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Big Data Series Part III of IV:
"Big Data" Impact on Healthcare Regulation and Reimbursement
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The four part HC Topics Series: Big Data examines the evolution and utility of big data in the healthcare industry, and its potential effects on various aspects of healthcare delivery within the Four Pillars of the Healthcare Industry: regulatory, reimbursement, competition, and technology. Part I discussed the history of big data and an overview of how it has been applied in healthcare; Part II addressed the intersection of big data with HIPAA/HITECH, data, and information security in a growing age of healthcare technology; Part III of the series will review the regulatory drivers and utility for big data in healthcare reimbursement; and, Part IV will assess the implications of big data for healthcare delivery, providers, and consumers.
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 Big Data Series Part III of IV: "Big Data" Impact on Healthcare Regulation and Reimbursement
In this third installment of a four part series, will examine the use of, and opportunities for, the use of big data in the healthcare regulatory and reimbursement environment, including federal data initiatives, and use within the context of healthcare reform.
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Infection Control and "Never Events" Series Part III of IV: Data Metrics for "No Pay" Events: How Accurate is it?
The four part HC Topics Series: Infection Control and Patient Safety in an Era of "Never Events," examines the history and development of the current patient safety and infection control environments within the context of current regulations regarding mandatory public reporting and the reimbursement impact of never events. Part III addresses the potential pitfalls and challenges regarding validation and accuracy of patient safety indicators.
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New Consumer Health Insurance Exchange Options Likely to Vary by State
On June 19, 2013, The Centers for Medicare and Medicaid Services (CMS) published newly proposed rules regarding Affordable Insurance Exchanges or Health Insurance Marketplaces (Exchanges) established under the Patient Protection and Affordable Care Act. The rules announce oversight of Exchanges by the Department of Health and Human Services (HHS) for several operational, cost, and quality compliance standards. On May 30, 2013, the Obama Administration released early data estimating that approximately 80% of potential enrollees will have the option to choose coverage from at least five insurers and at least 31 states will offer multi-state insurance plans in 2014, with all 50 states offering such coverage by 2017. Despite this favorable preliminary data, concerns have arisen regarding how drastically potential differences and availability of consumer healthcare plan choices may vary based on the characteristics of each state or market area.
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Challenges to Contain Costs and Standardize End-of-Life Care
With an aging baby boomer population and resulting increase in Medicare beneficiaries, one area of care that is receiving more scrutiny in the healthcare market is hospice and end-of-life care. In a study recently released by the Dartmouth Atlas Project, it was shown that from 2007 to 2010, chronically ill Medicare patients suffered fewer deaths in the hospital; spent fewer days in the hospital; and, reduced the number of physician visits. Despite improvements in care for end-of-life patients, the report also found that the cost of care for these patients in the last two years of life increased from $60,694 to almost $70,000 during the same time frame, an increase that outstrips the rise in the consumer price index (15.2%, compared to only 5.3%). The report also observed a continued lack of standardization in growth of end-of-life care improvement across entities.
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