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Washington Debrief: ONC Looks to Pivot HITPC Work In Support of Future ONC

April 14, 2014
by Jeff Smith, Director of Public Policy at CHIME
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Jeff Smith, Senior Director of Federal Affairs

Key Takeaway: ONC asked the Health IT Policy Committee (HITPC) to consider a new work plan, which would reform several workgroups for future policy development. Along with other evidence, this signals that ONC is looking to “pivot” away from the era of Meaningful Use and the HITECH program, choosing to focus its standards and certification authority on healthcare reform, patient safety and EHR usability.

Why it Matters: ONC is the lead agency for most federal health IT regulatory activity. Healthcare IT executives should consider ONC’s agenda while formulating their own plans for the future.

This month, members of the Health IT Policy Committee were treated to a new round of data from CMS on Meaningful Use participation. They were asked by National Coordinator Karen DeSalvo to help ONC “pivot” its work, now that many of the HITECH Act grants are sun-setting.

The HITPC’s new work plan includes the formation of four workgroups, across which, experts in privacy/security and patient engagement would contribute.

The new HITPC workgroups are:

  • HIT Strategic Planning
  • Advanced Health Models & Meaningful Use
  • HIT Implementation, Usability & Safety
  • Interoperability & Health Information Exchange

When considered in tandem with ONC’s FY 2015 budget justification, it becomes clear that ONC expects to continue its work as a “convener” across federal agencies and the private sector on matters related to health IT policy. The budget request also signals more work in the areas of standards development, through the S&I Framework; patient safety, through the formation of a “Health IT Safety Center;” and a more dedicated focus on health IT implementation and usability.

HHS Secretary Sebelius Steps Down, OMB’s Burwell Named as Successor

Key Takeaway: HHS Secretary Kathleen Sebelius has resigned and President Obama has named Sylvia Mathews Burwell as her successor.

Why it Matters: HHS has endured a tumultuous few years as implementation of the Affordable Care Act (ACA) shifted into high gear. The nomination of Burwell signals the administration’s intent to mobilize a seasoned policy veteran to ensure the long-term sustainability of the ACA.

Last week, more than five years after she took the helm of HHS, former Kansas Governor, Kathleen Sebelius, stepped down. Ms. Sebelius oversaw the most sweeping changes to healthcare access the country has ever seen.

Beyond the impact on the insurance industry, much of the ACA is dedicated to delivery reforms, such as accountable care organizations, bundled payment pilots and other models meant to push reimbursements away from fee-for-service approaches.

To replace Sebelius, President Obama has tapped current Office of Management and Budget (OMB) director, Silvia Mathews Burwell. Burwell has an impressive resume, which includes executive positions with both the Bill & Melinda Gates and Walmart foundations. She has a widespread reputation for her management skills and budgetary acumen. “I’ve never met a policy official with more focus on and capacity for execution,” former Treasury Secretary Larry Summers, told Politico in an interview. “I can’t imagine a stronger person to take on HHS at a moment when the key priorities must be implementation of the Affordable Care Act and refocusing on poverty in America.” It remains to be seen what impact Burwell will have on health IT policy. Burwell’s appointment is another indication that execution will be a central theme for the remaining years of the Obama administration.

Administration Releases Medicare Payment Data Ahead of Quality Discussion

Key Takeaway: This week CMS released data on physician pay that will bring more visibility to payment and performance data, ahead of possible Congressional action to tie reimbursement to quality measures.

Why it Matters: While the full SGR repeal has yet to happen, the policies within the proposed SGR repeal bill seemed to garner broad consensus around the transition from the current fee-for-service healthcare model to fee-for-quality.

The release of Medicare payment data indicates that CMS is moving forward with plans to make more data available to judge how much doctors and hospitals get reimbursed, to reduce Medicare fraud, and to focus on quality of care.

In the wake of the release of payment data, BNA is reporting that CMS will create a star-ranking system for physician similar to the existing five-star ranking system for nursing homes. Details on how physicians will be ranked have yet to be finalized, but proponents believe the plan will give consumers the ability to choose the best physician in their area for services ranging from an office visit to in-patient surgical procedures and more. Officials said that beginning in late 2014 or early 2015, the ratings will be published on the “Compare” websites – Hospital Compare, Home Health Compare, and Dialysis Facility Compare. With these efforts by Congress and the Administration, there’s no doubt that the emphasis on care quality for reimbursement is here to stay.