Five new payment models unveiled by the Centers for Medicare & Medicaid Services are designed to test whether financial risk and performance-based payments will improve overall patient outcomes and reduce cost. Providers who adopt the approaches will be financially rewarded by better coordinating care with other providers and keeping patients healthier. (Healthcare Finance ; CMS announcement )
Efficient workforce management—ensuring that every member of the health care team functions at the top of their license—can significantly impact labor costs, the biggest part of the budget for most organizations. About 44 percent of health care executives in a recent survey say controlling these expenses is a priority. With physician and nursing shortage projections on the rise, solutions should involve direct feedback from staff about scheduling, workflows and clear roles on the team ( RevCycle Intelligence )
Evidence & Innovation
St. Jude in Memphis and UCSF Beioff Children’s Hospital in San Francisco report success using gene therapy to cure 10 infants with X-linked severe immune deficiency syndrome—commonly known as “bubble boy” disease. Babies in the trial, who came to the hospitals with life- threatening infections and an immune system that was unable to respond, developed fully functioning immune systems after the treatment and continue to grow normally. Researchers hope the therapy can be a model to treat other disorders. ( USA Today )
Half the patients with advanced cancer and who had undergone previous, unsuccessful treatment responded positively to therapy that was matched to their genetic profiles, a new study finds. That compares with only 22 percent of similar patients who received typical, unmatched treatment. The research team used genomic profiling and high-tech sequencing to create customized, multi-drug combinations for each patient. “Our next step is to determine if we can increase the benefit rate further if this strategy is instituted earlier in the course of the disease,” the principal investigator said. ( Biospace)
The Office of the National Coordinator for Health IT extended the period for public comment on new data interoperability rules by 30 days (through June 3). The Centers for Medicare & Medicaid Services noted the rules, a product of the 21 st Century Cures Act, have the potential to greatly impact the ability of providers to share and access data where and when they need it, and the ability for patients to access their own data. (Healthcare IT News )
Medicare’s “antiquated” payment system hasn’t kept up with “transformative technologies” like CAR T-cell therapy for cancer treatments, says Seema Verma, administrator of the Centers for Medicare & Medicaid Services. Verma says CMS may boost hospital payments for these gene therapies that use the patient’s own immune system cells to fight cancer. Current Medicare reimbursement only pays 50 percent of the cost of treatment. ( Washington Post )
The GTMRx Institute Learning Network will host two of the researchers who identified the $528 billion opportunity to reduce the overall cost of health care. Lead study author Jonathan Watanabe, Pharm.D., MS, Ph.D., BCGP and co-author Dr. Terry McInnis will explore the direct costs of non-optimized medication use that adds up to a $528 billion every year, and discuss why they believe comprehensive medication management integration offers a viable, cost-effective, scalable solution. Pro tip: Co-author Jan Hirsch, Ph.D., will join Dr. McInnis for a second free webinar May 14, “Acting on the $528B Opportunity,” which will explore training to advance CMM. Register for the free webinars .