Crystal Ewing, Product Manager, ZirMed

In the next 18 months, 150 million Medicare beneficiaries (active, archived, or deceased) will be transitioned to new ID numbers, called Medicare Beneficiary Identification (MBI) codes. The goal – to protect a vulnerable population from identity fraud – is admirable and urgent.

But the sheer magnitude of the process, combined with significant uncertainties about its rollout, should be of great concern to health IT leaders at hospitals and healthcare systems. Hiccups in the transition could potentially disrupt continuity of care and delay payments to providers. Health IT leaders would be well-served to develop a strategy now to minimize negative impacts down the road.

Why the change is needed

Up until now, Medicare beneficiaries have been using 11-character codes called Health Insurance Claim Numbers (HICN). The problem is that they all begin with the member’s social security number, with two characters added to the end. These ID numbers are easy to crack and – since Social Security numbers provide access to all sorts of private information – leave beneficiaries open to identity theft, both medical and financial. A Medicare card that is lost, copied, or even left in view in a public area or in the home could jeopardize a member’s personal health information or life savings.

So as part of the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), the Centers for Medicare and Medicaid Services (CMS) will be replacing the old Health Insurance Claim Number (HICN) on Medicare cards with new, randomly generated Medicare Beneficiary Identification (MBI) codes. Officially, the change is known as the Social Security Number Removal Initiative. The new MBI codes will use a randomly generated combination of letters and numbers, similar to the recommended best practices for passwords.

Newly published research by Harvard Medical School and the RAND Corporation reveals a dramatic growth in the use of telemedicine for the diagnosis and treatment of mental health disorders in rural areas, but strikingly uneven distribution of services across states.

The results, published in Health Affairs, stem from analysis of telemedicine use among Medicare beneficiaries nationwide over10 years.

The study shows an average 45 percent jump per year in telemedicine visits between 2004 and 2014, among rural patients, with striking variation across states. Four states had no such visits in 2014, while in nine states, there were more than 25 telemedicine visits per 100 patients with serious mental illness.

The reasons for the dramatically uneven distribution remain unclear, but the study investigators say state laws that regulate the provision and reimbursement of telemedicine services for mental health appear to play some role.

“Our results highlight the growing importance of telemedicine in the treatment of mental health disorders in rural settings where access to mental health care is often problematic,” said study lead investigator Ateev Mehrotra, associate professor in the Department of Health Care Policy at Harvard Medical School.

It was a fix that didn’t fix much — but Veterans Choice is expected to be extended anyway, with a stroke of President Donald Trump’s pen that could come as early as Wednesday.

Veterans Choice is a $10 billion response to the 2014 scandal in which Veterans Affairs health facilities altered records to hide months-long waits for care in Phoenix and elsewhere. The troubled Choice program pays for private-sector health care for veterans and was set to expire in August, but the VA and some of the program’s harshest critics in Congress have agreed to extend it, with a few changes, until January. They said that will give the VA time to propose a more comprehensive package of reforms — fixes for the fix.

Montana Democratic Sen. Jon Tester authored the extension bill, which won bipartisan support in the House and Senate this month. It will become law when Trump signs it.

Nearly half of California hospitals received a grade of C or lower for patient safety on a national report card aimed at prodding medical centers to do more to prevent injuries and deaths.

The Leapfrog Group, an employer-backed nonprofit group focused on health care quality, issued its latest scores last week. The report card is part of an effort to make consumers and employers aware of how their hospitals perform on key quality measures, so they can make better-informed health care decisions. The scores are updated twice a year, in spring and fall.

After steady improvement in recent years, California hospitals lost ground in last week’s report card. Two years ago, 37 percent of California hospitals received a C, D or F grade. That increased to 46 percent of the 271 California hospitals rated in the most recent report.

Joncé Smith, Vice President of Revenue Cycle Management, Stoltenberg Consulting

Written by: Joncé Smith

Entering 2017 brings a huge degree of uncertainty amid major healthcare industry changes. In particular, the Medicare Access and CHIP Reauthorization Act (MACRA) holds several options for Medicare physician payment paths as healthcare providers interpret implications and exemption possibilities.

MACRA replaces the old sustainable growth-rate (SGR) formula for physician payment, shifting focus from the fee-for-service model to value-based care. Physicians must now pick from one of two reimbursement tracks: the Merit-based Incentive Payment System (MIPS) or Advanced Alternative Payment Models (APMs).

To help you better understand MACRA, we’ve outlined the program’s tracks below.

A selection of opinions on health care from around the country.

Each week, KHN’s Shefali Luthra finds interesting reads from around the Web.

A collection of public health opinions from around the country.

Fortune: Why ‘Precision Medicine’ Isn’t Precise Enough
Every time I talk with Lloyd Minor, the Dean of Stanford University School of Medicine, I come away with a sharper, fresher, more illuminated perspective on one topic or another. And such was the effect of our conversation on Thursday. This time, Dean Minor made a good case that the goal of “precision medicine” — the meme célèbre in healthcare circles today — is the wrong one. The right goal is “precision health.” (Clifton Leaf, 4/10)

The Kansas City Star: Why Do Kansas Lawmakers Think Guns In Hospitals Are A Good Idea?
Nearly 20 years ago, the Kansas Legislature had the foresight to take steps that would save what was then known as the University of Kansas Hospital from impending ruin. By allowing it to split from state control, they gave the now sprawling health care system a competitive edge. It has flourished ever since. … Today, the same political body’s lack of vision is threatening to undermine the massive institutional improvements that lawmakers’ predecessors made possible. Talk about coming full circle. The state’s senators and representatives have failed to exempt the University of Kansas Health System from a law that will allow concealed weapons to be carried in the state’s public buildings starting in July. (4/10)

Rebecca Bruno, MPM, Director of Policy and Regulatory Affairs, Cognosante

Person-centered approach

Many individuals enrolled in Medicaid also access services from other state human services agencies and community-based providers. Deploying a “whole person” approach for enrollees – supported by modern tools and one-to-one support – can increase beneficiary engagement while lowering a state’s overall costs and administrative burden.

The Medicaid landscape is changing

Since implementation of the Affordable Care Act (ACA) in January 2014, Medicaid enrollment has been steadily increasing. As of August 2016, the latest period for which data is available, more than 73 million Americans were covered by Medicaid.[i] This is approximately a 28 percent increase from the enrollment period just prior to the first Marketplace Open Enrollment period in October 2013.[ii] In addition to Medicaid’s traditional coverage of low-income families, low-income elderly individuals, and individuals with disabilities, in many states Medicaid now covers adults without dependent children. Also, more Medicaid beneficiaries in need of long-term services and supports (LTSS) are being served in home and community-based settings rather than nursing homes and institutions.