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CMS Announces New ACOs
In January, the Centers for Medicare and Medicaid Services (CMS) announced that an additional 106 accountable care organizations (ACOs) will participate in Medicare's Shared Savings Program. ACOs are voluntary groups of hospitals, physician organizations, long-term care providers, and others that have agreed to work together to improve the health of a designated group of patients. Among the 106 are 15 "Advance Payment Model" ACOs. Made up of physician-based or rural health providers, they will have greater access to capital to invest in staff, electronic health record systems, or other infrastructure required to improve care coordination. CMS will recoup the advance payments through future shared savings. 

New York Seeks to Promote Early Sepsis Identification, Treatment
The New York Times reported in December that New York will become the first state in the nation to issue standards requiring doctors and nurses to actively monitor patients for sepsis and follow best practices in its treatment. Sepsis, a self-destructive immune response to illness or infection that is a leading cause of hospital deaths, can be hard to diagnose early since its symptoms—including high pulse rate and fever—mimic that of flu and other conditions. Attention focused on the issue after the April 2012 death from sepsis of a 12-year-old boy from Queens, New York. The regulations, now being drafted, would require hospitals to publicly report the results of their efforts.

Study: "Never" Events Are Far from Never
A study led by Johns Hopkins researchers and published in the journal Surgery found that surgical "never events"—such as operating on the wrong patient or wrong body part, or leaving a foreign object like a sponge in a patient's body after surgery—occur more than 4,000 times a year in the U.S. The study also found that, among physicians named in a malpractice claim involving a never event, 12.4 percent were later named in at least one future surgical never event claim.

Telehealth on the Rise
iHealthbeat reported last month that greater numbers of employers and insurers are paying for telehealth services, including remote consultations with physicians or virtual physician visits. The article cites a survey by the consulting firm Mercer in which 15 percent of major employers now offer some form of telemedicine, while an additional 39 percent are considering the option. Experts say that telehealth technologies have the potential to alleviate the shortage of primary care physicians and help control costs. Another iHealthbeat article reported on a bill recently introduced in the U.S. House of Representatives to promote coverage for telehealth services in government health plans including Medicare, Medicaid, Tricare (for active and retired members of the military and their families), and other programs.

Patient-Generated Data May Be Required for "Meaningful Use" of EHRs
The federal Office of the National Coordinator for Health Information Technology's Health IT Policy Committee is seeking public comment through January 14 on its proposed recommendations for the stage three definition of "meaningful use" of electronic health records (EHRs). The committee's request states that "stage 3 is the time to begin to transition from a setting-specific focus to a collaborative, patient- and family-centric approach" to use of EHR technology. Among other proposed recommendations, providers would have to electronically accept patient-generated information, for example on their experiences with diet and exercise, as well as any information related to their health goals and advanced directives. Interest in patient-reported health information is being driven by consumers' growing use of health care apps to manage their chronic conditions, quit smoking, or lose weight and by the desire to engage patients in managing their health through these and other tools.

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