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D.C. Report: EHR Incentive Payment Status, CMS Releases Clinical Data to Improve Performance Measurement

December 14, 2011
by Jeff Smith, Assistant Director of Advocacy at CHIME
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Jeff Smith, Assistant Director of Advocacy at CHIME

EHR Incentive Updates Heard During HITPC Meeting According to new figures from CMS, the EHR Incentive Payments Program is on track to handout over $2 billion in reimbursement payments during its first year – $920 million of which has been paid through Medicare.  During the last Health IT Policy Committee hearing of the calendar year, CMS’ Robert Anthony told members that 57 percent (2,868) hospitals have registered for EHR Incentives and that 1,211 hospitals have successfully attested to Meaningful Use under Medicare, Medicaid or both.  Mr. Anthony said the exact number of attesting hospitals was unknown because some attested under both programs.  Over 21,000 eligible professionals have been paid this year.  The presentation also highlighted what measures and objectives eligible hospitals were deferring.  Among the higher rates of deferral were summary of care at transitions, medication reconciliation, and submission of reportable lab results and syndromic surveillance data to public health agencies. 

CMS Releases Claims Data to Improve Performance Measurement As mandated by the Patient Protection and Affordable Care Act, CMS is making Medicare claims data under parts A, B and D available to “qualified entities” to evaluate hospital, physician and other providers’ performance.  According to the final rule, release this week, CMS will allow a new category of organizations to obtain the data, including community groups comprising doctors, health insurers, businesses, consumers and government that work to improve health care at the local level.  The Wall Street Journal reportsthat these groups number about 25 nationwide and they will be able to use the data to publish studies, such as report cards on certain procedures, hospitals or doctors.  Between the proposed rule and the final rule, CMS reduces the cost of the data per 2.5 million beneficiaries from $200,000 in the proposed rule to $40,000 for the first year and $32,000 each subsequent year and included various requirements and penalties related to privacy and security.  Report subjects will be notified 60 days in advance, but they won’t be able to block publication.  Additionally, researchers must combine Medicare data with private payer data to produce the reports.

ONC Says HIE Standards ‘Not Optional’ In a blog postingby Dr. Doug Fridsma, Director of ONC’s Office of Standards and Interoperability, he said that data standards for HIE building block “need to be unambiguous and have very limited (or no) optionality.”  Dr. Fridsma overviewed the work undertaking this summer by the Standards & Interoperability Framework (S&I Framework) and the HIT Standards Committee to drive consensus on standards for Transitions of Care (ToC), Lab Results Interface (LRI), public health reporting and vocabulary for administrative, clinical, laboratory and medications domains.  “While there is still much work to be done, we are making tremendous progress toward interoperable health information exchange,” Fridsma wrote. For a list of the various projects and standards being endorsed, read the post and go to www.siframework.orgto learn more.

New Democratic Coalition to Focus on Health IT and Payment Reforms A new coalition of Democrats in the House of Representatives released a policy platform paperthis week, outlining their goals to develop: a new Medicare payment system that rewards quality, new delivery models that increase efficiency, an FDA approval process that moves more quickly and widespread adoption of health IT systems. The New Democrat Coalition Health Care Task Force is led by co-chairs Representative Allyson Y. Schwartz (PA-13) and Representative Kurt Schrader (OR-5).  The co-chairs specifically focus on payment reforms currently underway at the CMS Innovation Center, voicing support for demonstrations around Patient-centered medical homes, Bundled payments, Accountable care organizations, and Global payment, among others.  The coalition’s fourth policy principlefocuses on health IT, stressing that “We must  build upon existing HIT programs to ensure that small practices have access to the training and technology necessary to meet meaningful use standards established by CMS.”  Additionally, the coalition hopes to focus on small provider practices, small hospitals and providers in disadvantaged communities can purchase and become meaningful users; ensure confidence that available systems will enable providers to become fully compliant with “meaningful use” standards and incentivize Regional Extension to seek out providers most in need of the technical assistance, guidance, and information on best practices to become meaningful users of EHRs.

Reps. Want to Speed Medicaid Payments to Hospitals Reps. Anna G. Eshoo (CA-14) and Brian Bilbray (CA-50) introduced legislation this week to ensure that Medicaid providers are paid in an appropriate timeframe.  The Fair Pay to Medicaid Providers Act would require Medicaid to reimburse all providers, including nursing facilities, hospitals, and community health centers in a timely manner.  According to a press releasefrom Rep. Eshoo’s office, the 2008 budget impasse in California forced providers to operate without Medicaid payment for approximately 60 days, placing many of them in financial risk. “Some nursing facilities notified residents' families that if buildings were forced to close, they would have to pick up their loved ones from the facility and take them elsewhere,” the announcement said.  The Fair Pay to Medicaid Providers Act would require states to pay 90% of Medicaid claims within 30 days of the date of receipt of the claims, and 99% of claims within 90 days of the date of receipt.

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