From Anthem to Premera Blue Cross, healthcare data breaches have been buzzing in our news feed since the beginning of 2015. But did you know that five of the biggest data breaches in the healthcare industry occurred this year? And that over "92 million individuals" have been affected by healthcare breaches in 2015 already (just up until May). Unfortunately, it's been a big year for cyber attacks and according to Bloomberg Business "nearly 90 percent of health-care providers were hit by breaches in the past two years, half of them criminal in nature, the report found." While many organizations are buffing up on security and creating awareness around the important issues of cyber security and healthcare, a recent survey by KPMG found that only 66% of providers feel they are prepared a cyber attack.
In the wake of the Anthem breach, which put 800,000 subscribers at risk, hospitals nationwide have their ears perked up to establish a first-line defense against data breaches. These types of breaches cost the industry over $6 billion each year.
Many healthcare providers are gearing up in 2015 for the HIPAA enforcement that's slotted to take place throughout the year. In fact, the Office of Civil Rights (OCR) anticipates receiving 17,000+ complaints this year filed for breaches of private patient information. As of early December 2014, 1,170 security breaches under the Health Insurance Portability and Accountability Act involving 31 million records had been reported to the U.S. Department of Health and Human Services (HHS)--so the problem of data breaches is very real. Enforcement can come with serious fines for violations, too. Accidental violations can cost anywhere from $100-$50,000...even on the first offense. So what should you be on the lookout for? In this post, we'll discuss some of the main areas you should beef up security around to prepare for HIPAA enforcement.
Managed care has been around for almost one hundred years, at least in theory. When placed up against fee-for-service payment models, however, it was a hard sell. Traditionally, the way that physicians were compensated for their services was a fairly straight-forward invoicing process: they would bill the patient (or later, the payer) for everything they did in terms of diagnosing or treating the patient. Everything.
One of the most costly and complex elements of today's healthcare system is prescription drugs. For each state, there are tools and resources for hospitals to review prescription drug use and make sure it's in line with Medicare's program.
Since last fall, the Recovery Audit Contractors have greatly slowed their requests for charts from hospitals nationwide. The program, which has been under fire from the American Hospital Association virtually since it’s inception in 2006, is currently undergoing reform. That being said, for many involved in the previous audits the damage has already been done.
What factors go into the costs of healthcare? Fraud, waste, inefficiencies, limited number of primary care physicians, the rising costs associated with baby boomers, increased cases of chronic illness..... the list goes on and on. Enjoy this infographic.