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D.C. Report: HITSC Looks Ahead to 2012, Bi-Partisan Medicaid Reform Plan Released

December 29, 2011
by Jeff Smith, Assistant Director of Advocacy at CHIME
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Jeff Smith Assistant Director of Advocacy CHIME

HITSC Looks Ahead to 2012 After Reviewing Activity in 2011 During the last meeting of the Federal Advisory Health IT Standards Committee of 2011, the agenda focused on what lies ahead in 2012.  Of particular interest was a report by Dr. Doug Fridsma, director of ONC’s Office of Standards and Interoperability, who gave an overview of several high-profile projects underway through the Standards and Interoperability (S&I) Framework.  Updates were given for initiatives like Query Health, Data Segmentation for Privacy, Transitions of Care (ToC) and others during Wednesday’s meeting, and according to Fridsma, ONC is looking for ways to find innovation through regulatory flexibility.  “The plan is to take all of these things for discussion so that we have a broad and rich description of what needs to happen so we can align the Committee and Workgroup activities,” he said during his presentation.  “It is an ongoing challenge to find regulatory flexibility. We have another shot at it with the Stage 2 Meaningful Use NPRM.”

Dr. Fridsma also outlined a preliminary framework for HITSC’s 2012 workplan.  He said the goal is to present a draft 2012 plan at the January 25th meeting that will take a strategic long-term view to plan for Meaningful Use Stage 3.  “Adoption and use is our success metric: we have to produce things that are usable and relevant and implementable,” Dr. Fridsma said.

A breakdown of what HITSC is looking at by quarters is as follows:
Quarter 1

  •  NPRM response (MU Stage 2)
  •  QM standards
  •  NWHIN standards criteria
  •  Value sets/mapping

Quarter 2

  •  NWHIN portfolio (extended)
  •  Query Health review
  •  Radiology Standards
  •  Governance

Quarter 3

  •  Consumer-mediated info exchange
  •  One-stop-shop for resources
  •  GreenCDA

Quarter 4

  •  Maintenance strategy for standards (who does what over time)
  •  Public Health
  •  Data/Practice Portability
  •  APIs/tools

House, Senate Narrowly Avoid (Yet Another) Government Shutdown In a scene that is becoming commonplace in Washington, House and Senate leaders agreed late Thursday night on an omnibus spending bill that would keep the government running if passed by members on Friday.  The $1 trillion-plus, year-end spending bill, covers the country’s entire domestic budget, the Pentagon and foreign aid — plus tens of billions more related to the war in Afghanistan.  According to a draft Conference Report, Labor / HHS is looking at the budget to be around $1.4 billion, which would satisfy requirements set in the August Budget Control Act.  For the Office of the National Coordinator, the spending bill would appropriate $61,257,000 for the “development and advancement of interoperable health information technology.”  This number is about $17 million short of what President Obama called for in his Fiscal Year 2012 budget plan.

Bi-Partisan Medicaid Reform Plan Is Released A Democrat from Washington and a Republican from Wisconsin released a plan (.pdf) this year to save Medicare from insolvency.  According to Rep. Ron Wyden (WA) and Rep. Paul Ryan (WI) their plan “would strengthen traditional Medicare by permanently maintaining it as a guaranteed and viable option for all of our nation’s retirees. At the same time, our plan would expand choice for seniors by allowing the private sector to compete with Medicare in an effort to offer seniors better quality and more affordable health care choices.”  Some observers might remember Rep. Ryan, who earlier this year released a “Path to Prosperity” to turn Medicare into a voucher system where seniors would be given around $8,000 per year to pay for expenses. This plan has a similar provision, but it would also keep Medicare as-we-know-it and limit its spending growth to GDP growth, plus one percent.  The plan calls for a Medicare exchange, beginning in 2022, that would have private plans competing alongside the traditional fee-for-service option – and if a senior chose a plan costlier than a pre-determined benchmark, he or she would have to pay the difference, but if they chose one less than the benchmark, they would be given a rebate for the difference.  The plan is not yet in bill form, something its authors said was deliberate – so it could get an honest treatment by all sides as an idea.

Reaction to the plan was not well received by most Democrats in Washington, with the White House rebuking efforts to make Medicare “wither on the vine.”  Republicans gave it a lukewarm welcoming, with leaders calling it a “step in the right direction.”