The URAC Report

Washington, DC -- Independent accreditor URAC today published its latest industry insight report addressing the present and future of the telehealth industry. The report, Disrupting Healthcare: Risks and Rewards of Telehealth, examines the major factors driving the growth of telehealth in the U.S. healthcare sector, including financial incentives, changing medical philosophies and a growing need to serve patient populations who lack access to care.

Washington, DC, – URAC’s Vice President for Quality, Research, and Measurement, Marybeth Farquhar, PhD, MSN, RN, has been selected to represent URAC on the National Quality Partners (NQP) Leadership Consortium in 2017.

Just like the critical handoff of the baton in a relay race, a smooth transition of care from one healthcare provider or setting to the next is key to reaching the finish line of positive health outcomes, lower hospital readmissions and fewer medication errors. In the move toward value-based reimbursement, best practices in transitions of care have never been more important. 

“It’s not just looking at the medical aspects of what the patient is dealing with, but those non-clinical issues that so many times impact a transition and can cause avoidable hospital readmissions,” said Cheri Lattimer, executive director of the National Transitions of Care Coalition. “In good care coordination, the team understands their role is not done when the patient walks out their door. The team must put forth the effort to communicate, share and transfer information and make sure the patient and family caregiver are included.”

Patient experience plays a big and increasing role in measures of quality, accounting for eight of CMS’s 34 quality care measures for ACOs, for instance. That’s why many providers and health plans are taking steps to make sure their call centers enhance patients’ satisfaction rather than leave them hanging up in frustration. 

“It’s just like with any customer service line, if we have to wait on hold forever, it leaves a bad taste in your mouth,” said Bonnie Zickgraf, integrated services manager for URAC. “Plus, with social media, the bad experiences are 10 times more magnified than the positive ones.”

Healthcare ranking systems intended to measure quality of care can garner mixed reviews among providers. While many critics point to flaws in how such systems are structured, organizations like URAC are focusing on approaches to quality measurement that may be more reflective of provider performance. 

 “Ranking systems are heavily weighted toward process measures,” says Marybeth Farquhar, URAC’s Vice President of Quality, Research and Measurement. “Many of the measures that contribute to a ranking are basically indicating that a task has been completed, rather than looking at patient outcomes that resulted from that task.”

Hardly a month goes by that we don’t hear about a cyber or ransomware attack on a healthcare provider, manufacturer or health plan. Though major attacks are the ones that make the news, healthcare providers across the country face the risk of an attack of any size.

The Privacy Rights Clearinghouse estimates that more than 900 million records have been breached in the United States since 2005 as a result of nearly 5,200 reported incidents. Of those, about 30 percent—more than 1,500 data breaches—occurred in the healthcare industry.

Uncertainty in the legal and regulatory landscape. Lack of HIPAA enforcement. Little interest in fraud from the OIG. State licensure statutes that were written long before the technology for telehealth existed. Risks to quality healthcare. Plus, the changing expectations from patients as consumers. 

The rapidly growing telehealth industry is replete with challenges – and opportunities, which was the focus of a URAC-sponsored webinar, Challenges and Outlook for Telehealth in the Changing Healthcare Economy, on October 26, 2016. URAC Vice President Deborah Smith moderated the discussion with Adam Romney, partner at Davis Wright Tremaine, and Robert Bernstein, MD, vice president for clinical affairs, Carena. 

If physicians don’t understand MACRA – or think they don’t need to understand MACRA – how will ACOs get physician practices to align with the requirements of the Patient-Centered Medical Home (PCMH) model?