In early May 2017 Republicans in the U.S. House of Representatives voted to repeal and replace the Affordable Care Act (or Obamacare). Subsequently, Republicans in the U.S. Senate began working on their version of a law to do the same. The House bill is flawed, leaving many uncertainties that the Senate has promised to address. While the fate of the bill is in flux, there are three immutable trends in the U.S. health care system that won’t change. As a result, regardless of how the law evolves, tremendous opportunities will remain for consumers, medical providers, health care payers, and investors to shape and improve the health care system.
As the healthcare industry continues to move to value-based care with its emphasis on patient experience and reducing costs, some hospitals and health systems are putting stock in a new leadership role: chief experience officer (CXO). Hospitals that designate a C-suite executive expect to benefit financially from higher patient satisfaction scores and positive publicity.
As 2017 approaches, healthcare professionals should prepare for new sets of reporting requirements, including patient engagement provisions under meaningful use for hospitals and MACRA for eligible clinicians.
Lung screening recently moved to the forefront of the cancer prevention discussion. As you may be aware, lung cancer is the leading cause of cancer death in both men and women in the United States—and incidence is on the rise.1 Unfortunately lung cancer isn’t typically caught until the late stages when prognosis is poor, but lung screening programs can help increase survival odds by identifying cancer in its early stages.
In 2011, the National Lung Screening Trial (NLST) demonstrated a 20% reduction in lung cancer mortality using low-dose CT scanning for high-risk patients. In response to this study, the United States Preventive Services Task Force (USPSTF) released lung screening recommendations aimed at patients aged 55 to 80 who are current (or former) smokers with a 30-pack-year smoking history. When Medicare announced coverage for low-dose CT lung screening programs in February 2015, hospitals and cancer centers across the U.S. began launching their own screening programs.
CMS publishes the proposed rules for their new Advancing Care Information Program, which will replace Meaningful Use.
PWC publishes a study on cancer care that highlights the need to personalize the approach to treatment, coordinate care, and go digital to improve the quality of live throughout care.
Andy Slavitt, acting administrator of the Centers for Medicare & Medicaid Services, made some bold remarks at the annual J.P. Morgan Healthcare Conference, most notably stating that “The meaningful use program as it has existed will now be effectively over and replaced with something better.” He went on to describe that “something better” would take the form of MACRA (Medicare Access and CHIP Reauthorization Act), a combination of merit based incentive programs and alternative payment models, which will be rolled out in coming years.
This statement was met with approval from many healthcare providers, who have been vocal in their criticism of Meaningful Use (MU). However, others were merely left confused by what seemed to be the sudden death of a program into which many had invested so much time and money.
In the wake of this confusion, he and ONC Director, Karen DeSalvo released a follow up statement on the CMS blog:
“The approach to meaningful use under MACRA won’t happen overnight. Our goal in communicating our principles now is to give everyone time to plan for what’s next and to continue to give us input. We encourage you to look for the MACRA regulations this year; in the meantime, our existing regulations – including meaningful use Stage 3 – are still in effect.”
What initially sounded like the sudden death of Meaningful Use, now sounds a gradual transition to MACRA. And healthcare providers breathing a sigh of relief at avoiding MU stage 3 may want to hold off on that relaxation; according to this timeline, published by the American Academy of Family Physicians in December 2015, MU stage 3 will continue until 2018.
If Meaningful Use is not over until at least 2018, meeting Stage 3 is a reality we need to face.
As CMS reveals their plans for MACRA, we hope to learn more about what that means for healthcare providers and the technology required. Whatever the regulatory future looks like, we will continue to develop tools that meet the new standards. We have supported Meaningful Use from the beginning, we’ll support MU stage 3 until it’s truly over, and be ready for MACRA when it comes into action.
Delivering healthcare in the face of complicated, and forever changing regulations is surely difficult (take heart, it’s difficult for vendors too!) but our aim is always to deliver tools that take a complicated process and make it easier to manage operationally. We certainly don’t have all the answers in the MU and MACRA space but we spend a lot of time delving into how these regulations affect healthcare providers so please contact us with your questions.
To learn more about MU and how the modified rule changes affect ARIA users, please join a Webinar hosted by Malcolm Wright, VP of Product Management on February 4th at noon PST.
With the release of ASTRO’s new survivorship care plan template in late November, we’ve seen a renewed focus on the care plan, and the logistical problems of delivering one. What should a care plan look like and how do you choose a template?
The evidence for the need for care plans is strong. As ASTRO states in their press release, the American Cancer Society (ACS) predicts a 37% increase in the number of cancer patients surviving five years or longer over the next decade, and as the numbers of survivors grows, so does the need for structured follow up care. Accrediting bodies like the ACS Commissions on Cancer (CoC) have included survivorship in their new requirements but providers report that delivering a survivorship care plan is the most difficult of the CoC’s new standards to meet (Association of Community Cancer Centers, 2015 membership survey).
The need for clarity on care plan content and format has resulted in a variety of care plan templates. The ASTRO care plan, designed for Radiation Oncologists, joins templates from organizations including ASCO, LiveStrong, Journey Forward and others. Each template varies slightly, but most include the following common elements:
- Contact information for the patient’s care team
- Patient diagnosis
- Treatment summary including radiation therapy, chemotherapy, surgery, and enrollment in clinical trials.
- Information on the side and late effects of treatment
- Psychosocial distress screening
- Follow-up plan
Most of these templates, including ASTRO’s latest addition, pack all that information into a short 2 -3 page format. We know that many providers value the concise nature of these templates and others want to include much more.
So how much information should we include in a care plan? How many years do we look ahead for follow-up? How many years of treatment history are necessary? Do we include educational articles and community resources within the care plan?
With a variety of templates from industry leaders, the answers to these questions aren’t clear. Will a long care plan overwhelm some patients? Or does a shorter plan run the risk of missing valuable information? Depending on the patient, both may be true.
The right level of detail depends on the age, education level, diagnosis and treatment of the specific patient. A one-size-fits-all care plan probably doesn’t exist but if we focus on where we can add the most value for patients, we’ll probably find the right balance.
As a vendor of survivorship software, we’re hardly neutral on this subject, but we are certainly passionate about doing the right thing for patients. Equicare’s care plans can be as sparse as this 2-pager with just a treatment summary and follow up plan. Or as detailed as this comprehensive one, which also includes detailed educational articles and info about questionnaires to complete. Our goal is to deliver a care plan that not only ticks the requirements box of your accrediting body (which we certainly do!) but to make it easy for you to deliver a care plan that adds value to your patients, their families and your physicians.
|2 Page Care Plan|
|Comprehensive Care Plan|
Which template do you use? And why do you love or hate it? We’d love to talk templates, so get in touch and let us know.
A new template published by the American Society for Radiation Oncology (ASTRO) standardizes and streamlines the creation of patient-focused plans for long-term cancer survivor care following radiation therapy (RT).
This article examines the features a care coordinator should look for in care coordination tools to ensure they meet the needs of patients, the care team, and the care coordinator.