions were much like what was happening across town. What are the next steps? Where do we go from here? What should we expect from our regulatory bodies and the current administration? The truth is that much is known and yet unknown at this point. It is expected by most that some type of health reform will be developed this year. However, the size, scale and price tag remain a mystery.
Streamlining Cost and Quality of Care: Cost reductions and the management of costs are at the forefront of all discussions. Being creative is essential, thus newer ways to incent (i.e. work with) providers are emerging, such as payment programs and quality metrics to determine performance within their patient base and to their peers. Most would see this as the old standard capitation methodology with a twist. However, when you delve deeper, you can see the potential cost savings and the new horizon for quality metrics reporting, monitoring and performance.
Health and Wellness of the Membership Base / Moving Health and Wellness to the Next Level: Health and wellness of our membership continues to be a key to any solution worth implementing, and therefore new ways to carve out components of our membership and incent them to actively participate in wellness campaigns is on the horizon more so now than ever before. There are two basic reasons:
- To enhance/improve a members overall quality of life.
- To streamline/enhance cost savings.
Service: This concept continues to be a major separator in the playing field. While price and benefits continue to be the top components, service is a close second. With a competitive price in the market place, service will be the key component that separates plans. Members are looking for "first call resolution" (as opposed to be being transferred multiple times) and a one-stop shop for answers. Those that can perfect (or come closest to) a model in which a single phone number can result in a live body that can handle all their needs will have a leg-up on competitors. The event provided all that attended with an abundance of information, with the added benefit of zero television cameras, so ideas could be shared without 'post-event wrap-up commentary.' The next step is the hardest, though. We need to take these ideas and philosophies back to our respective corners of the world and turn them into solutions.
----------------------------------------------------------------------------------
Wednesday, December 2, 2009
Patient Care: A Healthy Debate
“In 2002, USPSTF concluded that there was fair evidence that mammography screening every 12 to 33 months could significantly reduce breast cancer mortality. The evidence was strongest for women aged 50 to 69 years, with weaker evidence supporting mammography screening for women aged 40 to 49 years.”
“Current knowledge about the development of breast cancer is limited. The effectiveness of screening mammography seen in trials presumably results from the early detection of smaller, earlier-stage tumors, which are more responsive to available treatments. Although the most common breast cancer occurs in the epithelial cells that line the duct system of the gland (ductal carcinoma), the sequence of development of invasive cancer is not entirely known.”
“The USPSTF noted with moderate certainty that the net benefits of screening mammography in women aged 50 to 74 years were at least moderate, and that the greatest benefits were seen in women aged 60 to 69 years. For women aged 40 to 49 years, the USPSTF had moderate certainty that the net benefits were small. Because of the uncertainties related to harms of screening, particularly over diagnosis, and the near total lack of trial data for older women, the USPSTF had low certainty about the net benefits of screening mammography for women 75 years or older.”
Patient care should never be compromised. Given the attention that Health Care reform has generated, any news is viewed good and bad based on the reader and interpretation.
The bottom line is that advancements in technology, research and education, not specific to any issue, or disease, has allowed for greater practicality in administering invasive tests. All progress is positive and debate is healthy.
-------------------------------------------------------------------------------------------
Pam Argeris is a thought leader in the Healthcare Industry and possesses extensive, hands-on experience with CMS compliance, and multiple regulatory bodies such as NCQA, JACHO, and DOI. In her role at Merrill Corp., Pam focuses on developing solutions for compliance and quality assurance, delivered in a cost effective manner to improve beneficiary and prospect communications. You can contact Pam at Pamela.Argeris@merrillcorp.com.
Tuesday, November 17, 2009
Wellness: Measurement Shows Improved Health
While the debate rolls on with the insurers, Zieger goes on to point out that Emory University has been at work to see if the results are there.
According to the study conducted by Woodruff Health Sciences at Emory, measurable results were found in employee absenteeism (down 3.9 days in 2006 to 3.4 days in 2007 - 1.5 days lower than at standard sites).
This netted a savings of about $414.90 per employee per year, according to the study.
Our Take:
Results are found only when measured. Moving from discussion to action is critical for private insurance plans and measurement needs to be implemented by insurers across all types of coverage.
-------------------------------------------------------------------------------------------
Pam Argeris is a thought leader in the Healthcare Industry and possesses extensive, hands-on experience with CMS compliance, and multiple regulatory bodies such as NCQA, JACHO, and DOI. In her role at Merrill Corp., Pam focuses on developing solutions for compliance and quality assurance, delivered in a cost effective manner to improve beneficiary and prospect communications. You can contact Pam at Pamela.Argeris@merrillcorp.com.
Friday, October 2, 2009
Health Care: Forward thinking to reduce costs
Do you know the multi-cultural dynamics of your employees, or your insured base membership?
As an industry looking for all ways to reduce health care costs, an innovative forward thinking approach to is to better understand the multi-cultural dynamics of your members.
Diving deeper into the demographics – categories such as ethnicity, coupled with age, sex, religious affiliation and other characteristics – can guide and aid you in understanding their needs, develop better treatment plans, and implement more effective out reach programs with the ultimate goal of producing better outcomes related to their specific health issues.
Better outcomes with improved quality of care for each cultural sector combined with understanding a groups specific disease issues, behavioral dynamics, and family relations will provide better methods of treating our population in general, thus reducing overall health care costs.
The Multi-cultural dynamics of employees and insured base of membership is an untapped source of analysis that can be applied in reducing overall health care costs.
This is definitely something to think about, ponder and explore.
-------------------------------------------------------------------------------------------------
Pam Argeris is a thought leader in the Healthcare Industry and possesses extensive, hands-on experience with CMS compliance, and multiple regulatory bodies such as NCQA, JACHO, and DOI. In her role at Merrill Corp., Pam focuses on developing solutions for compliance and quality assurance, delivered in a cost effective manner to improve beneficiary and prospect communications. You can contact Pam at Pamela.Argeris@merrillcorp.com.