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Washington Debrief: Senate Bill Calls for More Medicare Data Transparency

June 11, 2013
by Jeff Smith, Director of Public Policy at CHIME
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Jeff Smith, Director of Public Policy at CHIME

Health Datapalooza Recap – CMS Commits to Data Liberation, Senate Bill Calls for More Claims Transparency Last week at the two day Health Datapalooza conference in Washington, DC, developers, policy makers, vendors, entrepreneurs, academics and individuals came together to discuss and demo innovative uses of health data.  Keynote speakers included government, industry and medical professionals – HHS Secretary Kathleen Sebelius, UK Secretary of State for Health Jeremy Hunt, US Chief Technology Officer Todd Park, athenahealth Co-Founder Jonathan Bush, Professor of Surgery at Harvard Medical School Atul Gawande, and more.  Concurrent with the track sessions, Code-A-Palooza brought ten teams of coders together to create an app or tool that would improve care by primary care physicians.  The winner received a $25,000 prize.  Other competitions presented at the event awarded coders as much as $100,000 for their innovative uses of health data.

Companies weren’t the only ones releasing data during Health Datapalooza.  In a short keynote address on day two, CMS Administrator Marilyn Tavenner reiterated CMS’ and ONC’s commitment to “data liberation” a phrase previously coined by Todd Park.  In a press release on Monday, CMS, ONC and AHRQ all announced newly available data.  CMS’ announcement included “new data sets for the first time at the county level: one on Medicare spending and utilization, and another on Medicare beneficiaries with chronic conditions.”

Despite the release of new data by numerous agencies, Congress still wants more transparency.  A bipartisan bill –  the Medicare Data Access for Transparency and Accountability Act (Medicare DATA Act) – will be reintroduced by Sens. Chuck Grassley (R-Iowa) and Ron Wyden (D-Ore.) calling for the release of more Medicare claims data.  In a joint press release, Grassley said, “More transparency about billing and payments increases public understanding of where tax dollars go and foster accountability.”

With all of this newly released data, and the promise of more data in the future, we can only imagine what will come out of Health Datapalooza V next June (6/1-6/3/2014).

SGR Permanent Fix Has a ‘Down’ Week If the prospects of a permanent fix to the Sustainable Growth Rate (SGR) was a company on the NASDAQ or part of the DOW its stock price would have taken a dive this week.  Optimism has not been in abundance this week, following the release of draft legislation by the House Energy & Commerce Committee.  Washington observers, Democrats and even some Republicans dismissed the Energy & Commerce draft as being woefully incomplete.  Energy & Commerce aids maintain the sparse draft was done on purpose to “get feedback, comments and thoughts.”   Rep. Allyson Schwartz (D-Pa.), who introduced an SGR replacement proposal with Rep. Joe Heck (R-Nev.) earlier this year, said the draft doesn’t do enough.  “It’s a missed opportunity at best and certainly we were hopeful they would move forward on a more significant proposal and work with us.”  Another facet of the draft is that it signals a divide between Energy & Commerce and Ways & Means, who had been working jointly on a permanent fix.  This is not to suggest that the two House committees are in disagreement, but it does mean that different paths have been chosen, which means the two committees could arrive in different destinations.  On the Senate side, the Finance Committee has begun seeking input for their own SGR plan and last week committee staff collected about 100 letters from physicians and other stakeholder groups.  Stay tuned!

HHS Moves Ahead with Plans to Build National Research Network for Patient-Center Outcomes Nearly $200 million was made available in the Affordable Care Act to support the development of an interoperable data infrastructure for patient-centered outcomes research.  The Office of the National Coordinator and the Patient-Centered Outcomes Research Institute (PCORI) recently announced a partnership to begin this work.  ONC and the Office of the Assistant Secretary for Planning and Evaluation will work with PCORI to craft data-sharing policies, standards and services.  “We want to work alongside PCORI to ensure that we help lay the foundations for their discoveries to be nationally scalable as quickly and effectively as possible,” an ONC spokesman said. A presentation by Joe Selby, M.D., described the work being planned to the Health IT Policy Committee last week.  Dr. Selby described how PCORI has made two funding announcements totaling $68 million to inform two types of national patient-centered clinical research networks: a Clinical Data Research Network (CDRN) and Patient-Powered Research Networks.  “The proposed network would unite patients, researchers and healthcare systems and support rapid, effective observational and interventional studies with active participation from a broad patient population,” Selby said.  The “network of networks” approach envisions a steering committee composed of PCORI awardees, PCORI, AHRQ, NIH, FDA, ONC, CMS and the VA.

ONC Releases New Data on Hospital and EP Attestation The Office of the National Coordinator unveiled some interesting data last week.  Since December 2012 industry observers had few data points on how many eligible hospitals and eligible professionals had actually met the task of attesting to Meaningful Use.  The best that could be done was looking at the published list of facilities and EPs, maintained by CMS, and then apply industry-standard estimates on the population of EHs and EPs.  This week, however, ONC gave members of the Health IT Policy Committee a “data analytics” update that included numbers of Meaningful Users as of April 2013.  Some 60 percent of EHs have attested to Meaningful Use with another 19 percent having received Medicaid payments for “Adopt, Implement, or Upgrading” to an EHR.  On the EP side, 43 percent have attested to Stage 1 meaningful use and an additional 21 percent have been paid under Medicaid for AIU.  The ONC update also presents information on how EHs and EPs have fared in meeting each objective.  Sizable majorities of EHs scored above 90 percent in meeting individual measure thresholds (slide 15).  Additional updates were given by CMS and the S&I Framework, which continues its standard-setting work in a dozen different initiatives.

CHIME News & Notes

CHIME Outstanding Service Award now open!  This award recognizes a CHIME member CIO who has shown outstanding dedication to the CHIME organization as evidenced by participation in CHIME’s programs and through volunteer service.  Nominate a colleague or apply today.

Coming soon: CHIME State Public Policy Award for CIO Leadership.  This award will be presented in Washington, DC during NHIT Week (September 16-20).  Stay tuned for more information.

Edited by Gabriel Perna

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