In scheduled appearances at the HIMSS Conference being held at the Ernest N. Morial Convention Center in New Orleans both Marilyn Tavenner, R.N., Acting Administrator of the federal Centers for Medicare & Medicaid Services (CMS), and Farzad Mostashari, M.D., National Coordinator for Health IT, made explicit references to recent mainstream media coverage, including a widely commented-upon New York Times article critical of the HITECH (Health Information Technology for Economic and Clinical Health) Act, in their remarks on Wednesday morning, March 6.
Tavenner spoke first, at a scheduled HIMSS educational session, whose opportunity she leveraged in order to provide details of the announcement that had been released just a couple of hours earlier online, which focused on the agenda of the Department of Health and Human Services to pursue a very aggressive healthcare IT-facilitated agenda for the federal government’s healthcare reform agenda. Tavenner referred both directly and indirectly to a recent New York Times article whose author implied strongly that the HITECH Act was designed solely for the purpose of benefiting software sales on the part of the large electronic health record (EHR) vendors whose executives had contributed to congressional campaigns leading up to the passage of the American Recovery and Reinvestment Act (ARRA), of which the HITECH Act was a component.
Importantly, Tavenner announced that no preliminary Stage 3 rule for meaningful use would be released during calendar year 2013. Instead, she said, senior officials at the Office of the National Coordinator for Health IT (ONC) and CMS would spend time digesting input and feedback on Stage 2 from the industry, before proceeding to finalize Stage 3 plans.
Shortly after the conclusion of the Tavenner appearance, Mostashari held a press conference for working media covering HIMSS13. Asked by Healthcare Informatics for his perspective on the recent Times article, he responded by saying, “I think that those sorts of stories do create an impression that is I think unfortunate and mistaken, that the health IT incentive program is not achieving the goals and expectations set out for it; and I could not disagree more vehemently,” Mostashari said. “At the time the legislation was drafted, and the Congressional Budget Office reviewed the expectations for it, and I think folks would have been pretty impressed at what has occurred in the past three years. And it’s not just buying the system, it’s shifting the access of how health systems shift the access towards patient safety, care quality, care coordination, etc patient engagement.”
Noting the evolution of attitudes and activity at recent HIMSS conferences since the passage of HITECH, Mostashari went on to say, “If you have been here at this conference in the past three years, the shift among the customers of these systems and among the vendors is marked and palpable. We would not have that progress absent that action. Are there is there progress that still needs to take place? Absolutely. Are there program integrity issues we need to look at? Absolutely. And do we need to consider the burden on the providers? Absolutely.” That having been said, Mostashari concluded firmly, “I really find a lot of the discussions in the mainstream media not helpful. Whether or not this is a good idea is now a moot point. The question is how we can make things better,” and move forward towards the full automation of healthcare delivery in the U.S.
At the outset of the press conference, Mostashari told the media that “I wanted to announce an exciting request for information that CMS and ONC put out today. And the main message, echoing what Marilyn Tavenner, the CMS Acting Administrator, just said moments ago, is that the administration is absolutely committed to health information technology as a platform for payment and delivery reforms, and that we can really cannot succeed in shifting payment and delivery models from volume to value without having information technology as a platform and as a strategy.”
Tavenner strongly links health IT to healthcare reform success
At her event, Tavenner made clear to the assembled audience that the Obama administration would stand firm and moving forward on what it sees as its most important healthcare reform-related and healthcare IT-related priorities, as indicated in an announcement circulated via press release and online just prior to Tavenner’s appearance. Those include an aggressive plan to compel more physicians forward to adopt EHRs, improving interoperability via the Blue Button Initiative and other means, and cracking down on potential “gaming of the system” through EHR-facilitated upcoding.
In her appearance, Tavenner repeatedly stressed the healthcare reform-healthcare IT adoption link. “What I can say is that I am truly committed to health IT as a platform and a strategy for the work ahead of us at CMS,” she said. “We have made so many strides, and the progress is truly amazing.”
With regard to the successful leveraging of healthcare IT that has already taken place in the past few years, Tavenner said, “There’s been a lot of work that’s gone on, and all of us can tell stories of how we’ve benefited. I want to thank each of you in this room for the work that you’ve done to make this possible. And there have been challenges. It hasn’t always been smooth. Yes, there are articles and yes there are hearings, but we continue to make progress. More than 190,000, or almost one-third of eligible professionals, and almost one-third of the nation’s hospitals, have received payments,” she noted. In addition, she reported that, as of the end of January 2013, over $11.7 billion has been paid out to over 210,000 providers under HITECH. What’s more, she noted, “More than 40 percent of all primary care physicians are working with regional extension centers; over half of all rural PCPs and nearly 70 percent of federally qualified health centers are doing so.”
And she went on to reiterate in detail some of the elements of the morning’s announcement, including the announcement of the goals of getting 50 percent of physicians using EHRs by the end of 2013, and 80 percent of eligible hospitals receiving meaningful use incentive payments by the same point in time; increasing the government’s emphasis on interoperability; enhancing the effective use of EHRs through initiatives like Blue Button; implementing Stage 2 of meaningful use; and underscoring program integrity.