News in brief - Oct. 10, 2011

Tricare reports major personal-data breach

Personal data belonging to an estimated 4.9 million Tricare beneficiaries could be at risk after a contractor reported that backup tapes to electronic medical records were missing. Tricare is the federal government's health care coverage for active and retired military personnel and their families.

The tapes contain the records of patients seen at San Antonio-area military treatment facilities, or who had lab workups processed in the facilities, from 1992 through Sept. 7. The data could include Social Security numbers, addresses and phone numbers. They also could include health data, including clinical notes; lab tests; and prescriptions. No financial data are on the tapes.

The vendor, Science Applications International Corp., and Tricare said the risk of harm is low because retrieving the data would require knowledge of and access to specific hardware and software.

Back to top

House calls worth a visit, Australian study says

A report analyzing an Australian program providing medical care through house calls as an alternative to hospitalization -- a strategy employed under U.S. health system reform -- found that it could reduce costs while achieving similar health outcomes.

Researchers with Deloitte Access Economics in Barton, Australia, analyzed data on the country's Hospital in the Home program for the Hospital in the Home Society Australasia. The program achieved mortality and readmission rates similar to in-hospital care. Patient satisfaction was high, but the impact on health care costs varied by condition. For instance, the program was more expensive than usual care for chronic obstructive pulmonary disease but cheaper for venous thrombosis, pulmonary embolus or a knee replacement.

The authors cautioned that to achieve cost savings, patients must be chosen carefully with regard to health status and availability of others in the home to provide support. In addition, physicians and nurses can care for fewer patients in the home than in a hospital setting, which reduces productivity.

The full report is being used to argue for expansion of the program in Australia.

In the United States, Independence at Home, scheduled to launch Jan. 1, 2012, provides payment incentives for primary care teams that make house calls. They would receive a portion of the money saved by improving health outcomes and reducing preventable hospitalizations, readmissions and emergency department visits. The program, which is in the demonstration stage, is limited to 10,000 patients.

Back to top

IRS offers deal on misclassified employees

The Internal Revenue Service announced Sept. 21 that companies, including physician practices, that have misclassified workers as independent contractors when they should have been called employees will be able to resolve the issue voluntarily at a lower cost than if the problem were discovered during an audit.

Differences in how independent contractors are taxed can make the designation appealing for both employees and employers, but a misclassification can lead to expensive fines for companies.

Medical practices may run afoul of the IRS' classification system if a nurse practitioner, physician assistant or administrator has an independent contractor agreement but is treated like an employee and should be classified as such. Generally, if a practice is able to control how a worker performs his or her job, provides supplies for the job and gives benefits such as vacation, that person would be an employee.

For instance, a practice's accountant who works off-site and has many other clients would fall into the independent contractor category. But a practice's biller who works on-site and gets workplace benefits most likely should be classified as an employee.

More information about the Voluntary Classification Settlement Program is available online. (www.irs.gov/businesses/small/article/0,id=246013,00.html)

Back to top