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Practicing Across State Lines is Getting Easier for Physicians

Multistate licensure for healthcare practitioners is a solution whose time has come. Already, a multistate licensure compact for nurses, strongly supported by the nursing workforce, is well underway. Now, physicians have the Interstate Medical Licensure Compact, an evolving agreement currently among 22 states and the 29 Medical and Osteopathic Boards in those states. These agreements allow practitioners to qualify to practice across state lines among compact states if they meet eligibility requirements.

The Interstate Medical Licensure Compact (IMLC) is particularly important for improving access to medical care for people in underserved areas – particularly in rural America. Through the use of telemedicine and other technologies, specialists can more easily connect with patients who may be hundreds of miles away from the physicians. The compact also expedites the licensure of physicians with good practice histories so they can more quickly apply and receive state licenses, including for locums or in emergency situations such as the devastating hurricanes of 2017.

The IMLC began in 2013, when a group of state medical board officials wrote standards for licensure of physicians that that could be applicable to more than one state. This language became the multistate compact; state legislatures had to authorize, and governors had to sign, identical language for each state. Then, when a physician applies for licensure in a compact state, the state licensing board shares the results with the IMLC Commission, which in turn notifies the state boards in the state’s where the physician also wants to be licensed.

The IMLC went into force and the commission was created in 2015, after seven states adopted the compact. Since then, a total of 22 states have joined while several others have introduced legislation to become part of the compact. Some high population states have not yet opted to join the compact, most notably California, Texas, Florida, Ohio and New Jersey.

Proponents say multistate compacts are necessary in an era of growing shortages of most types of healthcare practitioners, where healthcare organizations need the flexibility to quickly engage physicians, nurses and allied health professionals from other states and where telemedicine across state lines hold the promise of better care in underserved areas.

For physicians themselves, a multistate license allows them to more easily practice telemedicine and work locum tenens assignments, work for healthcare organizations with locations in more than one state, and find better employment opportunities in other states.

Licensing across state lines among compact states can now be accomplished in a matter of days, which is a major advance for healthcare organizations and healthcare practitioners alike.


Trump’s budget could let those on Medicare use this tax-favored account

Budget proposal would let Medicare beneficiaries contribute to health savings accounts.

A provision tucked in President Donald Trump's proposed budget would give people on Medicare a way to save for health care costs on a tax-advantaged basis. In the proposal, the White House calls for a new option that would permit Medicare beneficiaries to make tax-deductible contributions to health savings accounts.

That's a shift from today's law, as the IRS doesn't allow those on Medicare to contribute to HSAs, and the proposal offered few details as to how this would work. It's also unclear whether this provision will be supported in Congress, which ultimately controls the purse strings. Here's what the proposal may mean for your ability to pay for retirement health care costs.

Triple-tax savings

Health savings accounts have a triple-tax benefit. That is, they allow insured individuals to save money on a tax deductible or pre-tax basis. Contributions grow free of taxes, and account holders may make tax-free withdrawals as long as the money goes toward qualified medical expenses. This year, HSA holders can sock away up to $3,450 if they have single insurance coverage, while those with family coverage may save up to $6,900. Those over 55 can save an additional $1,000 each year. It's unclear what the limits would be for Medicare beneficiaries if adopted.

Unused HSA balances roll over into the following year. As of 2016, more than 20 million people were enrolled in high-deductible health plans with HSAs, according to America's Health Insurance Plans, a trade association that represents insurance companies.

HSAs in retirement

While HSA holders who are on Medicare can't make contributions under current law, they can still tap their savings for qualified medical costs in retirement. HSA users can leverage their accounts in one of two ways: Either they pull money from the account to cover ongoing health expenses, or they cover those expenses out of pocket and allow the HSA to accumulate over time. You can strengthen your HSA's growth potential by contributing to the account over the long term, and investing your contributions into mutual funds or exchange traded funds, if they're available at your provider. Given enough time to grow, an HSA can be an additional pot of assets in retirement: You can use them to cover qualified medical expenses, including certain long-term care services. Consider allowing your account to grow, as a couple's retirement healthcare costs can run as high as $275,000, according to Fidelity. That figure excludes the cost of long-term care.

Flu Shot

Deadly Flu Season Is Far From Over, Set to Be the Worst in 15 Years

The CDC says it isn't too late to get a flu vaccine.

The Centers for Disease Control and Prevention warned on Friday this flu season is gearing up to be one of the worst in more than a decade, and it won't be over anytime soon. The CDC reported this is the first time in 15 flu seasons all states in the continental U.S. have reported widespread flu activity in the same week.

Dr. Dan Jernigan, director of the influenza division at the CDC said in a news briefing the season is only about halfway through. "It's been a tough flu season so far," Jernigan said. "Flu is still happening all over the United States." According to the CDC's Weekly U.S. Influenza Surveillance Report released Friday, the spread of influenza has continued to increase over the past several months across the United States. There were seven pediatric deaths just last week, and 37 total since flu season began in October. Additionally, 11,965 people have been hospitalized with influenza since the beginning of the season.

Baby boomers are getting hit the hardest this flu season, with those aged 50 and older comprising most hospitalizations, according to the report. Those aged 65 and older were the most hospitalized, adults aged 50 to 64 the second most and those aged 0 to 4 the third most. This is uncommon as those aged 0 to 4 usually take the second hardest hit, Jernigan said.

He attributed this irregularity to the evolution of flu strains over time. This age group has less immunity because the viruses the baby boomers were exposed to when they were younger are much different than ones circulating today. The majority of people diagnosed with the flu are falling ill with the H3N2 strain, which presents with more severe symptoms in young children and older adults. However, there has been an increase in the strains of Influenza A H1N1 and Influenza B, Kristen Nordlund, a spokeswoman for the CDC, told CNN. The CDC recommends anyone over the age of 6 months get vaccinated, ideally by the end of October. However, officials say it is not too late to get a flu vaccine if you haven't already and stress the importance of early treatment if you think you have the flu.

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4 Trends Driving Digital Health Care Transformation

Healthcare of Tomorrow

The health care industry is evolving, thanks to policy changes, societal shifts and technological advances. Healthcare of Tomorrow from U.S. News & World Report examines the challenges facing health care, and how it must change to face the future. See more U.S. News special reports.

1. IoT Explosion Drives Diversification of Devices and New Challenges

The "internet of things" is fundamentally changing the way people live – an effect that is also launching change and innovation in health care. As IoT continues to spread globally – market intelligence firm IDC expects nearly $1.4 trillion in global IoT spending by 2021 – its expansion will continue to drive proliferation and diversification of medical device innovation and the associated challenges.It seems that every day, developers introduce new IoT platforms, solutions and open standards or protocols. They promise greater insight into patient health, physical performance and monitoring of vital signs, in facilities and at the patient's home. Practically, the direct value these devices bring to patients is up to the determination of care teams. From an IT perspective, organizations must acknowledge a business case for incorporating IoT devices and ensure monitoring and analysis of connected equipment and sensors occurs reliably.

2. Widespread Adoption of Digital Clinical Workspaces

The demand for digital clinical workspaces will intensify as the natural productivity and mobility benefits they afford become more integrated into health care delivery strategies. In a digital clinical workspace environment, the health IT enterprise is expanded beyond the four walls of a facility and beyond regular operating hours. Doctors hoping to check in on a patient's overnight progress can do so at home from work-issued or personal mobile devices. IT administrators can correspondingly monitor the health and viability of the enterprise. If secured appropriately, digital clinical workspaces can transform workplace technology from the cliché obstacle into a purveyor of productivity and convenience.

3. HIT Cloud Adoption Will Begin a Steeper Increase as Security Concerns Decline

Partly driven by the expansion of IoT devices and the growing need to manage them, we also expect heightened use of cloud technologies in health care. Organizations undergoing a digital transformation will reinvest in core applications that live in the cloud, off-premise, to enable greater agility. The evolving continuum of care also requires that patients' EMRs are accessible and transferrable by care providers, community partners and health care payers alike. The cloud does face a cultural obstacle, however, to more widespread adoption. At the 2017 CHIME CIO Fall Forum in San Antonio, 45 percent of focus group participants told us they believe that most of their core applications will live off-premise in one to three years, while 40 percent said that all their core applications will stay on-premise throughout that time.

4. More Devices = More Threats = More Security Frameworks

The adoption of cloud technology and proliferation of the clinical workspace to include IoT-enabled devices and allow for anytime, anywhere, any device will necessitate health care organizations taking a new or closer look at how they are securing their entire enterprise, as well as their patients' sensitive medical information.Applications with sensitive information will be the main driver of this shifting dynamic. To afford care teams the agility to work from anywhere on any device at any time and access these critical apps, health care IT admins must ensure that security is innate throughout the IT enterprise, not just its perimeter or the data center. A reliable way to achieve this is micro-segmentation. This security architecture divides the IT environment – networking, storage, applications, the gamut – into small parts that are more manageable to protect than an enterprise-wide perimeter net. Security frameworks are embedded into all IT services and functionalities – each workload serves as its own security perimeter. In the event of a security breach, micro-segmentation mitigates and minimizes the spread of damage and the impact of compromised data. Micro-segmentation is poised as a technology disruptor much like IT virtualization was at the outset of its development, with app-level security the main driver. Much excitement also surrounds another new technology: blockchain. While still an immature technology within the context of the health care industry, the concept of blockchain offers potentially promising utility if regulated appropriately and managed strategically by health care entities seeking to use it.