The Affordable Care Act’s Reporting Electronic Backbone—The AIR System

If you are wondering how the IRS will invade your health privacy.......there is software for that.  Given the miserable rollout for health.gov you may be in for a surprise. Most likely there will be many errors. What will the dispute process be? The actual workings of plans such as they may be at March 1, 2016 reveals high deductibles and co-payments. High enough that it will pay for people to ignore the requirements for mandatory health care insurance, and just pay the fine for several years.  We have not as yet calculated the cost curve.

The Affordable Care Act’s Reporting Electronic Backbone—The AIR System

For the last half of 2015, we spent a good deal of time explaining the Affordable Care Act reporting requirements that applied to carriers and large employers. A compilation of these posts, which generally address the content of the ACA reporting requirements, is available here. This post examines the how of ACA reporting. In particular, it provides a primer on the electronic filing system—referred to as the Affordable Care Act Information Return System (AIR)—that the IRS has developed and deployed to facilitate the submission of reporting data to the government.

AIR’s Antecedent—The IRS Filing Information Returns Electronically (FIRE) system

When explaining the ACA’s filing requirements, we found it helpful to point to the similarities between the payroll reporting on IRS Form’s W-2 (“Wage and Tax Statement”) and W-3 (“Transmittal of Wage and Tax Statement”), and the Forms 1094-B and 1095-B (that apply to providers of minimum essential coverage) and Forms 1094-C and 1095-C (that apply to applicable large employers). Form W-2 is (all too) familiar to taxpayers of all stripes as the form that employers provide to them in connection with the filing of their annual Form 1040 (“U.S. Individual Tax Return”), and employers recognize Form W-3 as the form they use to provide copies of W-2s to the government. Forms 1094-B and 1095-B, and 1094-C and 1095-C, operate in a similar fashion. Forms 1095-B and 1095-C are individualized forms that are provided to employees, and Forms 1094-B and 1094-C are used to transmit information reflected on Forms 1095-B and 1095-C to the government.

The Gary M. Levin Daily

Hollywood Presbyterian Medical Center takes systems offline due to ransomware attack - FierceHealthIT

There is a new game in town. It is a twist on cyber-security. Hackers have decided to monetize their hacking habits.    

Ransomware takes Hollywood hospital offline, $3.6M demanded by attackers

The computers at Hollywood Presbyterian Medical Center have been down for more than a week as the Southern California hospital works to recover from a Ransomware attack.

According to officials HPMC, they're cooperating fully with the LAPD and FBI, as law enforcement attempts to discover the identity of the attackers.

However, in the meantime the network is offline and staff are struggling to deal with the loss of email and access to some patient data.

In such attacks, cybercriminals infect a system with malicious software--often via phishing attacks--and lock up files, demanding ransom to unlock them under threat of deleting them. The hackers, who have not yet been identified, are demanding payment of 9,000 Bitcoins, or just over $3.6 million dollars, according to CSO.

Ransomware attacks are on the rise, including an attack on Mount Pleasant, Texas-based Titus Regional Medical Center in January. Meanwhile, Forrester Research has predicted that this year ransom attacks will begin to target medical devices such as pacemakers.

Hollywood Presbyterian Medical Center takes systems offline due to ransomware attack - FierceHealthIT

Big data, genetics and telemedicine well represented in Google Venture's $800M healthcare portfolio -

While traditional medical device startups are struggling to find financiers, digital health companies are not.
There are a multitude of VC companies that have already invested in health startups. The interest is high not only in information technology, but overlaps into Pharma and genomics as well.

Top Venture Capital Firms

Not only are VCs looking at Health IT there is a flurry of investment in Pharma and Biotechnical Enterprise.

Digital Health Funding: 2015 Year in Review | Rock Health ...

According to Rock Health  2015 surpassed all expectations for VC funding of HIT.

VC investment (2015)

It is not difficult to deep dyve into facts and figures. For a fee Rock Health has produced two reports;  

  

Ongoing subscription to Research Data  

A one time report to Research Data

Big data, genetics and telemedicine well represented in Google Venture's $800M healthcare portfolio - FierceMedicalDevices

The Doctor's Computer Will Email You Now

A health care startup made a wild pitch to Cara Waller, CEO of the Newport Orthopedic Institute. The company said it could get patients more engaged with their care by automating physician empathy.

It "almost made me nauseous," she said. How can you automate something as deeply personal as empathy?

But Waller needed help. Her physicians in Orange County, Calif., perform as many as 500 surgeries a year, managing large numbers of patients at various stages of treatment and recovery. The doctors needed a better way to communicate with patients and track their progress.

The California startup, HealthLoop, told Waller its messaging technology would improve patient satisfaction and help keep them out of the hospital. High satisfaction scores and low readmission rates mean higher reimbursements from Medicare. Waller was intrigued and decided to give the technology a try.

So far, she's been surprised at patients' enthusiasm for the personalized — but automated — daily emails they receive from their doctors.

Companies like HealthLoop are promising that their technologies will help patients stick to treatment and recovery regimens, avoid repeat hospital stays and be more satisfied with their care. Similar companies that aim to improve patient engagement include Wellframe, Curaspan and Infield Health.

HealthLoop's technology is being tested at medical centers that include the Cleveland Clinic, Kaiser Permanente-Southern California and the University of California, San Francisco.

How does it work? Doctors can send daily emails with information timed to milestones in surgery prep and recovery. The emails can ask patients or caregivers for feedback on specific issues that come up during recovery.

The doctors may write their own email scripts, as Newport Orthopedics' physicians did, or use the company's suggestions. An online dashboard helps doctors and administrators keep track of which patients are doing well and who might need more follow-up care.

A patient might see this message: "How are you? Let me know so I can make sure you're OK. I have four questions for you today." The answers to those questions can trigger a call from the doctor's office.

One of those calls may have been a lifesaver for David Larson, a Huntington Beach retiree. After Larson responded "yes" to an email that asked if he had calf pain after knee surgery, he got a call from his doctor's office telling him to come in immediately. An ultrasound confirmed he had a blood clot that could have landed him in the hospital — or worse. With treatment, the blood clot dissolved.

"There were times when it was like, 'Oh brother, they're contacting me again,' but none of this would have been caught if it wasn't for the email," said Larson, 66. "So it was more than worth it to me. Now I'm back to walking the dog, surfing, riding a bike."

The Doctor's Computer Will Email You Now : Shots - Health News : NPR