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What We’re Watching: February 12, 2019

QUENCH THE THIRST

HHS has taken a critical step forward in addressing HIT interoperability, including to adopt open, publicly available and standardized APIs to help providers access data at the point of care and within the workflow; require commercial insurers w/federal healthcare programs to implement open APIs; foster increased provider data access; and support ongoing innovation and competition in the HIT marketplace.

What we’re saying: We often say we have data, data everywhere and not a drop to drink. That’s because there’s a ton of it but in our industry it is disconnected and cannot be used in a meaningful way. These steps are imperative to remove the obstacles that hinder the ability for providers to access and exchange healthcare data. Recognition and adoption of API standards, for instance, will help ensure data liquidity so that providers can get the most out of predictive analytics, and clinical decision support and surveillance technologies. These proposed rules come on the first day of HIMSS, where multiple likeminded stakeholders are singing the same tune. Data is important but it has to be meaningful. Susan DeVore will discuss these issues and more during her HIMSS keynote.

PREVENTION PAYS

A new Premier analysis revealed ED visits for people with at least 1 of 6 chronic conditions contributed to nearly 60% of all annual ED visits in 2017 across ~750 hospitals. More than a third of these visits were potentially preventable and equated to an estimated $8.3B.

What we’re saying: People with chronic conditions, which contribute to 90% of healthcare spending, need better preventative and more coordinated care. That is what value-based care models, including ACOs and bundled payments, are designed to do – create incentives to better align primary care and other outpatient and community caregivers with the hospital to achieve healthier patients. In our work, we’ve seen that 30% of ED visits are for issues that could have been treated in outpatient settings. Preventable visits from these patients are often due to a lack of knowledge around how to management their disease, improper use of meds, inability to engage in self-care, low adherence rates and lack of access. Health systems need cross-continuum care management models that enable community organizations and primary care providers to more effectively met patient needs. In implementing this type of model, Southcoast Health Network has reduced revisits to the ED by 14.1% and hospital readmissions by 25.5% for multi-visit behavioral health patients. It’s all about better coordination of care and prevention.

DRUGS COST

Between the House and Senate hearings on drug pricing last week, Trump’s State of the Union and the upcoming testimonials from pharmaceutical executives to the Senate Finance Committees on 2/26, the fight to address drug prices presses on. At the same time, our generic drug venture, ProvideGx, is enabling greater accessibility to and pricing for a blood pressure medication that has been in shortage for some time.

What we’re saying: We need legislation, such as the CREATES Act, that stops bad actors from gaming the system. But we also need private market solutions that aid in creating market competition to improve access to drugs while reducing their costs. That’s what ProvideGx is designed to do. Our advocacy efforts and solutions to solving the high cost of drugs and limited access to life saving medications are all backed by the member health systems that own us.

IN CASE YOU MISSED IT

What We’re Watching is a weekly blog focused on the current events Premier is following and their relevance to the work of Premier and its members.

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