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Saturday, May 30, 2015
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  • We are located in the BioTech One building of the VA Bio•Technology Research Park.

    SMA Informatics
    800 E. Leigh Street
    Suite 206-14 Building One
    Richmond, VA 23219

    Phone: (804) 344-8111
    FAX: (804) 344-8113

    Contact Form: Web Contact Form
Last Modified: May 23, 2015
News Item - 05/28/2015
GAO calls data used to determine physician pay potentially flawed
Federal investigators say the current process to review and recommend how Medicare pays doctors leaves it susceptible to inaccurate reporting and conflicts of interests.

A report released Thursday by the Government Accountability Office found “weaknesses” in the survey data used by the American Medical Association/Specialty Society Relative Value Scale Update Committee, also known as RUC.

Investigators said the committee's recommendation process “relies on the input of physicians who may have potential conflicts of interest with respect to the outcomes of CMS's process.”

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News Item - 05/28/2015
New Affordable Care Act payment model seeks to reduce cardiovascular disease
Speaking today at the White House Conference on Aging regional forum in Boston, Health and Human Services Secretary Sylvia M. Burwell announced a unique opportunity for health care providers to decrease cardiovascular disease risk for tens of thousands of Medicare beneficiaries by assessing an individual patient’s risks for heart attack or stroke and working with them to reduce those risks.

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News Item - 05/28/2015
Top Medicare prescribers get top payments from drugmakers: Modern Healthcare
Pharma companies that make payments to doctors--and the doctors who receive those payments--have repeatedly insisted there's no link between those payments and prescriptions. But data on Medicare's top script writers may have them answering for it all over again.

Nearly one-fourth of Medicare's 400 most prolific prescribers in 2013--those who prescribe at least $1 million worth of meds in the Medicare Part D program--pocketed consulting fees or other financial perks from the makers of those very drugs, according to a Modern Healthcare analysis of Part D data and the Open Payments database.

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News Item - 03/26/2015
Innovation Pulse: Meet the new CMS code worth $17 billion annually
Travis Bond spoke plainly but with a sparkle in his eye when he confessed: “We just got lucky.”

Bond, CEO of personal health record company CareSync, was referring to CPT code 99490 – something of a sleeping giant in the Centers for Medicare and Medicaid Services 2015 Physician Fee Schedule that has the potential to be rather lucrative for providers and the IT innovators who serve them.

The meaningful use program incentivized hospitals to adopt electronic health records and the $30 billion CMS has thus far disbursed, in turn, has lured a rush of vendors to innovate with electronic health records software (albeit arguably within certain detrimental confines). And the new code carries a strikingly similar potential, as many health systems will have to invest in platforms that enable them to care for patients in accordance with 99490.

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News Item - 05/26/2015
Repayments and Refunds: Estimating the Effects of 2014 Premium Tax Credit Reconciliation
In January 2014, the Affordable Care Act (ACA) began making federal premium tax credits available to eligible individuals who purchased health coverage through exchanges, or Marketplaces. These subsidies are a centerpiece of the law and are designed to provide financial assistance to millions of Americans who could not otherwise afford health coverage.

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ACO Chart via PulsePilot
Interactive ACO Chart via PulsePilot
News Item - 01/26/2015
HHS seeks to have 85 percent of Medicare fee-for-service payments in value-based purchasing categories 2 through 4 by 2016 and 90 percent by 2018
Improving the quality and affordability of care for all Americans has always been a pillar of the Affordable Care Act, alongside expanding access to such care. The law gives us the opportunity to shape the way health care is delivered to patients and to improve the quality of care system-wide while helping to reduce the growth of health care costs.

When it comes to improving the way providers are paid, we want to reward value and care coordination – rather than volume and care duplication.  In partnership with the private sector, the Department of Health and Human Services (HHS) is testing and expanding new health care payment models that can improve health care quality and reduce its cost.

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