News at a Glance – September 2016

HIMSS Says Hospitals Slow to Adopt Precision Medicine. Precision medicine is slowly taking hold at the nation's hospitals, but the need to build up information technology to make it an organic part of the delivery of medicine would likely prove burdensome. That's the conclusion of HIMSS Analytics, which surveyed 137 health care organizations last month to gauge their approach toward the use of precision medicine— typically molecular-based tests for identifying specific disease variations in order to tailor care pathways. Respondents included standalone hospitals, academic medical centers, specialty hospitals and integrated delivery networks. According to the survey, only 29 percent of those providers surveyed conducted precision medicine onsite. Slightly more than a third of large academic medical centers performed it. "The limited adoption of precision medicine programs across the U.S. hospital market is understandable as very few organizations have the funds, technology or expertise to conduct precision medicine on site," the survey said.

As an alternative, 26 percent of respondents said they performed precision medicine through the use of third party laboratories, while a third used a combination of in-house and third-party services. The primary focus of the precision medicine efforts has been on cancer, with nearly 80 percent of respondents saying they used it for that purpose. Large numbers of the survey respondents said they were challenged with integrating genomic data with a patient's overall clinical data. Nearly 36 percent said they had yet to complete such an integration. Moreover, many organizations have uncertain plans regarding the future of their precision medicine initiatives. Nearly 43 percent said they had yet to develop a concrete strategy regarding their patients and the use of precision medicine. Another 21.4 percent were unsure about the strategy they would develop. Only 14.3 percent said they planned to develop a comprehensive marketing campaign to tout their precision medicine initiatives.

State Laws Seek to Improve Price Transparency. Despite the fact that the majority of state legislatures have passed some laws relating to pricing transparency for health care services, only seven states are receiving passing grades for both the statute's design and implementation, according to the report, Report Card on State Price Transparency Laws. Price transparency is necessary to combat significant pricing variation for health care services and the increasing financial burden individuals face, according to the study authors, the Health Care Incentives Improvement Institute (HCI3; Newtown, Conn.) and Catalyst for Payment Reform (Berkeley, Calif.). Many recent studies highlight regional variation in health care costs, including for laboratory tests. This variation is receiving more attention as of late as patients become responsible for a larger percent of their own bills as a result of high deductible health insurance plans. "The lack of information on the price of care hurts the pocket books of Americans every day," writes François de Brantes, HCI3 executive director and lead author of the report.

Analysts from the Source on Healthcare Price and Competition at the University of California, Hastings College of the Law and the University of California San Francisco assessed each state's enacted and proposed legislation on health care price transparency. Each state is given a letter grade with an explanation of the shortcomings that are holding back transparency. The authors say the scoring methodology rewards states that both have an all-payer claims databases (APCDs) and that publish that data on a well-designed, searchable website. The researchers found that all but seven states (Alaska, Alabama, Hawaii, Idaho, Mississippi, Oklahoma, and Wyoming) have passed some price transparency legislation. However, the quality of transparency varies due to differences in design and implementation of state laws.