More on Patient Engagement

2019 was the year of the patient

Since February, when CMS Administrator Seema Verma said patients needed immediate access to their health records, the hits have just kept on coming.

Innovation, payer reinvention, drug prices and price transparency, cybersecurity, getting paid for telehealth and investing in the social determinants as well as the continuing physician workforce shortage topped HFN's stories and trends for 2019. Here's a look back.

Surprise billing, drug prices left to 2020

Insurers got repeal of the Cadillac tax, HIT and an extension of silver loading in year-end spending package.

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Legislators question insurers about surprise billing practices

House Energy and Commerce Committee also sends letters to physician staffing firms.

Patient loyalty to healthcare providers is at risk over transparency, finds AccessOne survey

Most consumers say providers' willingness to share price information prior to service is a critical factor in determining where to seek care.

Extending Medicare Part D rebates to beneficiaries would save seniors $29 billion over 7 years

In contrast, taxpayers would face additional costs if manufacturer rebates were directly applied to insurers' pharmacy prices.

Healthy diet could save $50 billion in healthcare costs

Suboptimal diet costs about $300 per person, accounting for 18% of all heart disease, stroke and type 2 diabetes costs in the country.

HHS releases proposed rule to import drugs from Canada to lower the price for consumers

Drug companies have said they are hamstrung by the current pharmacy benefit manager system, says HHS Secretary Alex Azar.

Tacking surprise billing could reduce healthcare spending by $40 billion

When physicians bill out of network it means possible unexpected medical bills, undercutting the functioning of healthcare markets.

Three drug bills attempt to cap costs

The Senate Finance Committee's bill would cancel planned cuts to Medicaid disproportionate-share hospital payments for 2020 and 2021.

Health and Human Services appeals site neutral payments ruling

Beyond cost, CMS said it adopted the lower payments for hospital outpatient facilities as a method to control unnecessary increases in volume.

CMS to pay hospitals millions in site neutral payments for 2019

The AHA is calling on CMS to "abandon further illegal cuts for 2020" that CMS says would save Medicare $800 million.

Accessing medical records improves patient care, but only 10% of patients do so

Use was disproportionately low across all hospital types, suggesting there's more hospitals could be going to get more people to use the record.

Rival surprise billing plan unveiled by Ways and Means

The American Hospital Association is against an earlier proposal because disputes would be settled through lower reimbursement benchmark rates.

Roper St. Francis Healthcare launches multi-hospital tele-ICU initiative with Advanced ICU Care

The bedside teams at RSFH's three hospitals will be supported by Advanced ICU Care's team of intensivists and nurses.

Telehealth laws and regulations in 2019 have set the stage for increased access and use

As the care delivery platform becomes more legitimate and accepted, governments, payers and providers are coping with the changes it will bring.

Trade deal takes away pharma's biologic exclusivity and promotes drug competition

Intellectual property protections are needed for the ongoing discovery of drug treatments, PhRMA says.

Patients intrigued by digital health services, but still value face-to-face interactions

Most patients showed willingness to use apps and online scheduling systems, but they were a lower priority than quality interactions. says.

Laws ensuring commercial insurance coverage for telehealth increasing among states

Still, a new state-by-state survey from Foley & Lardner suggests there is still plenty of ground to cover in terms of telehealth payment parity, as well as the language used in the laws themselves.

How changing Affordable Care Act rules affect health insurance premium costs

It's the unanticipated consequence of the 2017 cut of the ACA's cost-sharing reduction payments to health insurers.

CMS Administrator Seema Verma lays out plan for 'digital data revolution'

Health plans doing business in Medicare, Medicaid, ACA, are being asked to share claims data, and all information should be transferable, Verma says.

American Hospital Association, provider groups to sue over final rule

The rule will accelerate anti-competitive behavior among health insurers and stymie innovations in value-based care delivery, the groups say.

Seema Verma rolls out new CMS interoperability initiatives at HIMSS18

The government-wide MyHealthEData initiative is led by the White House Office of American Innovation.

HIMSSCast: CMS price transparency rule, telehealth parity laws, and healthcare consumerism

The HFN team discusses some recent pieces of news from federal and state governments, and speculates on these developments.

AHIP says proposed interoperability rules push payers too far, too fast

The insurance group says it's supportive of more data sharing, but says CMS' timeline for API-enabled access is too aggressive.

How price transparency helped an Arizona health system achieve financial turnaround

At Maricopa Integrated Health System, price transparency became a top strategic imperative after it helped the system boost its margins.

CMS proposed rule requires hospitals to make public their payer-specific negotiated charges

CMS Administrator Seema Verma says agency is not afraid of legal push-back from providers or payers.

CMS releases final and proposed rules on price transparency bound to get provider and payer pushback

The final rule for hospitals, which goes into effect in 2021, includes the ability for CMS to impose civil monetary penalties of $300 per day.

CMS unveils new rules aimed at clinician burden, patient experience

The Omnibus Burden Reduction and Discharge Planning rules both aim to reduce red tape and enable transparency, says Centers for Medicare & Medicaid Services Administrator Seema Verma.

Benefit design, higher deductibles will increase bad debt for hospitals

Legislative proposals could reduce bad debt, but would likely introduce additional complexity to billing processes.