HIStalk Interviews Jason Krantz, CEO, Definitive Healthcare

HIStalk Interviews

Jason Krantz, MBA is founder and CEO of Definitive Healthcare of Framingham, MA. Definitive Healthcare was started in 2011. Why did HIMSS sell its HIMSS Analytics business and how did Definitive Healthcare end up acquiring it? The match with Definitive is about being a good shepherd of that data. We also have information around the quality of care provided and the Medicare penalties or incentives that each of these facilities is achieving.

Medicare: Cover CGMs Now!

Insulin Nation

Unfortunately, Medicare policy hasn’t kept up with evolving diabetes technology, and policymakers have left out CGMs from the list of reimbursable diabetes devices. There have been several petitions circulating to pressure lawmakers to make Medicare cover CGMs.

The Promise of Telehealth for Older People – the U-M National Poll on Healthy Aging

Health Populi

Health Populi’s Hot Points: I recently collaborated with HealthMine on a survey looking into Medicare Advantage members’ views of health and digital technology.

Medicare Told to Cover CGMs in Ruling

Insulin Nation

Medicare doesn’t typically provide coverage for continuous glucose monitors (CGMs), as insurors who oversee Medicare coverage have long argued that CGMs are a “precautionary” device rather than a “medically necessary” one. The Medicare-insuring contractor denied the claim.

Do Medicare providers located at a Distant Site have to be hospital-based to provide services?

South Central Telehealth Resource Center

Q: Per Medicare regulations, do the providers at a distant site have to be hospital-based or can they be in a private setting – for example, a group of pulmonologists who want to create a telehealth system on their own? Also, all telehealth services must meet the Medicare established set of criteria for reimbursement. Click here to visit the Medicare Eligibility Analyzer site. To review CCHP information on Medicare, go to: [link]. Medicare

Costs, Consumerism, Cyber and Care, Everywhere – The 2019 Health Populi TrendCast

Health Populi

Employers will endeavor to artfully design consumer-directed benefit plans (CDHPs) that nudge insured workers toward healthier habits, while integrating a broader definition of wellness. Today is Boxing Day and St.

HEART Act Targets Medicare Limits on Telehealth

American Well

the Helping Expand Access to Rural Telehealth (HEART) Act targets the Center for Medicare & Medicaid Services’ (CMS) strict limitations on RPM reimbursements in rural areas. Currently, CMS has a narrow definition of “rural,” which leaves many patients ineligible for reimbursement. Of the 107,000 telemedicine visits for Medicare beneficiaries recorded in 2013, approximately 40,000 of them served rural areas. are on Medicaid and/or Medicare.

Changes to Medicare Advantage Plans Could Allow for Expansion of RPM Services in Senior Care

care innovations

And that means that “senior living companies that double as Medicare Advantage insurers” will be given the opportunity for reimbursement for new modes of care targeting patient with chronic conditions. Changes to Medicare Advantage Plans Designed to Reduce Rehospitalizations.

MACRA: Medicare’s Opportunity to Finally Embrace Connected Health Technology

ConnectedHealth

The nation’s healthcare system is in the middle of a major transition – one that, if done well, will have an incredible impact on the lives of millions Americans who rely on Medicare. For a long time, Medicare has had a reputation for being bureaucratic, lethargic, wasteful, and outdated. Further, the Center for Medicare and Medicaid Services (CMS), which administers Medicare, has been slow to incorporate advances in advanced health technology in the program.

Blockchain in Healthcare: A Vehicle Towards Digital Health 2.0?

The Digital Health Corner

A good definition of blockchain is: “A blockchain , [1] [2] [3] originally block chain , [4] [5] is a continuously growing list of records , called blocks, which are linked and secured using cryptography. [1] I would like to apologize to the readers of this site for the long hiatus. I have been spending time as cardiologist, consultant, and caregiver for a seriously ill family member. My goal is to continue writing as it is something I truly love to do.

Fred Trotter on Data Journalism and Cybersecurity — Harlow on Healthcare

Health Blawg

Fred’s shorthand definition: “Using FOIA requests and other sorts of collaborations to get covered-over data out of the realm of the useless and into the realm of the useful.” Fred notes that the DocGraph dataset of Medicare physician relationships with patients is the largest graph dataset — i.e. a dataset organized with nodes and edges — using real-name data out there, and is one of the few “people” graphs that are open.

The The Five Biggest Areas of Opportunity for Digital Health

The Digital Health Corner

One early definition of Artificial Intelligence (AI) in medicine (1984) was “…the construction of AI programs that perform diagnosis and make therapy recommendations. Today a broader definition may be applied: “the simulation of human intelligence processes by machines, especially computer systems. Digital health is unquestionably becoming part of healthcare lexicon and fabric. Electronic health records (EHRs) and personal fitness trackers have helped create awareness through use.

Fred Trotter on Data Journalism and Cybersecurity — Harlow on Healthcare

Health Blawg

Fred’s shorthand definition: “Using FOIA requests and other sorts of collaborations to get covered-over data out of the realm of the useless and into the realm of the useful.”

Fred Trotter on Data Journalism and Cybersecurity — Harlow on Healthcare

Health Blawg

Fred’s shorthand definition: “Using FOIA requests and other sorts of collaborations to get covered-over data out of the realm of the useless and into the realm of the useful.”

Fred Trotter on Data Journalism and Cybersecurity — Harlow on Healthcare

Health Blawg

Fred’s shorthand definition: “Using FOIA requests and other sorts of collaborations to get covered-over data out of the realm of the useless and into the realm of the useful.” Fred notes that the DocGraph dataset of Medicare physician relationships with patients is the largest graph dataset — i.e. a dataset organized with nodes and edges — using real-name data out there, and is one of the few “people” graphs that are open.

Fred Trotter on Data Journalism and Cybersecurity — Harlow on Healthcare

Health Blawg

Fred’s shorthand definition: “Using FOIA requests and other sorts of collaborations to get covered-over data out of the realm of the useless and into the realm of the useful.” Fred notes that the DocGraph dataset of Medicare physician relationships with patients is the largest graph dataset — i.e. a dataset organized with nodes and edges — using real-name data out there, and is one of the few “people” graphs that are open.

Fred Trotter on Data Journalism and Cybersecurity — Harlow on Healthcare

Health Blawg

Fred’s shorthand definition: “Using FOIA requests and other sorts of collaborations to get covered-over data out of the realm of the useless and into the realm of the useful.” Fred notes that the DocGraph dataset of Medicare physician relationships with patients is the largest graph dataset — i.e. a dataset organized with nodes and edges — using real-name data out there, and is one of the few “people” graphs that are open.

Telehealth and the CHRONIC Act of 2017 (S. 870)

South Central Telehealth Resource Center

House of Representatives, allows for an expansion of telehealth/telemedicine coverage under the Medicare Advantage Plan B. While the act does not require a Medicare Advantage Plan to offer additional telehealth services, it does allow the option. Medicare Participants.

While Costs Are A Top Concern Among Most U.S. Patients, So Are Challenges of Poverty, Food, and Housing

Health Populi

While a “single payer health care system” was favored by 41% in terms of a candidate’s position, 77% of people could not agree on a definition for what “single payer” means in a U.S.

Health Consumer Behaviors in the U.S. Stall, Alegeus Finds in the 2019 Index

Health Populi

While two-thirds of consumers say they understand their insurance coverage, only one-half of them can correctly answer questions about the definition of premiums and deductibles. That’s in addition to what Americans had already saved into Medicare. Add patients to that definition.

Assessing the GAO’s Report on Single-Payer Healthcare in America: Let’s Re-Imagine Workflow

Health Populi

Calls for universal health care, some under the banner of Medicare for All,” are growing among some policy makers and presidential candidates looking to run in 2020. The CBO points out that Medicare in the U.S.

Prescription Drugs Are Becoming A Luxury Good in America – Join the #HCLDR Chat Tonight

Health Populi

But drug costs to patients are in the eye of the beholder, who in a high-deductible plan or Medicare Part D donut hole becomes the first-dollar payer.

South Central Legislative/Regulatory Update – February 2018

South Central Telehealth Resource Center

Revises the provision which authorizes health care providers to offer telemedicine services; provides definitions and conditions on providers offering telemedicine services; authorizes the state board of medical licensure to promulgate rules relating to telemedicine with certain exceptions.

Universal Health Care and Financial Inclusion – Not Mutually Exclusive

Health Populi

government (which offers several flavors of plans through the VA, Tricare for active military, Medicare for aging people and Medicaid for people with low-incomes) or private sector employers, unions, and other insurance-conveners.

The 2019 Invasion of Disruptors in Healthcare (Part 2) — Google, Lyft, Uber, IBM

Phoenix Health Systems

In a strategic windfall, the Centers for Medicare and Medicaid Services (CMS) announced last April that it would cover non-emergency transport, freeing up hundreds of thousands of dollars for rideshare companies. Earlier this year Lyft announced an expanded partnership with Medicare Advantage plans for people over 65 with BlueCross BlueShield and Humana. In a post last month , we took a quick tour of the inroads that Amazon and Apple are making into mainstream healthcare.

Essential Telemedicine Terms Clinicians Should Know

Enzyme Health

CMS : Stands for the Centers for Medicaid and Medicare Services. CMS is the federal agency that administers HIPAA standards and develops Medicaid and Medicare reimbursement policies for telemedicine. Applying for telemedicine jobs and want to stand out?

Telemedicine Reimbursement

American Well

Lack of understanding about how each of the three major payer types—Medicare, Medicaid, and commercial payers—reimburse for telemedicine visits has understandably prevented many providers and delivery systems from making informed decisions about adopting this technology. Medicare .

Why telemedicine and remote patient monitoring demand will skyrocket in 2019

Redox

As you might expect, this being healthcare and all, there isn’t one definition of “telemedicine”. My only tweak to the ONC’s definition would be to ignore the focus on “video conferencing”. A study published in Health Affairs found that Medicare and Medicaid, the two largest insurance programs administered by the Centers for Medicare & Medicaid Services (CMS), accounted for 59% of revenue for the 5 largest US commercial health insurance companies.

South Central Legislative/Regulatory Update – May 2018

South Central Telehealth Resource Center

in committee Provides that health insurance companies and employee benefit plans may limit telemedicine coverage to health care providers in network with the plan instead of in a telemedicine network approved by the plan; revises the definition of store and forward telemedicine services for the purposes of coverage and reimbursement for those services; revises the criteria for qualifying patients for remote patient monitoring services.

South Central Legislative/Regulatory Update – June 2018

South Central Telehealth Resource Center

in committee Provides that health insurance companies and employee benefit plans may limit telemedicine coverage to health care providers in network with the plan instead of in a telemedicine network approved by the plan; revises the definition of store and forward telemedicine services for the purposes of coverage and reimbursement for those services; revises the criteria for qualifying patients for remote patient monitoring services.

South Central Legislative/Regulatory Update – March & April 2018

South Central Telehealth Resource Center

Mississippi HB 799 1/30/18: Died in committee Provides that health insurance companies and employee benefit plans may limit telemedicine coverage to health care providers in network with the plan instead of in a telemedicine network approved by the plan; revises the definition of store and forward telemedicine services for the purposes of coverage and reimbursement for those services; revises the criteria for.

South Central Legislative/Regulatory Update – March 2018

South Central Telehealth Resource Center

Provides that health insurance companies and employee benefit plans may limit telemedicine coverage to health care providers in network with the plan instead of in a telemedicine network approved by the plan; revises the definition of store and forward telemedicine services for the purposes of coverage and reimbursement for those services; revises the criteria for qualifying patients for remote patient monitoring services.

South Central Legislative/Regulatory Update – November 2017

South Central Telehealth Resource Center

This bill would create the Telemedicine Act; amend the definition of telemedicine and originating site; addresses requirements of a professional relationship when using telemedicine; adds standards for the appropriate use of telemedicine; address insurance coverage of telemedicine; and for other purposes. Provides a definition for telemedicine and allows the required face-to-face encounter for care coordinators to take place over telemedicine.

The 2019 Invasion of Disruptors in Healthcare (Part 1) — Amazon and Apple

Phoenix Health Systems

So the market is definitely paying attention and thinks that this is going to be impactful on us.”. What have those upstart megaliths like Amazon, Apple, Google, Walmart, Lyft and Uber been toying with lately to disrupt our traditional healthcare models? From all appearances, they’re not wasting time; instead, several recent aggressive moves are making many traditional healthcare providers and payers nervous.

FHIR 150

The 2019 Invasion of Disruptors in Healthcare (Part 1) — Amazon and Apple

Phoenix Health Systems

So the market is definitely paying attention and thinks that this is going to be impactful on us.”. What have those upstart megaliths like Amazon, Apple, Google, Walmart, Lyft and Uber been toying with lately to disrupt our traditional healthcare models? From all appearances, they’re not wasting time; instead, several recent aggressive moves are making many traditional healthcare providers and payers nervous.

Paying for value. I’m overwhelmed. Please read this.

Society for Participatory Medicine

As you may know from previous posts, I sit as a patient/caregiver stakeholder on a Center for Medicare and Medicaid Services (CMS) technical expert panel (TEP) about Quality Measurement Development: Supporting Efficiency and Innovation in the Process of Developing CMS Quality Measures.

Virtual Reality Applications in Workers’ Compensation Reviews

Advanced Medical Reviews

For years, many insurance carriers offered limited coverage options for such telehealth consultations conducted via phone/VoIP or video conference, for several reasons, including: Lack of a clear definition of what services qualified as telemedicine. Restrictive telehealth payment rules under programs like Medicare. VR can be the next step in such high-definition telemedicine.

What the Federation of State Medical Board’s Decision Means for Telehealth

American Well

It also means that all states can utilize clear definitions and principles to guide policies governing the use of telehealth. The fact that the board did not make any changes to the telehealth definition outlined is not an oversight.

2019 Telehealth Predictions: The Emergence of a Game-Changer for Healthcare

American Well

But above all, in 2018, our definition of telehealth changed. The transition of telehealth from emergent-care settings into chronic-care settings is supported by the CHRONIC Care Act, which will release Medicare Advantage dollars to providers treating chronically ill patients remotely. Throughout 2018, we witnessed across-the-board advances in the world of telemedicine.

Significant FDA Regulatory Advancements Clear a Path Forward for Connected Health Innovators

ConnectedHealth

In addition to this definition, the FDA’s draft guidance offers examples to illustrate its regulatory approach to CDS software. This definition leaves PDS software unaffected by the 21CC Act’s section 520(o). With the 21CC Act’s passage, the FDA is proposing to revise each guidance document per the alternations made to the definition of a medical device under section 520(o)(1)(A)-(D) of the Federal Food, Drug, and Cosmetic Act.