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January 2014

 

Welcome to NAMSS Gateway!


NAMSS is excited to debut the first issue of our newest publication, NAMSS Gateway. This monthly newsletter includes all of the content from NAMSS Education e-News and Member e-News, along with the latest industry news and updates.

To produce NAMSS Gateway, our editorial staff monitors nearly 12,000 newspapers, business publications, Web sites, national and international wire services, and other periodicals and connects you right to the original source of the information. We hope you enjoy this inaugural issue—if you have feedback, we’d love to hear from you at info@namss.org.
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Headlines


News From NAMSS
Membership Renewal Update
Register Today for a Live Webinar on NCQA Standards and Updates
Register Now for a Live Webinar with Susan Lapenta – Contracting & Credentialing: The Good, the Bad, and the Oh So Ugly
NAMSS PASS - Read about the NAMSS Practioner Affiliation Sharing Source

Industry News
"Healthcare Sees Rare Drop in Hiring Growth"
"University Hospitals, UnitedHealthcare Collaborate on Accountable Care Organization"
"U.S. News Hospital Rankings to Double Role of Patient Safety, Cut Back Reputation"
"Many Illinois Doctor Investigations Originate in Other States"
"Health Care Spending Growth Still Very Low"
"Outlook 2014: Obamacare, SGR Repeal, ICD-10 and Payment Cuts Top the List of Challenges for Healthcare Players in 2014"
"Engaged, Empowered and Enthused: The Link Between Employee Engagement and the Patient Experience"
"University of Maryland Shore Regional Health Hospitals Awarded Accreditation From the Joint Commission"
"Federal Court in Pennsylvania Dismisses Claims While Upholding Others in Physician Suit Against Hospital"
"Survey: Doctors Mixed on Electronic Medical Records"
"Feds Might Object to Any State Law Forcing an Insurer, Hospital Into Contract"
"Bill Seeks to Clean Telehealth State Regulations Mess"


News From NAMSS


Membership Renewal Update

NAMSS Members - Thank you to the thousands of NAMSS members who have already renewed for 2014! We continue to receive renewal requests daily and for those of you that have not renewed yet, there is still time. Log in to renew online today! Do you need a paper invoice? Copies were mailed in December, but if you never received or have misplaced yours, email us for another copy at info@namss.org – we’re happy to provide one! Those of you who renew by January 31 will receive complimentary access to a free education session worth 1.5 CE credits. Also keep an eye out for a confirmation letter in the next month or so that includes a small gift.
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Register Today for a Live Webinar on NCQA Standards and Updates

January 23, 2014
1:00 p.m. - 2:00 p.m ET
Mr. Frank Stelling, NCQA


Start the New Year on the right foot - get up to speed on your professional development and sign-up to attend NAMSS' first webinar in 2014 - NCQA Standards and Updates

The National Committee for Quality Assurance (NCQA)'s, Assistant Director of Policy, Frank Stelling will provide an overview of the committee's credentialing standards and introduce recent updates to the standards. Webinar participants will gain a broader understanding of the credentialing process and learn how to help their managed care organizations meet these standards. This webinar has been approved for 1.0 CE Credits.
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Register Now for a Live Webinar with Susan Lapenta – Contracting & Credentialing: The Good, the Bad, and the Oh So Ugly

February 13, 2014
1:00 p.m. - 2:30 p.m. ET
Ms. Susan Lapenta, Horty, Springer & Mattern


Register now to attend a live webinar on contracting and credentialing with healthcare expert Susan Lapenta, JD from Horty, Springer & Mattern.

Physician candidates are often employed and then presented for medical staff appointment as if it is a fait accompli, with little understanding of the appointment criteria and an unreasonable expectation about the time it takes to perform essential primary source verification. This live webinar opportunity will explore the challenges of credentialing and privileging an employed physician, and provide clarity to the overall process.
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NAMSS PASS - Read about the NAMSS Practioner Affiliation Sharing Source

For several years, NAMSS has been solidifying our concept of the Ideal Credentialing Solution (ICS) and has identified 13 critical data elements to be included. There are already data sources that track education, training, and licensure. However, one universal resource that tracks practitioners' affiliation history does not exist. Imagine if it did...
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Industry News


Healthcare Sees Rare Drop in Hiring Growth
Modern Healthcare (01/11/14) Evans, Melanie

U.S. Bureau of Labor Statistics figures show healthcare added 271,000 jobs last year to bring the industry's total to 14.57 million -- about 2 percent below the annual average since 1990. Hiring trends across healthcare sectors were mixed in 2013, with anemic job growth among hospitals offset by a surge in ambulatory-care hiring. RAND Corp. economist David Auerbach observes that the findings appear to add to the mounting proof that hospitals are scaling back expenses in response to Medicare reductions and the growth of accountable care. Healthcare shed 6,000 jobs last month alone, only the second time in 23 years of employment tracking that the sector has shed jobs.
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University Hospitals, UnitedHealthcare Collaborate on Accountable Care Organization
Cleveland Plain Dealer (OH) (12/19/13) Zeltner, Brie

Ohio-based University Hospitals (UH) has agreed to collaborate with UnitedHealthcare on a new accountable care organization (ACO) designed to coordinate care and reduce costs for participants enrolled in the insurer's employer-sponsored health plans. Set to launch Feb. 1, the ACO will cover 19,000 participants who currently receive care from UH providers. Under the ACO, UH's staff will provide monthly updates on patients and maintain a secure patient registry, among other changes. Dr. Eric Bieber, UH's chief medical officer, concludes, "It's about trying to keep people well, not about acute episodic illness, which has been the real focus of American healthcare for the last century."
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U.S. News Hospital Rankings to Double Role of Patient Safety, Cut Back Reputation
U.S. News & World Report (01/11/14) Harder, Ben

U.S. News & World Report has announced that it will make several changes to this year's Best Hospitals rankings methodology. In a dozen specialties, the weight assigned to patient safety will double to 10 percent of each facility's overall score. At the same time, the weight given to hospital reputation will drop to 27.5 percent from 32.5 percent. According to the publication, "This shift reflects the ongoing evolution of the Best Hospitals rankings from their 1990 origin as survey-driven lists toward increasingly objective assessments. This movement is made possible by the growing availability of publicly reported, rigorously studied hospital quality metrics."
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Many Illinois Doctor Investigations Originate in Other States
Chicago Tribune (01/07/14) King, Karisa

In 2012, the Illinois Department of Financial and Professional Regulation (IDFPR) took disciplinary action against more than 100 physicians after medical boards in other states found they had engaged in misconduct or provided improper care. The cases involved physicians who hold or have held licenses in Illinois, yet often no longer work here. Patient advocates say such cases must be addressed as they prevent abusive or incompetent doctors from simply relocating to other states. According to the National Practitioner Data Bank, nearly 50 percent of all IDFPR actions against doctors in Illinois since 2004 were prompted by investigative findings in other states -- second only to Pennsylvania.
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Health Care Spending Growth Still Very Low
CNNMoney.com (01/06/14)

A new Centers for Medicare and Medicaid Services study confirms that the United States continued to curb its spending on health care for a fourth consecutive year in 2012. Spending on health care grew by only 3.7 percent. Researchers looked at all spending on health care services, from doctors and drugs to hospitals and nursing homes. According to their report, people continued to pull back on medical care amid a continued weak job market and providers sought to keep prices in check as a result. The Affordable Care Act had minimal impact as many of the reform's major provisions had yet to kick in.
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Outlook 2014: Obamacare, SGR Repeal, ICD-10 and Payment Cuts Top the List of Challenges for Healthcare Players in 2014
Modern Healthcare (01/11/14) Zigmond, Jessica; Demko, Paul; Dickson, Virgil

Looking ahead to the new year, physicians are hopeful 2014 will bring the repeal and replacement of Medicare's widely despised sustainable growth-rate physician payment formula. Hospitals, meanwhile, are pushing for the legislation to include provisions extending a variety of hospital payment programs. Additionally, hospitals will be looking to win relief from Medicare disproportionate-share hospital cuts that are scheduled under the Affordable Care Act. On the regulatory front, everyone from insurers to consumer advocacy groups to states are eagerly awaiting a final rule from HHS that lays out standards for the Affordable Care Act's Basic Health Program. Finally, a major regulatory concern for hospitals in 2014 is the healthcare reform law's Hospital Readmissions Reductions Program.
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Engaged, Empowered and Enthused: The Link Between Employee Engagement and the Patient Experience
Becker's Hospital Review (01/09/14) Baird, Kristin

Gallup's recently released "State of The American Workplace" study showed that an astounding 52 percent of all full-time workers in the country are not involved in or enthusiastic about their work and an additional 18 percent are "actively disengaged." That leaves only about 30 percent of the labor force that actually enjoys the work they are doing. With all of the stress associated with delivering healthcare today, there is a good chance this number is even lower at many healthcare organizations. Engaged employees drive the patient experience. Despite the fact that many healthcare experiences are inherently negative ones, patients want to feel good about the experience. Healthcare leaders have a critical role to play here and can influence the level of engagement among their staff members by owning engagement at the senior leadership level and charting the course for improving engagement and, along with it, patient satisfaction.
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University of Maryland Shore Regional Health Hospitals Awarded Accreditation From the Joint Commission
Nurse.com (01/10/14)

University of Maryland Shore Regional Health confirms that its three medical centers -- the University of Maryland Shore Medical Center at Cambridge, the University of Maryland Shore Medical Center at Chestertown, and the University of Maryland Shore Medical Center at Easton -- have earned The Joint Commission's Gold Seal of Approval for accreditation by demonstrating compliance with the commission's national standards for healthcare quality and safety in hospitals. Each of the three facilities underwent rigorous, unannounced, on-site surveys. A team of Joint Commission surveyors evaluated the hospitals for compliance with standards of care specific to the needs of patients, including infection prevention and medication management.
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Federal Court in Pennsylvania Dismisses Claims While Upholding Others in Physician Suit Against Hospital
National Law Review (12/17/13) Hethcoat, Gayland O.

In the recent federal case of Langenberg v. Warren General Hospital, the Pennsylvania hospital recruited a vascular surgeon promising that it would build a robust vascular practice. Either party could terminate the employment agreement without cause upon 90 days' written notice. Under terms of the agreement, the doctor obtained medical staff credentials at the hospital, which bound him to the facility's medical staff bylaws. These bylaws stipulate that a practitioner's credentials would terminate immediately upon termination of any contractual relationship between the doctor and hospital. Several months after starting work, the doctor raised various issues involving patient care to hospital officials and was terminated. The doctor sued the hospital and its CEO for breaching the bylaws by reporting the termination of his credentials as an "adverse action" to the National Practitioner Data Bank. The court rejected the defendants' contention that an immunity clause in the bylaws barred some of the physicians' causes of action because the defendants failed to explain how the clause applied to this particular case.
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Survey: Doctors Mixed on Electronic Medical Records
USA Today (01/07/14) Ellis, Jonathan; Walker, Jon

Physicians have mixed views about electronic health records, or EHRs, according to a Rand Corp. study. Respondents said they believe EHRs are improving certain aspects of quality care for patients, but the shift to EHRs has resulted in heavier workloads, restricted face time with patients, and has been costlier than envisioned. The study was sponsored by the American Medical Association, which has urged the federal government for greater flexibility with EHR mandates. Dr. Steven Stack, a member of the AMA's Board of Trustees, says doctors want the transition from paper to electronic to offer more leeway rather than be a "one-size-fits-all" initiative.
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Feds Might Object to Any State Law Forcing an Insurer, Hospital Into Contract
Pittsburgh Tribune-Review (12/24/13) Toland, Bill

In Pennsylvania, legislators are contemplating a new state law -- a first of its kind in the nation -- that would essentially force a hospital system to enter into a contract with a health insurance company against its will. The state House Health Committee recently heard testimony from Rep. Jim Christiana (R-Beaver) and Rep. Dan Frankel (D-Squirrel Hill) on legislation that would force University of Pittsburgh Medical Center (UPMC) hospitals and doctors to accept patients who carry Highmark health insurance at in-network rates. Currently, UPMC has no plans to renew its contract with Highmark after the current one expires at the end of December. However, Christiana and Frankel are pushing an "any willing insurer" law, meaning that any insurer willing to do business with a hospital network with its own insurance company would be able to.
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Bill Seeks to Clean Telehealth State Regulations Mess
InformationWeek (12/19/13) Terry, Ken

U.S. Reps. Doris Matsui (D-Calif.) and Bill Johnson (R-Ohio) have introduced a bill that creates a federal definition of telehealth and provides guidance to states on how to regulate this burgeoning field. Their announcement read: "Telehealth is a major contributing factor to increased health care quality, convenience, and lower costs. However, there currently are 50 separate sets of rules [in different states] as to what type of care can be provided. This often leaves both providers and patients in a state of uncertainty." The Telehealth Modernization Act grew out of recently adopted legislation in California. Among other things, that law allows California's Medicaid program to cover doctor-patient communications that take place outside of hospitals, skilled nursing facilities, and physician offices.
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