New data transparency for Medicare Advantage plans will provide valuable insights, five healthy habits that could extend your life, and more.
1. The Centers for Medicare and Medicaid Services administrator Seema Verma announced it will expand Medicare Advantage (MA) data transparency, which will provide insight into the cost and quality of the program. A Health Payer Intelligence article explains that 2015 MA data regarding the cost healthcare services, provider information and the setting of healthcare services will be released on an annual basis. The American College of Physicians (ACP) believes that increased MA data transparency will help decrease waste and burden while increasing quality. Given that only 85 percent of MA funding supports beneficiary care, the ACP contends the new changes will provide clarity on how payers fund benefits. New annual reports providing data transparency may also lead to identifying opportunities for improvement in MA program spending. According to the Commonwealth Fund, the 2014 data shows that CMS paid 12 percent more than their expected per enrollee costs to MA HMO plans.
2. Writing as a guest contributor to HIT Consultant, George T. Mathew, MD, MBA, FACP and chief medical officer at DXC Technology, examines how healthcare innovation can help deliver better care to patients. Given that “the number of Americans ages 65 and older is projected to more than double from 46 million today to over 98 million by 2060, and the population overall is set to increase exponentially over the next 30 years,” implementing effective data management solutions will be essential. Although approximately 1.2 billion clinical documents (or around 60 percent of all clinical data) are produced in the U.S. each year, much of this data is not being leveraged well in computer-based recording systems, according to Health Story Project. Mathew says that digital care transformation, including personalized patient treatment, remote monitoring, telehealth, artificial intelligence (AI) and machine learning are key to providing a connected healthcare delivery model focused on turning data into actionable insights. He writes, “Healthcare organizations need to take on more financial risk, understand their costs better, and manage the care of their communities better: To do this, they must become more innovative, and find new ways to attack these problems. This can only be done through an increased focus on properly capturing and using data from the communities around them.”
3. Understanding social determinants of health to improve outcomes and reduce costs was the focus of healthcare leaders at the fifteenth annual World Health Care Congress in Washington D.C., Healthcare Informatics reports. Author and consultant Ian Morrison gave the opening address at the event and emphasized the growing interest in the role social determinants of health play in helping hospitals and health plans improve operational efficiency “due to the rising burden of chronic care, mounting research evidence, and the shift toward providers and payers taking on more risk.” Morrison contends that income is one of the biggest disparities that affect health outcomes. Martin Otto, the chief operating officer of San Antonio-based supermarket chain H-E-B and another speaker at the event, pointed out that healthcare access is also a major challenge for individuals. Otto believes that the lack of focus on poverty-related challenges and education has lead to worse health outcomes and increased healthcare spending. Akram Boutros, M.D., president and CEO at Cleveland-based MetroHealth, explained how his company, when faced with the reality of almost going out of business eight years ago, started to collaborate with legal aid agencies, local food banks and other community organizations in an effort to reduce costs while providing better healthcare. In addition, the World Health Care Congress discussed the importance of interoperability and actionability of solutions to offer personalized solutions. “Today, we have a paternalistic system in which the doctor owns your health information. But why don’t you own it in a way so that you can understand what it means and act on it? That flips the paradigm to a personalized system,” said Harold Paz, M.D., executive vice president and chief medical officer of Aetna. The event panelists concluded that as long as personalized patient engagement is achieved first, wasted healthcare money could instead be used to help pay for new social determinant initiatives.
4. Adhering to five healthy habits could add 10 years to your life, according to new research published in the journal Circulation. The habits include not smoking, eating healthy, exercising regularly, maintaining a normal weight and drinking in moderation. WebMD reports that two studies conducted by a team at Harvard analyzed 123,000 U.S. health professionals since the 1980s, along with detailed records of their diets, exercise habits and other factors. Government health data was also used. Researchers considered “regular” exercise as moderate or vigorous activity for at least 30 minutes a day and moderate drinking as no more than one alcoholic drink per day for women and two per day for men. A scoring system was also created to quantify participants’ diets. By 2014, approximately 42,000 participants from the study had died. Results found that for those participants who maintained the five healthy habits, they were 74 percent less likely of dying, 82 percent less likely of dying of heart disease or stroke, and 65 percent less likely to die of cancer. Currently, government statistics estimate that an average 50-year-old American can expect to live another 30 to 33 years. The study, however, found that this life expectancy could be extended by almost a decade: “At the age of 50, U.S. women who’ve maintained those five healthy habits can expect to live another 43 years. Their male counterparts can expect to live for roughly 38 more years.” However, women and men who did not engage in any of the five lifestyle choices could expect to live another 29 and 25.5 years, respectively. Unfortunately, the researchers also found that only eight percent of American adults follow these rules in recent years and the World Health Organization ranked the U.S. 31st in the world for life expectancy at birth in 2015, demonstrating the country’s need to encourage better health habits. “Our findings have significant public health implications because they demonstrate the great potential of diet and lifestyle changes in improving life expectancy,” said Frank Hu, senior researcher and chair of nutrition at the Harvard School of Public Health.
5. A new Fitbit and Google partnership will merge user-generated data with EMRs and transform how this health information is typically leveraged, according to Becker’s Hospital Review. Fitbit will utilize Google’s cloud healthcare application programming interface to improve scalability and population health analysis while providing Fitbit a platform that is already HIPAA compliant to protect consumer data. The partnership will also look to ways that it can incorporate Twine Health, a health coaching platform recently acquired by Fitbit, to improve patient management of chronic conditions, like diabetes and hypertension, through provider-patient collaboration. “Together, we have the opportunity to deliver up-to-date information to providers, enhancing their ability to follow and manage the health of their patients and guide their treatment,” Gregory Moore MD, Ph.D., vice president of Google Cloud’s healthcare division.