Attention Hospices: Updated HIS Q + A

The new Q + A document is available on the Hospice Item Set portion of the HQRP webpage. The document contains frequently asked HIS-related questions received on the Help Desk July-September 2014.

Click here to access it.


HMS Gives Back To The Community


Thousands of families struggle with hunger and rely on food banks-especially during the holiday season. This holiday season, HMS Healthcare Management Solutions, Inc. is collecting non-perishable food items to donate to the Connecticut Food Bank. The HMS Thanksgiving Food Drive will be held from Wednesday, October 29th through Friday, November 21st.  

Click here to see the food items most needed by the Connecticut Food Bank.

In addition to the HMS Thanksgiving Food Drive, HMS will be hosting a raffle this week. As part of our company team-building exercise, we decorated pumpkins for Halloween. Tickets are $1 for 3, and the drawing will be held this Friday, October 31st. All proceeds from the raffle will go towards the Fred Ulbrich, Jr. Family Center as part of the Wallingford Emergency Shelter.

If you would like to participate in either activity and/or donate, please feel free to stop by the HMS office at 8 Research Parkway in Wallingford, Connecticut between the hours of 7:30am and 5pm Monday-Friday.

HMS appreciates your support. Every bit helps!

Tiptastic Tuesday: 3 Ways To Improve Health Insurance Literacy

According to a recent survey conducted by the Associated Press-NORC Center for Public Affairs Research (with funding from the Robert Wood Johnson Foundation), about half of health consumers with private insurance admit to not fully knowing what their benefits cover. Due to poor healthcare literacy, patients may forego or delay care until their conditions become serious, and may also not be prepared to manage their out-of-pocket responsibilities when they do use services.

The good news is that organizations can take steps to improve consumers’ healthcare literacy. Here are a few suggestions from a recent post by O’Dwyer’s:

  • Create and provide a glossary of healthcare/insurance terms. Put together a list of commonly misunderstood terms and define them in a way your patient population will understand.
  • Promote transparency. Identifying exact out-of-pocket costs upfront can be challenging, but the list of tools to help providers access such information is growing. Most recently, the state of Massachusetts began mandating health insurers to post costs of medical procedures for their enrollees.
  • Eliminate embarrassment. Keep patients and consumers involved in their care. Use games, videos, or blogs to educate people.

Click here to read more.

New HHS Initiative Will Improve Patient Care & Reduce Costs

The U.S. Department of Health & Human Services announced today that it would spend up to $840 million over the next four years to fund innovative healthcare strategies designed to improve patient care and lower costs. The initiative called the Transforming Clinical Practice Initiative is aimed at supporting networks that help doctors access information and improve outcomes. It is estimated to save between $1 billion and $4 billion. The project will fund strategies such as improving physician access to information on patient medication adherence, expanding available modes of patient/doctor communication, and improving coordinated, team-based care. The project will be open to applications from healthcare systems, providers associations, group practices and regional and state institutions.

Click here to read more.

Study: Hospital Ownership Of Doc Groups Leads To Higher Costs

According to a new study in the Journal of the American Medical Association, hospitals and healthcare systems may want to rethink plans to acquire physician practices to increase care coordination. The new research finds that hospital ownership of physician groups in California led to a 10 to 20 percent increase in overall costs. The study was conducted to assess whether total expenditures per patient were higher in physician practices owned by hospitals or multihospital systems compared to organizations owned by participating physicians. Researchers analyzed total expenditures of care provided to 4.5 million patients treated by integrated medical groups and independent practice association in California between 2009 and 2012. Expenditures per patient were 10.3 percent higher for hospital-owned physician organizations than physician-owned organizations after researchers adjusted for patient severity and other factors.

Click here to read more.

The Affordable Care Act, One Year Series: The Losers Part I

It’s been one year since the Affordable Care Act became law. In our last posts, we explored the positive impacts of the health law. In this post, we will take a look at those who didn’t fare nearly as well.

  1. Insurance companies. Insurance companies have been particularly affected by the ACA. Due to competition in the marketplace, the companies with the lowest monthly premiums appeal the most to those shopping for healthcare. According to a recent Huffington Post report, policyholders value lower premiums more than access to a wider network of doctors. Additionally, insurers that did not comply with ACA standards, sent out cancellation notices to thousands of customers.
  2. Employers. Starting in 2015, employers with over 100 employees will be required to provide health insurance to their employees. If they do not, they will be fined a penalty.
  3. Employees with modified benefits. Some employers are changing benefits to pass on more costs to employees in the form of higher premiums and higher deductibles and some are even cutting schedules to avoid providing health insurance under the employer mandate. Furthermore, many employees who work two part-time jobs are losing out since they may not receive insurance from either employer, but make too much to qualify for subsidized insurance on the exchanges.
  4. Insurance brokers. The health law has initiated numerous new changes in regards to health insurance, making education and compliance especially important during this time. Brokers will need to keep clients abreast of specific plan changes, new fees and taxes, reporting requirements, new rules regarding enrollments, non-discrimination and other changes. Being able to assist clients through this process and ensure that they understand the law and comply with it, will be particularly challenging during this transitional period.