Archive for January, 2023


Hospitals Improving Electronic Data Exchange

Hospitals are improving their interoperability and doing a better job of exchanging health data electronically, according to a review by the federal Office of the National Coordinator for Health Information Technology (ONC).

According to a new ONC report,

  • In 2021, more than 6 in 10 hospitals engaged in key aspects of electronically sharing health information (send, receive, query) and integrating of summary of care records into EHRs, a 51 percent increase since 2017.
  • Availability and usage of electronic health information received from outside sources at the point of care significantly increased over the last four years, reaching 62 and 71 percent, respectively, in 2021.
  • Health Information Service Providers (HISPs) and HIEs were the most common methods used for electronic exchange among hospitals.
  • About three-quarters of hospitals participate in health information exchange organizations (HIEs) and about 35 percent participate in both HIEs and national networks.
  • In 2021, 39 percent of hospitals reported participating in more than one of four measured national networks.
  • Nearly 90 percent of hospitals upgraded their EHRs to 2015 Edition through 2021 and 74 percent of hospitals adopted bulk data export technology.

Learn more about progress in the federal government’s quest for health data interoperability in the ONC …

States Look to Take on Prior Authorization

The majority of states may act on insurer prior authorization practices in the coming year and even though the year is still only a month old, 16 states are already considering legislation to do so.

The desire to act on prior authorization comes as providers continue to express dismay over delays in insurer review of the courses of treatment they seek to initiate for their patients, with some providers maintaining that those delays are jeopardizing the well-being of those patients.

Insurers, meanwhile, insist that their reviews are necessary to ensure the health of their patients.

In response to such expressed concerns, the Centers for Medicare & Medicaid Services late last year proposed revising some current prior authorization regulations.

Learn more about the prior authorization issue and what might be expected in the coming year from the Axios article “States jump into fight over prior authorization requirements.”…

Telehealth Not Improving Opioid Treatment

Telehealth is not improving access to help for patients with opioid use disorders, a new study has found.

Instead, use of telehealth is comparable to visits to providers’ offices when it comes to access.

According to the analysis,

Results of this study revealed that clinical outcomes were similar among patients who were treated by clinicians with high and low telemedicine use during the COVID-19 pandemic, suggesting that telemedicine is a comparable alternative to in-person OUD care. There was no evidence that telemedicine was associated with increased access to or improved quality of OUD treatment.

Learn more from the JAMA Network Open article “Telemedicine Use and Quality of Opioid Use Disorder Treatment in the US During the COVID-19 Pandemic.”…

Future Financial Prospects Mixed for Post-Acute Providers, Analysis Suggests

Assisted living facilities, hospice, and home health providers should see their profitability rise over the next three years, according to a new analysis by McKinsey & Company.

Nursing homes and inpatient rehabilitation facilities, on the other hand, may see their profitability decline as they continue to struggle with the current shortage of qualified nurses.

Learn more about the near-term prospects for post-acute-care providers from the McKnight’s Long-Term Living article “Skilled nursing profits will shrink through 2026, even as other post-acute lines gain: analysis.”…

Federal Health Policy Update for January 20

The following is the latest health policy news from the federal government for the week of January 13-20.  Some of the language used below is taken directly from government documents.

Centers for Medicare & Medicaid Services

  • CMS has published updates to the Healthcare Common Procedure Coding System (HCPCS) codes on the Required Face-to-Face Encounter and Written Order Prior to Delivery List.  The update adds ten codes to the list of items that require a face-to-face encounter between provider and patient and a written order prior to delivery as a condition of payment.  Go here for a summary of the update and a link to a formal Federal Register notice.  The update takes effect on April 17.
  • CMS has published a technical update of codes used for billing by ambulatory surgical centers.  Find it here.
  • The latest edition of MLN Connects, CMS’s online newsletter with information about Medicare reimbursement matters, includes features on the latest FY 2023 ICD-10 codes and grouper software effective April 1; January 2023 integrated outpatient code editor files, including updates; tip sheets for post-acute-care quality reporting programs during the COVID-19 public health emergency; and more.  Find it here.
  • CMS has updated and expanded its