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Editor’s Note: Payers stay informed with information security trends to protect their patients’ data. Click HERE to learn how BHM’s investments into cyber-security protect your data.

It can be difficult to effectively document sensitive health information of pediatric patients and older adults whose family members have access to their patient portals without violating the patient’s privacy, according to a viewpoint article in AAP News and Journals.

The article, written by Hannah Galvin, MD, a member of the American Academy of Pediatrics Council on Clinical Information Technology, states that the inability to hide a patient’s sensitive health information in the EHR has presented limitations to patient portals for various organizations.

When a pediatric patient or an individual who has granted portal proxy access to his or her family requests that some of their medical history is kept private, it is not always possible to do so, according to Dr. Galvin. Often when sensitive data is entered into the EHR, it can automatically appear in the patient portal, be printed in a care summary report or get transmitted to other providers or payers.

“Scanning an EHR output to families to ensure the redaction of sensitive data is a cognitive burden for pediatricians,” Dr. Galvin wrote. “Even the most diligent provider cannot prevent transmission of a payer’s explanation of benefits. Pediatricians are left to simply advise patients of this limitation and risk to their privacy.”

As part of its rule proposal earlier this year, ONC presented the use of an interoperability standard, called Data Segmentation for Privacy, that would allow vendors and organizations to label certain health information that is transferred between EHR systems as sensitive. “For example, a user could tag a diagnosis of chlamydia on a problem list so that it would not be transmitted to another site or populate the summary of care record without the patient’s consent,” Dr. Galvin wrote.

Implementing DS4P can pose issues such as what should be displayed in the EHR to notify providers that they do not have the patient’s complete medical record, should emergency measures be available to view nondisclosed data and whether the sensitive information should be used in clinical decision support algorithms.

Click HERE to learn how BHM’s investments into cyber-security protect your data.

The post Privacy Issues with Patient Portals appeared first on BHM Healthcare Solutions.

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Editor’s Note: Payers and providers have shed fears about the deployment of services. In addition to improving and expanding patient service, the vast financial benefits makes telemedicine consults a makes payers eager to gather more research on closing the telehealth gap. Click HERE to discuss how BHM helps payers integrate evidence-based best practices. 

The number of physicians who self-report telemedicine as a skill rose 20 percent each year, from 2015-18, according to Doxmitiy.

For its 2019 Telemedicine and Locum Tenens Opportunity Study, Doximity, a physician networking service, analyzed data on physician engagement with job postings on its network. More than 70 percent of U.S. physicians are members of Doximity.

Here are the top 15 physician specialties that are most engaged with telemedicine job postings, according to the report:

1. Radiology
2. Psychiatry
3. Internal medicine
4. Neurology
5. Family medicine
6. Dermatology
7. Pediatrics
8. Emergency medicine
9. Geriatrics
10. Allergy and immunology
11. Endocrinology
12. Infectious disease
13. Urology
14. Pediatric pulmonology
15. Occupational medicine

To access the full report, click here.

Payers and providers have shed fears about the deployment of services. In addition to improving and expanding patient service, the vast financial benefits makes telemedicine consults a makes payers eager to gather more research on closing the telehealth gap. Click HERE to discuss how BHM helps payers integrate evidence-based best practices. 

The post Study: Physician Specialties Engaged with Telemedicine appeared first on BHM Healthcare Solutions.

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Editor’s Note:  Medical cost pressures challenge a consistent patient/member experience. CLICK HERE to learn more about how BHM helps your organization build resources while focusing on patient/member experiences.

In 2015, cancer deaths cost the U.S. $94 billion in lost earnings, according to a study published in JAMA Oncology.

For the study, researchers used 2015 cancer mortality and life expectancy data from the National Center for Health Statistics and the U.S. Census Bureau to calculate person-years of life lost. They also used data on annual median earnings in the U.S. to determine lost earnings due to cancer deaths.

Cancer caused more than 600,000 deaths in 2015 and a collective 8.7 million years of life lost, translating into $94.4 billion in lost earnings.

After adjusting for age and population differences, researchers found Kentucky had the highest rate of lost earnings at $35.3 million per 100,000 people. Utah had the lowest rate at $19.6 million per 100,000 people, according to STAT. If every state matched Utah’s rate, the U.S. would’ve prevented 2.4 million years of lost life and $27.7 billion in lost earnings in 2015.

“Preventing premature deaths from cancer through delivery of effective cancer prevention, screening and treatment may have economic benefit for the United States nationally and in all states,” researchers concluded.

Medical cost pressures challenge a consistent patient/member experience. CLICK HERE to learn more about how BHM helps your organization build resources while focusing on patient/member experiences.

The post Cancer Deaths Cost $94B in Lost Earnings appeared first on BHM Healthcare Solutions.

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Editor’s Note: Increasing costs for prescriptions is creating a long-term financial impact on Medicare Part D and its beneficiaries. Can your claims review resources maximize the turn around time needed for complex claims? CLICK HERE and let us show how BHM’s economically maintain turn-around times and accuracy for new members.

A new study provides more evidence that America’s ongoing opioid epidemic was fueled by doctors prescribing more painkillers than patients needed — leading to what’s now the deadliest drug overdose crisis in US history.

For the study, published in JAMA Internal Medicine, Harvard researchers looked at overdoses that resulted in an emergency room visit or hospitalization and whether the patient’s family members were previously prescribed opioids.

They found that individuals with family members who previously received opioid prescriptions were about three times as likely to report an overdose ending with a hospitalization or an ER visit, compared to those whose family members did not get opioids. And the more opioids a family member was prescribed, the higher the risk of such an overdose.

In short: When a family member received opioids, people were much more likely to overdose.

There are two dueling explanations for the opioid crisis. In one explanation, the overprescription of opioid painkillers made the drugs far more accessible to people, leading to a rapid rise in misuse, addiction, overdoses, and deaths. The other explanation emphasizes “root causes” like mental health problems, socioeconomic factors, or a general sense of despair, and suggests that prescription practices were less important, because people with these underlying issues were bound to use some type of drug no matter what.

Experts generally agree that both explanations played a role, but the question is which explanation played a bigger one. The new study strongly suggests that overprescription played a major role.

Increasing costs for prescriptions is creating a long-term financial impact on Medicare Part D and its beneficiaries. Can your claims review resources maximize the turn around time needed for complex claims? CLICK HERE and let us show how BHM’s economically maintain turn-around times and accuracy for new members.

The post Opioid Overdose Associated With Opioid Prescriptions to Relatives appeared first on BHM Healthcare Solutions.

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Editor’s Note: Increasing costs for prescriptions is creating a long-term financial impact on Medicare Part D and its beneficiaries. Can your claims review resources maximize the turn around time needed for complex claims? CLICK HERE and let us show how BHM’s economically maintain turn-around times and accuracy for new members.

Two-thirds of drug deaths around the world were caused by opioids in 2017, and that proportion was even higher in the U.S., where overdose deaths reached a new high, according to a report from the United Nations.

The report found that 110,000 of 167,000 deaths from drug use disorders stemmed from opioids in 2017. In the U.S., overdose deaths spiked to 70,237 in 2017, up 10.4 percent compared to the year prior. Of those deaths, opioids accounted for 47,600, or 68 percent. The increased use of synthetic opioids like fentanyl is to blame for the dramatic increase in opioid-related deaths in 2017, according to the U.N.

In the U.S., 28,466 people died overdosing on synthetic opioids other than methadone in 2017, a 47 percent increase from 2016, according to the report.

Over 53 million people used opioids worldwide in 2017. However, North America had the highest prevalence of opioid use of any global region, according to the report.

Read more here.

Increasing costs for prescriptions is creating a long-term financial impact on Medicare Part D and its beneficiaries. Can your claims review resources maximize the turn around time needed for complex claims? CLICK HERE and let us show how BHM’s economically maintain turn-around times and accuracy for new members.

The post Opioids Caused 66% of Drug Deaths Worldwide in 2017 appeared first on BHM Healthcare Solutions.

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Editor’s Note: Given the rapidly changing health care environment, it is critical to quantify the economic impact physicians have on society. BHM watches health trends and understands the importance of improving and changing with the industry. Click HERE to learn more about how BHM helps your organization address opportunities.

Increasing amounts of in-basket messages generated by the EHR is correlated to higher levels of burnout symptoms among physicians, according to a study published in Health Affairs.

For the study, Palo Alto (Calif.) Medical Foundation researchers analyzed EHR workflows and survey results from 934 primary and specialty care physicians from the nonprofit organization during a six-week period in 2016. The team observed the volume of in-basket messages in the physicians’ workflows as well as the physicians’ responses to a burnout measure survey.

Of the multispecialty practice physicians, the researchers found that in-basket messages generated by the EHR totaled 114, which is almost half of the 243 weekly in-basket messages received by each physician on average. These messages included pending orders, prior authorization requests and patient health reminders. Additionally, 42 percent of physicians received more than the average number of EHR messages per week.

Survey results showed that 36 percent of physicians reported experiencing burnout symptoms, and 29 percent of participants said they wanted to decrease their clinical work time in the coming year. Physicians who received more than 114 EHR-generated in-basket messages were associated with a 40 percent increase in probability for burnout and 38 percent higher probability of intention to decrease clinical work time.

The study authors noted that the research presented various limitations, including the use of only one questionnaire on burnout and its neglect to measure other related aspects of well being besides burnout symptoms, intention to reduce clinical work time and physicians’ life satisfaction. Additionally, the survey’s question wording was only vetted by Palo Alto Medical Foundation physicians and leaders, the study did not analyze the amount of in-basket messages that had been read or responded to and the results of the research came from analyzing one large healthcare organization that adopted an EHR in 1999, so the results may not be generalizable.

The study authors concluded that healthcare organizations should consider different approaches to alleviate physician burnout by redesigning EHR in-basket workflows, such as re-routing certain messages to nonphysician clinicians and instituting new email work policies.

To access the full report, click here.

Given the rapidly changing health care environment, it is critical to quantify the economic impact physicians have on society. BHM watches health trends and understands the importance of improving and changing with the industry. Click HERE to learn more about how BHM helps your organization address opportunities.

The post Physician Burnout Linked to Electronic Health Records appeared first on BHM Healthcare Solutions.

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Editor’s Note: For payers, developing a new, collaborative payer provider model reinvents the role of payers as provider allies. BHM understands the special bridge between payers and providers because our they both are clients. Click HERE and discuss how BHM helps reinvent payers and build relationships.

 More than eight and 10 Americans see insurers as the largest contributor to surprise medical bills, according to a recent poll.

Morning Consult, a research and technology firm, surveyed 1,500 registered voters between May 31 and June 1 and released the findings this week. The findings were published by the American College of Emergency Physicians.

Four poll findings:

1. Eighty-one percent of respondents said they believe health insurance companies are responsible for most costs associated with surprise billing rather than hospitals and physicians (15 percent) or patients (4 percent).

2. Fifty-nine percent of respondents said they want their insurer to provide coverage with lower deductibles.

3. Sixty-nine percent of respondents favor a third-party dispute resolution process as a solution to surprise medical bills over allowing the government to set rates for out-of-network providers.

4. Sixty-seven percent of respondents agreed federal lawmakers must protect healthcare access for residents of rural communities.

Read more about the poll here.

For payers, developing a new, collaborative payer provider model reinvents the role of payers as provider allies. BHM understands the special bridge between payers and providers because our they both are clients. Click HERE and discuss how BHM helps reinvent payers and build relationships.

The post Poll: 81% of Americans Blame Payers for Surprise Medical Bills appeared first on BHM Healthcare Solutions.

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Editor’s Note: For payers, developing a new, collaborative payer provider model reinvents the role of payers as provider allies. BHM understands the special bridge between payers and providers because our they both are clients. Click HERE and discuss how BHM helps reinvent payers and build relationships.

Federal proposals to end surprise-billing pose an increasing social risk for hospitals and healthcare staffing companies, particularly those that treat a large share of out-of-network patients, according to a newly issued reportby Moody’s Investors Service.

Federal lawmakers have been ramping up efforts to address surprise billing that occurs after insured patients unintentionally receive care from out-of-network providers. This often happens in emergency situations.

Surprise-billing proposals include banning out-of-network deductibles in emergencies and establishing an arbitration process to settle out-of-network payment disputes between health plans and providers.

But Moody’s said a bundled billing proposal — which would require one bill for emergency care or have hospitals pledge that their affiliated physicians and service providers are not out-of-network — would have the most negative effect for hospitals and healthcare staffing companies.

“This is because many hospitals completely outsource the operations and billing of the emergency department to a staffing company,” the agency wrote. “Bundling the services would require a significant change in the relationship between these entities. Further, an in-network guarantee would add significant complexity because many physicians and ancillary service providers are not employed or controlled by the hospital.”

Moody’s said it also projects that the largest providers would be the least affected by the proposals due to their notable negotiating leverage with insurers.

Changes could also lead to more consolidation as smaller providers with high out-of-network exposures would likely be more willing to join a larger group, the agency said.

For payers, developing a new, collaborative payer provider model reinvents the role of payers as provider allies. BHM understands the special bridge between payers and providers because our they both are clients. Click HERE and discuss how BHM helps reinvent payers and build relationships.

The post Surprise-Billing Proposals Present Risks appeared first on BHM Healthcare Solutions.

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Editor’s Note: Increasing costs for prescriptions is creating a long-term financial impact on Medicare Part D and its beneficiaries. Can your claims review resources maximize the turn around time needed for complex claims? CLICK HERE and let us show how BHM’s economically maintain turn-around times and accuracy for new members.

Post-discharge opioid use is far more likely among patients who are given opioids during their hospital stay compared to patients who do not receive opioids, according to a study published in the Annals of Internal Medicine.

Researchers conducted the retrospective cohort study at 12 community and academic hospitals in Pennsylvania. They examined 191,249 admissions of patients with at least one outpatient encounter within 12 months before and after the admission.

Researchers found that opioids were administered in 48 percent of admissions. The opioids were administered for 67.9 percent of their hospital stay.

Of the inpatients receiving opioids, 5.9 percent continued to use the prescription within 90 days post-discharge, compared to 3 percent of those patients who did not receive opioids at the hospital. Additionally, opioid use at 90 days was higher among inpatients receiving opioids less than 12 hours before discharge versus those patients with at least 24 opioid-free hours before discharge.

Increasing costs for prescriptions is creating a long-term financial impact on Medicare Part D and its beneficiaries. Can your claims review resources maximize the turn around time needed for complex claims? CLICK HERE and let us show how BHM’s economically maintain turn-around times and accuracy for new members.

The post Inpatients Receiving Opioid Prescription Continue Usage After Discharge appeared first on BHM Healthcare Solutions.

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Editor’s Note: For payers, developing a new, collaborative payer provider model reinvents the role of payers as provider allies. BHM understands the special bridge between payers and providers because our they both are clients. Click HERE and discuss how BHM helps reinvent payers and build relationships.

Boston Children’s Hospital earned the No. 1 spot on U.S. News & World Report‘s Best Children’s Hospitals rankings for the sixth consecutive year.

To compile the 2019-20 list, U.S. News examined 191 children’s hospitals nationwide, ranking the top 50 centers in 10 specialties. The ranking is based on hospitals’ clinical outcomes; the level and quality of hospital resources tied to patient care; healthcare delivery; and expert opinion from pediatric specialists.

Here are the 10 hospitals on U.S. News‘ 2019-20 Honor Roll, which had the highest rankings across all specialties. Note: This list includes a tie.

1. Boston Children’s Hospital
2. Children’s Hospital of Philadelphia
3. Cincinnati Children’s Hospital Medical Center
3. Texas Children’s Hospital (Houston)
5. Children’s Hospital Los Angeles
6. Children’s National Medical Center (Washington, D.C.)
7. Nationwide Children’s Hospital (Columbus, Ohio)
8. UPMC Children’s Hospital of Pittsburgh
9. Johns Hopkins Children’s Center (Baltimore)
10. Seattle Children’s Hospital

U.S. News also ranked the top five hospitals in selected specialties:

Pediatric cardiology and heart surgery

  1. Texas Children’s Hospital
  2. Ann and Robert H. Lurie Children’s Hospital of Chicago
  3. UPMC Children’s Hospital of Pittsburgh
  4. Children’s Hospital Los Angeles
  5. Boston Children’s Hospital

Pediatric cancer

  1. Dana-Farber/Boston Children’s Cancer and Blood Disorders Center
  2. St. Jude Children’s Research Hospital (Memphis, Tenn.)
  3. Texas Children’s Hospital
  4. Nationwide Children’s Hospital
  5. Johns Hopkins Children’s Center

Pediatric neonatology

  1. Children’s National Medical Center
  2. Boston Children’s Hospital
  3. Children’s Hospital of Philadelphia
  4. Cincinnati Children’s Hospital Medical Center
  5. UCSF Benioff Children’s Hospitals, San Francisco and Oakland

To view U.S. News‘ full rankings methodology, click here.

For payers, developing a new, collaborative payer provider model reinvents the role of payers as provider allies. BHM understands the special bridge between payers and providers because our they both are clients. Click HERE and discuss how BHM helps reinvent payers and build relationships.

The post 10 Best Children’s Hospitals appeared first on BHM Healthcare Solutions.

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