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Boehner: Obamacare repeal and replace 'not what's going to happen' Print E-mail
Written by FHI's Week in Review   
Monday, 27 February 2017 15:16

Terence Burlij, reporting for CNN on Fri., 2/24/17:

Former House Speaker John Boehner threw cold water Thursday on the prospect of congressional Republicans following through on their pledge to repeal and replace the Affordable Care Act.

"They'll fix Obamacare," the former Ohio congressman predicted at a conference hosted by the Healthcare Information and Management Systems Society (HIMSS) in Orlando, Florida. "I shouldn't have called it repeal and replace because that's not what's going to happen. They're basically going to fix the flaws and put a more conservative box around it."

Read more in the curent issue of Week in Review>>

Last Updated on Saturday, 25 March 2017 08:34
Cyber Security in 2017 Print E-mail
Written by Jeffrey Herschler   
Friday, 24 February 2017 00:00

Phishing, spoofing, data breaches, ransomware and other scary digital stuff were among the topics at the South Florida Executive Forum (SFHEF) produced panel discussion held at the UHealth/Jackson campus last week (2/16/17). The featured speakers were:
  • Helenemarie Blake, Esq Chief Privacy & Data Security Officer and Assistant Vice President Compliance, Interim at University of Miami and U Health
  • Forest Blanton, Senior VP / Chief Information Officer, Memorial Healthcare System
  • Karl Norris, Founder and Architect of Duolark, LLC and Med-Detect
  • Matt Gracey, co-Founder and CEO of Danna-Gracey, an independent insurance agency specializing in insurance coverage for the healthcare industry
I had a chance to catch up with Matt Gracey immediately after the program. Below is a transcript of our chat:

JH  Cyber liability insurance was pretty obscure when you first started offering the product a few years back. Now, many data breaches later, how would you describe the market?

MG  The medical community seems to have awakened to the cyber risks much more recently. This follows and abundance of breaches and ransom issues for medical practitioners. Doctors and their administrators are finally realizing they are cyber targets not just hospitals and large healthcare entities. Patient records are some of the most sought after data for cyber criminals some the risks are rising rapidly. One study now says over 90% of medical practitioners have had their data breached in the last 24 months.

JH  One particularly nasty form of cyber crime is ransomware. A lot of providers just pay the ransom and move on. Is that a good idea? 

MG  Each situation is different so it all depends on the specific circumstances of the event. This is why healthcare providers need insurance coverage which allows the organization to get expert help in the event of a ransom demand.

JH  What's the biggest cyber threat to a health practice/facility?

•     The unemployed millennial living in his parent's basement
•     An East European criminal gang of hackers
•     A careless or dishonest employee

MG  Over 50% of breaches are caused by criminal hackers but the disgruntled employee or ex-employee as well as device theft/misplacement are also issues.

JH  Some doctors, solos and from small groups, have told me they don't need cyber insurance because the deep pocketed mega groups and hospitals are the real targets. Is that a valid argument against a cyber liability insurance purchase?

MG  This is the biggest misconception that we hear and is totally false. As the big guys get their defenses more improved, the smaller practices will be even harder hit since many are not keeping up with their systems.

JH  Twenty-six percent of U.S. consumers have had their personal medical information stolen from healthcare information systems, according to results of a new study from Accenture. This is mind-boggling. If you were running a medical practice or facility, what would be the three things you would do immediately to prevent this from happening to your patients?

MG  Get a comprehensive risk assessment, follow its findings and continually educate all of the doctors and employees in the practice.

The SFHEF will hold its next panel discussion March 16. You can learn more about that event here>>

Last Updated on Wednesday, 01 March 2017 17:27
Health Law's 10 Essential Benefits: A Look At What's At Risk in GOP Overhaul Print E-mail
Written by Michelle Andrews | KHN   
Thursday, 23 February 2017 00:00

khn logo black As Republicans look at ways to replace or repair the health law, many suggest shrinking the list of services insurers are required to offer in individual and small group plans would reduce costs and increase flexibility. That option came to the forefront last week when Seema Verma, who is slated to run the Centers for Medicare & Medicaid Services in the Trump administration, noted at her confirmation hearing that coverage for maternity services should be optional in those health plans.

Maternity coverage is a popular target and one often mentioned by health law critics, but other items also could be watered down or eliminated.

There are some big hurdles, however. The health law requires that insurers who sell policies for individuals and small businesses cover at a minimum 10 "essential health benefits," including hospitalization, prescription drugs and emergency care, in addition to maternity services. The law also requires that the scope of the services offered be equal to those typically provided in employer coverage.

"It has to look like a typical employer plan, and those are still pretty generous," said Timothy Jost, an emeritus professor at Washington and Lee University Law School in Virginia who is an expert on the health law.

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Accountable Care Options, LLC Selected to Particpate in the Next Generation Accountable Care Organization Model for 2017 Print E-mail
Written by Don Silver | BoardroomPR   
Wednesday, 22 February 2017 00:00

Boynton Beach, FL based Accountable Care Options, LLC has been selected to participate in the Centers for Medicare & Medicaid Services’ (CMS’) Next Generation ACO Model starting January 1, 2017.

The federal government is transitioning to alternative payment models from traditional, fee-for-service Medicare payments. CMS is partnering with experienced ACOs deemed ready to assume higher levels of financial risk and reward.

“This is the next stage in a new model of payment for medical care,” said Accountable Care Options CEO Richard Lucibella. “We embrace the model’s challenges and the opportunity to produce greater financial rewards for the physician practices in our organization.”

Accountable Care Options has earned financial rewards for its members since it formed in 2013 and joined the Medicare Shared Savings Program. In its first year, physician Shared Savings payments averaged $500 per fee-for-service Medicare patient in addition to the practice’s regular Medicare reimbursement; physician practices also achieved a quality score of 100 percent from CMS. Accountable Care Options’ Shared Savings totaled $4.4 million in 2014 and $7.2 million in 2015.

Based on its successes, Accountable Care Options applied this year to the Next Generation ACO Model, whose “Better, Smarter, Healthier” approach to improving health care is based on the quality rather than the quantity of patient care provided. The Model tests whether strong financial incentives for ACOs, coupled with tools to support better patient engagement and care management, can improve health outcomes and reduce expenditures for Medicare beneficiaries.

Accountable Care Options currently has 100 primary care providers in 36 offices throughout Palm Beach and Broward counties, serving nearly 12,000 Medicare ACO beneficiaries. Most practices have one or two physicians.

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About Accountable Care Options, LLC: Accountable Care Options, LLC is a privately owned and managed network of South Florida primary care practices providing coordinated care as part of the Medicare Shared Savings Program. The Accountable Care Organization, or ACO, takes all financial risk in the program, while member physicians receive their normal Medicare payments. The network and physicians share in bonuses paid by Medicare for reaching quality care and savings goals. For more information, visit
Billionaire's moonshot is falling far short of the hype Print E-mail
Written by Rebecca Robbins | STAT   
Tuesday, 14 February 2017 14:49

The world's richest doctor had a very bold plan.

He'd assemble an unprecedented collaboration of companies, researchers, and doctors. Their mission: to vanquish cancer. By the year 2020, they'd build a working vaccine and test therapies in 20,000 patients. They would forever transform medicine.

Or so Dr. Patrick Soon-Shiong vowed when he launched his audacious "Cancer MoonShot 2020" a year ago.

The supremely self-confident billionaire behind that vision has drawn attention at the highest levels: He's talked cancer research with Joe Biden, Bill Clinton, even the Pope. He's met with President Donald Trump at least twice since the election. Riding high on his pledge to win the war on cancer, Soon-Shiong is said to have pitched a role for himself as national health care czar in discussions with Trump's team.

But a STAT investigation of Soon-Shiong's cancer moonshot has found very little scientific progress.

Last Updated on Monday, 06 March 2017 16:48
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