Vita Advisors

sftwr

Kevin Roche — Wed, 19 Jun 2013 15:23:06 +0000

Cleveland-based Clinical Outcomes Management Systems has raised over $20 million for its disease management software for long-term care facilities business.

mds

Kevin Roche — Wed, 19 Jun 2013 15:16:36 +0000

Americans trust physicians far more than other players in the health system to look after the patients’ best interests, according to a new survey. Too bad that trust is often misplaced.

mediware

Kevin Roche — Wed, 19 Jun 2013 14:55:53 +0000

Mediware, the maker of software for home therapies, has acquired Fastrack Healthcare Systems to add to its customer base and functionality.

vitals

Kevin Roche — Wed, 19 Jun 2013 14:47:17 +0000

Vitals, a brand of MDx Medical, raised an additional $22 million to support its business of helping patients find doctors and understand health care costs.

MedPAC on the Health Care Delivery System

Kevin Roche — Wed, 19 Jun 2013 12:00:34 +0000

The Medicare Payment Advisory Commission consistently issues reports which have concise analysis and insight into the health care system, with an obvious focus on Medicare implications. Their latest report discusses various aspects of the health care delivery system. (MedPAC Report) One area the Commission looked at is a competitive bid model couple with premium support as an option for the Medicare system. If the Medicare Advantage reimbursement process were properly designed it would look like this and likely lower costs significantly. The Commission also examined the issue of payment variations for the same service in different settings, a growing issue because hospitals have been acquiring physicians and moving their services to the hospital outpatient setting where they cost more. There is no reasons for this and the best solution is pay hospitals the same as physicians get for office-based services. If hospitals can’t figure out how to provide the services as cheaply as physician offices do, that is the hospitals’ problem. Services after a hospitalization is an area with significant cost and quality concerns. Multiple settings may be used, with varying reimbursement formulas and service limits. The Commission suggests just creating a single bundled episode payment. In regard to the poorly designed hospital readmission program, the Commission says it is unfairly penalizing hospitals which treat large numbers of poorer patients and also uses the wrong and too few measures and needs to be fixed. How about scrap the whole thing. While hospice is a desirable venue for many patients facing end-of-life care, the reimbursement system is flawed and may encourage inappropriate use and lengthy stays. The Commission also addresses the needs of dual-eligible beneficiaries and ambulance service misuse. Finally, the Commission says that some geographic adjustment is appropriate for paying health professionals, but the current approach used by CMS is flawed.

Kevin Roche — Tue, 18 Jun 2013 14:25:29 +0000

HHS’ health insurance exchange rules.

hie

Kevin Roche — Tue, 18 Jun 2013 14:24:44 +0000

HHS has released proposed regulations relating to the reform law’s health insurance exchanges, adding to the tens of thousands of pages of rules under the law.

medivo

Kevin Roche — Tue, 18 Jun 2013 12:57:52 +0000

Medivo, a company which has a software platform that connects patients, providers and clinical labs to share results, has raised an additional $15 million in capital, with Merck Ventures as the lead investor.

cc

Kevin Roche — Tue, 18 Jun 2013 12:53:38 +0000

CareCloud, a provider of hosted EMR and other health care software applications, has raised an additional $20 million in capital.

Rand Report on Wellness Programs

Kevin Roche — Tue, 18 Jun 2013 12:00:47 +0000

Wellness programs are now widespread and encouraged by the reform law. The Rand group was contracted to evaluate the characteristics and prevalence of these programs, the evidence for impact, the role of incentives and what are factors leading to success. (Rand Report) Rand reviewed the literature, did a survey of employers, analyzed a claims database for wellness impact and did five case studies of employer wellness programs. At least half of employers have at least one wellness effort, either health promotion, or primary or secondary disease prevention. The focus is on diet, weight, exercise, smoking, stress management and the usual litany of chronic diseases. A surprisingly small number of employees, about 46%, take advantage of these programs in some way and only about 20% participate in an intervention recommended based on HRA or screening results. That may change as more employers put higher incentives or penalties in place in regard to wellness participation. The literature suggests positive health effects on an employee population and on individual participants from wellness programs, but not as large as would be hoped. While employers strongly believe that their wellness programs reduce medical costs, absenteeism and health-related productivity, many have not actually done an evaluation. Rand’s analysis suggests a lowering of health utilization and costs for employees who do participate, a trend that appears to grow with increasing years in a wellness program. The Rand survey found the use of incentives is widespread and growing, most commonly for HRA completion and participation in a lifestyle intervention. Incentives appear to be effective in changing behavior, at least in the short term. Communication strategies, employee and leadership engagement and continuous evaluation were listed as factors in a successful wellness offering.