Medicare diabetes program’s paltry numbers

With help from Arthur Allen (@arthurallen202) and Darius Tahir (@dariustahir)

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Quick Fix

— Medicare diabetes program’s paltry numbers: Just about 200 people signed up last year for a flagship Medicare program, well short of the 110,000 patients the government hopes to engage annually.

— Cerner snaps up AbleVets: The EHR giant working to modernize VA’s health IT acquired a consulting firm to scale up its federal expertise.

— Progress on SDOH data standards?: eHI is pushing for the use of standard ICD-10 codes when recording information about a patient’s social determinants of health.

Looking ahead to the rest of the week, the Bipartisan Policy Center convenes a discussion on drug pricing, ARQH tackles health IT research and the Health Innovation Alliance hosts a briefing on patient matching.

eHealth mega Tweet thread of the day (excerpted): Albert Attia (@albertattia7): Possibly controversial tweet: patients should not have full access to MD notes (digitally) as this is only going to create more confusion...and possibly distrust...thoughts? @VUMCRadOnc

Enlightening Results (@GraceCordovano): Patient have a legal right to accessing their records. Where does anyone have a place to make the judgement that it will cause confusion? There are also plenty of carepartners that help coordinate care & are heating seeking missiles for info. #PatientAdvocacy #UnblockHealth

Liz Salmi (@TheLizArmy): Patients can’t wait for all of the vendors to play well with each other. Give people easy access to their own health information so they can get care and loop in their various doctors. Patients are the agents of interoperability. We are the simple, low tech, no cost solution.

Welcome to MONDAY at Morning eHealth. What else is on tap this week? Tips go to [email protected]. Reach the rest of the team at @arthurallen202, @dariustahir, @ravindranize, @POLITICOPro and @Morning_eHealth.

Driving the Day

PROVIDERS FRUSTRATED BY MEDICARE DIABETES PROGRAM — CMS data shows just a small fraction of the people expected to sign up for a flagship Medicare program designed to help avert Type 2 diabetes actually did so, Darius reports.

... People familiar with the program said heavy regulatory burden kept providers from offering the diabetes prevention service; the rollout could hint at troubles for any future CMS programs aimed at paying providers for addressing social determinants of health, such as covering housing payments or job training.

An analysis conducted for POLITICO by open data startup CareJourney found that just 202 beneficiaries had used the program in 2018, though the pace seems to have accelerated in the first quarter of 2019, with almost 400 accessing prevention services. CMS neither confirmed nor denied the figures but cautioned that the data wouldn’t be complete until 2020.

... “HHS had a huge amount of turnover from folks who understood the benefit, the rationale, the cost-saving and life-saving benefits,” said Matt Longjohn, the former chief medical officer of the Y, whose pilots established the benefits of the program for CMS actuaries. He attributed the slow growth of the program to lack of providers and a lack of promotion that may have stoked demand for the services of the diabetes prevention providers thus far authorized by CMS, Darius writes.

CERNER’S BID TO BROADEN FEDERAL REACH — The EHR company mired in the VA’s $16 billion health records upgrade is purchasing AbleVet, saying the consulting firm’s federal expertise will help the combined entity provide more “integrated, seamless care” for veterans.

The two companies have already worked together; AbleVets was a subcontractor on Cerner’s VA deal.

The acquisition brings on about 350 AbleVets employees who specialize in topics such as cyber and agile engineering, according to Cerner. The firm’s founder, Wyatt Smith, previously served as a Navy oncologist.

The news comes about a month after Cerner announced plans to lay off about 255 employees, including around half from its Kansas City, Mo., headquarters, in an effort to cut costs.

EHI PUSHES ICD-10 CODES FOR SOCIAL DETERMINANTS — The eHealth Initiative & Foundation, known as eHI, is advocating for broader use of a subset of ICD-10 to encode data related to patients’ social determinants of health. ICD-10-CM Z codes can be used to record data about housing, food and transportation directly in the health record, CEO Jennifer Bordenick said in a release.

... The effort has buy-in from groups such as the American Hospital Association. Using the “Z” codes would help hospitals better track patient needs, the organization said.

In Congress

HOUSE DEMOCRAT CHEERS X12’S UDI RECOMMENDATION — The Accredited Standards Committee X12 recently recommended that unique device identifiers, known as UDIs, be included in medical claims forms to help track the impact of certain products on health outcomes. Among the most enthusiastic UDI advocates is Rep. Bill Pascrell (D-N.J.), who called the potential addition of identifier fields a “transformative victory for patient safety.”

...Other supporters include Premier. “Particularly in an era of value-based care, providers need this information to make informed decisions about the products they use,” according to a company statement.

WYDEN TELLS COMPANIES TO MIND THEIR OWN BUSINESS — Over on the Senate side, Ron Wyden last week introduced the “Mind Your Own Business Act of 2019” that would pressure tech companies to do just that. Among the proposals is one authorizing the FTC to create a national “Do Not Track” registry allowing consumers opt out of having their data sold, tracked or shared. The bill would also empower the agency to establish minimum cybersecurity and privacy standards.

Health IT Business Watch

GENOMICS ROUNDUP — A couple of gene sequencing tidbits this week:

— All of Us, NIH’s effort to collect data and biospecimens from 1 million research subjects, awarded $7 million to the HudsonAlpha Institute for Biotechnology to evaluate DNA sequencing technology, the agency announced. HudsonAlpha plans to use the grant to use “long-read” whole genome sequencing technology, which analyzes larger segments than a standard “short-read”, on 6,000 samples on diverse participants.

The project, according to NIH, can help researchers better understand the potential value of long-read sequencing and whether it can help researchers understand variations in genomic structure.

— Ochsner is partnering with Color, a genetic counseling service that itself received $4.6 million in NIH funding, to send genomics information directly into patients’ electronic health records, the Louisiana health system announced last week. The project aims to flag patients at higher risk for certain cancers and heart disease.

... Select patients will receive an at-home genetic testing kit, which will be screened for hereditary breast and ovarian cancer risk from BRCA1 and BRCA2 genetic mutations; Lynch Syndome, which is associated with higher colorectal and ovarian cancer; and hypercholesterolemia, which is associated with heart disease and stroke risk.

PREDICTING ICU INTERVENTIONS — Philips launched a new product called Sentry Score that aims to predict the probability of patient interventions in the ICU. The algorithm, which incorporates changes in vital signs, is designed to flag those patients likely to receive an intervention within 60 minutes, potentially giving clinicians more time to plan for their care, the company said. The predictive system could also give clinicians more time to set up telemedicine consultations and potentially intervene earlier than they might have otherwise, according to Philips.

What We're Reading

— Clinicians are encouraging patients to get 3D mammograms despite a lack of evidence that they save more lives, KHN’s Liz Szabo reports.

— vRoger Kuan outlines barriers to AI adoption in health care for the Harvard Business Review.