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Washington Debrief: CMS Seeks Input on Primary Care Innovations

February 23, 2015
by Jeff Smith, Vice President of Public Policy at CHIME
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Top News

CMS Seeks Input on Primary Care Innovations

Key Takeaway:  The Centers for Medicare & Medicaid Services (CMS) has issued a Request for Information (RFI) asking for input on how to test new models of advanced primary care.  The deadline for comment is March 16, 2015.

Why it Matters:  The RFI includes questions specific to how providers could use health IT to support advanced primary care.

Last week, CMS issued an RFI on initiatives related to test innovations in advanced primary care. Specifically, CMS is seeking input on initiatives to test innovations in advanced primary care, particularly mechanisms to:

  1. ​Encourage more comprehensiveness in primary care delivery; 
  2. Improve the care of complex patients; 
  3. Facilitate robust connections to the medical neighborhood and community-based services; and 
  4. Move reimbursement from encounter-based towards value-driven, population-based care. 

Directly related to health IT, CMS is asking for information on how primary care can use data for quality measurement and quality improvement, effectively manage the volume and priority of clinical data, coordinate care across the medical neighborhood, engage patients, and manage population health through team-based care.

For more information on other questions, click here.


IOM Researchers Reiterate Need to Include Behavior, Social Measures into MU Stage 3

Key Takeaway: Researchers at the Institute of Medicine urged CMS to include 12 sets of social and behavioral indicators in Meaningful Use Stage 3 proposed rules.

Why it Matters: Researchers believe that tracking behavioral and social health data will enable better care and lower service utilization. However, tensions may arise over the increased burden of capturing such data.  Health IT executives watching for new MU rules should expect a number of additional requirements as a wide range of stakeholders look to leverage the third, and likely final, stage of the Electronic Health Record (EHR) Incentive program.

Clinicians should be capturing data on social determinants of health in standard formats through their EHR systems to ensure the data are electronically accessible to other clinicians and health researchers, a pair of IOM researchers wrote in a New England Journal of Medicine editorial last week.  Nancy Adler and William Stead, health researchers who co-chaired the IOM's Committee on Recommended Social and Behavioral Domains for EHRs, reiterated recommendations offered to regulators last year, calling for the capture of 12 social and behavioral domains and measures, including:

  • race or ethnic group;
  • education;
  • financial-resource strain;
  • stress;
  • depression;
  • physical activity;
  • tobacco use;
  • alcohol use;
  • social connections or isolation;
  • intimate-partner violence;
  • residential address; and
  • census-tract median income.

Stage 3 rules are expected by early March and it is not known if these kinds of data will be included as part of new program requirements.

Legislation & Politics

Bill Re-Introduced to Exempt Encounters at Ambulatory Surgical Centers from MU

Key Takeaway: In the latest display of Congressional interest in the Meaningful Use Program, Rep. Diane Black (R-TN-06) reintroduced a bill that would exempt patient encounters that take place in ambulatory surgery centers (ASCs) from counting toward meaningful use requirements.

Why It Matters: Beginning in 2015, physicians participating in the Meaningful Use Program must perform at least half of their outpatient encounters in a facility with a certified electronic health record or be subject to a penalty. However, there is currently no requirement that ambulatory surgery centers use EHRs, and ONC offers no certification program specifically for them.

The ‘Electronic Health Fairness Act of 2015’ introduced on February 11, 2015 by Congresswoman Diane Black H.R. 887, cosponsored by Representatives Linda Sanchez (D-CA-39), David Scott (D-GA-13) and Vern Buchanan (R-FL-16), would exempt encounters in ambulatory surgical centers from meaningful use until ONC develops standards for EHR certification in such care settings.  Rep. Black first introduced the Electronic Health Fairness Act last September with Rep. Scott.