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General Medical Practice
Health information exchange (HIE)
Written by Patricia King, JD   

The push for health information exchange (HIE) began back in the Bush administration, with the long-term vision of a National Health Information Network (NHIN). While the NHIN remains a long way off, local and regional exchanges are developing in many areas of the country.[1]. The eHealth Initiative, in its 2010 survey, found 234 active HIE initiatives across the country. Seventy-three of these HIEs were actively exchanging data. Furthermore, there are now 56 state-designated entities that are working, often in coordination with state health officials, to guide HIE development in their state.

What will the availability of HIE mean for your practice? As HIEs are developing across the country, they face a number of decision points that will make a difference for what information you can obtain through the HIE. Here are some of the most critical:

Health information exchange

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Accountable Care Organizations: wave of the future or blast from the past?
Written by Patricia King, JD   
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Accountable Care Organizations (ACOs) are generating quite a buzz these days. Health policy experts rejoiced to see ACOs included in the health reform law; hospital systems and medical groups are talking about collaborating to form their own accountable care organizations; and insurance companies are coming up with their own private market models. What are ACOs, and should physicians be excited - or scared stiff?

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EHR risk management
Written by Patricia King, JD   

EMR and EHR
One of the policies underlying the government's push to encourage adoption of electronic health records (EHRs) is the expectation that EHRs will help prevent medical errors. This view is held not only by health policy experts, but also malpractice insurers.  In an earlier article, we explored incentives that some carriers are offering physicians to encourage EHR adoption. It is important to recognize, however, that some features of EHRs could actually cause problems from a risk management perspective if not properly addressed.

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Shared savings program
Written by Patricia King, JD   

Section 3022 of PPACA calls for the establishment of a Medicare shared savings program by January 1, 2012.  The shared savings program would reward accountable care organizations (ACOs) that lower average per capita Medicare expenditures while continuing to meet quality performance standards.

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Value based purchasing
Written by Patricia King, JD   

Title III, Subtitle A, Part I of PPACA is entitled “Linking Payment to Quality Outcomes under the Medicare Program”.  These provisions require the Department of Health and Human Services (HHS) to establish a value-based purchasing program for hospitals; develop a plan for value-based purchasing programs for skilled nursing facilities and home health agencies; and adopt a value-based payment modifier under the physician fee schedule.

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