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WEDI ICD-10 Post-implementation Survey Results Released

Smooth Transition; Industry is Now Focused on Other Initiatives

RESTON, Va. — May 9, 2016 WEDI, the nation’s leading authority on the use of health IT to create efficiencies in healthcare information exchange, announced the release of its findings from its March 2016 ICD-10 post-implementation survey. In the May 2 letter to the Health and Human Services (HHS) Secretary, WEDI shared survey results and an analysis of the responses on the ICD-10 transition following the Oct. 1, 2015 implementation.

“WEDI has played a tremendous role in educating the industry and helping to best ease the impacts of the ICD-10 transition for many years,” said Jean Narcisi, chair of WEDI. “We wanted this post-implementation survey to be a closing chapter of assessment on why the transition went so well overall and to also leverage specific lessons learned for future large implementations.”

Some key observations from the survey results include the following:

  • Response rate: This survey had a low response rate in relation to prior surveys, possibly indicating the reassignment of ICD-10 project personnel and likely a lack of interest in further ICD-10-related activities that are not operational in nature.
  • Impact of delays: While the changes to the compliance date added cost for many organizations and caused a lack of momentum, all sectors also indicated that the delays improved the ability to perform testing and resulted in a smoother transition.
  • Cost: Vendor and health plan respondents indicated that the cost of implementation was on target with expectations or was more than anticipated. While the majority of provider responses also indicated that costs were in line with expectations or higher, many providers responded that costs were less than expected.
  • Return on investment (ROI): The majority of respondents indicated that they did not expect to realize any ROI with ICD-10.
  • Productivity: The impact to productivity was primarily neutral for vendors and health plans, but there was a slight decrease in productivity for providers.
  • Information sources: All respondents indicated that CMS and WEDI resources were very helpful along with coding materials from industry organizations.
  • Key lessons: Some common themes reflected in the responses indicate the value of starting early, communicating with trading partners and conducting extensive testing.

More information on WEDI events and ICD-10 work products are also available on the WEDI website at www.wedi.org/workgroups/icd-10.

About WEDI

The Workgroup for Electronic Data Interchange (WEDI) is the leading authority on the use of health IT to improve healthcare information exchange in order to enhance the quality of care, improve efficiency, and reduce costs of our nation’s healthcare system. WEDI was formed in 1991 by the Secretary of Health and Human Services (HHS) and was designated in the 1996 HIPAA legislation as an advisor to HHS. WEDI’s membership includes a broad coalition of organizations, including: hospitals, providers, health plans, vendors, government agencies, consumers, not-for-profit organizations, and standards development organizations. To learn more, visit www.wedi.org and connect with us on Twitter, Facebook and LinkedIn.

May 9, 2016 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

First-ever CMS Innovation Center pilot project to test improving patients’ health by addressing their social needs

$157 million in funding will bridge clinical care with social services

The Department of Health and Human Services today announced a new funding opportunity of up to $157 million to test whether screening beneficiaries for health-related social needs and associated referrals to and navigation of community-based services will improve quality and affordability in Medicare and Medicaid. Many of these social issues, such as housing instability, hunger, and interpersonal violence, affect individuals’ health, yet they may not be detected or addressed during typical health care-related visits. Over time, these unmet needs may increase the risk of developing chronic conditions and reduce an individual’s ability to manage these conditions, resulting in increased health care utilization and costs.

The five-year program, called the Accountable Health Communities Model, is the first Centers for Medicare & Medicaid Services (CMS) Innovation Center model to focus on the health-related social needs of Medicare and Medicaid beneficiaries, including building alignment between clinical and community-based services at the local level. The goal of this model is that beneficiaries struggling with unmet health-related social needs are aware of the community-based services available to them and receive assistance accessing those services.

“We recognize that keeping people healthy is about more than what happens inside a doctor’s office, and that’s why, for the first time, we are testing whether screening patients for health-related social needs and connecting them to local community resources like housing and transportation to the doctor will ultimately improve their health and reduce the cost to taxpayers,” said HHS Secretary Sylvia M. Burwell. “The Accountable Health Communities model is yet another step towards building a health care system that results in healthier people and stronger communities and spends our health care dollars more wisely.”

Award recipients under this model, referred to as “bridge organizations,” will oversee the screening of Medicare and Medicaid beneficiaries for social and behavioral issues, such as housing instability, food insecurity, utility needs, interpersonal violence, and transportation limitations, and help them connect with and/or navigate the appropriate community-based services. For example, a patient who isn’t taking his medication because he or she lacks transportation to the pharmacy would be referred to federal, state or local assistance programs. Some bridge organizations will assist beneficiaries in applying for community-based services, such as the Low Income Home Energy Program, which can provide much-needed assistance with utility bills and allow beneficiaries to maintain their medication supply rather than having to choose between maintaining their health or paying their heating bill.

“For decades, we’ve known that social needs profoundly affect health, and this model will help us understand which strategies work to help improve health and spend dollars more wisely,” said Dr. Patrick Conway, CMS Deputy Administrator and Chief Medical Officer. “We will learn how health and health care improvements can be achieved through strong partnerships and linkages at the community level.”

The Affordable Care Act provides tools, such as the Accountable Health Communities Model, to move our health care system toward one that rewards doctors based on the quality, not quantity of care they give patients. Today’s announcement is part of the Administration’s broader strategy to improve the health care system by paying providers for what works, unlocking health care data, and finding new ways to coordinate and integrate care to improve quality. In January 2015, HHS announced the ambitious goal of tying 30 percent of Medicare payments to quality and value through alternative payment models by 2016 and 50 percent of payments by 2018. More than 4,600 payers, providers, employers, patients, states, consumer groups, consumers and other partners have registered to participate in the Health Care Payment Learning and Action Network, which was launched to help the entire health care system reach these goals.

Model Description

Thanks to funding provided under the Affordable Care Act, the Accountable Health Communities Model will support up to 44 bridge organizations, which will deploy a common, comprehensive screening assessment for health-related social needs among all Medicare and Medicaid beneficiaries accessing care at participating clinical delivery sites.

The model will test three scalable approaches to addressing health-related social needs and linking clinical and community services – community referral, community service navigation, and community service alignment. Bridge organizations will inventory local community agencies and provide referrals to those agencies as needed. They may also provide intensive community service navigation such as in-depth assessment, planning, and follow-up until needs are resolved or determined to be unresolvable for high-risk beneficiaries.

The pilot allows participants to assess community services and encourage partner alignment to ensure these services are available and responsive to the needs of beneficiaries. This continuous quality improvement approach includes organizing an advisory board and data sharing to inform a gap analysis and quality improvement plan.

To measure the effectiveness of the model on impacting total cost of health care utilization and quality of care, the primary evaluation will focus on reduction in total health care costs, emergency department visits, and impatient hospital readmissions.

Eligible applicants for the Accountable Health Communities model are community-based organizations, hospitals and health systems, institutions of higher education, local government entities, tribal organizations, and for-profit and not-for-profit local and national entities with the capacity to develop and maintain a referral network with clinical delivery sites and community service providers. Applications will be due in early 2016 and CMS anticipates announcing awards in the fall of 2016.

To view a fact sheet on the Accountable Health Communities Model or for more information on the Accountable Health Communities Model, including the Funding Opportunity Announcement, please visit: https://innovation.cms.gov/initiatives/ahcm.

January 5, 2016 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

HHS issues rules to advance electronic health records with added simplicity and flexibility

Public comment period offers forum to gather additional feedback and inform future policies

The Centers for Medicare & Medicaid Services (CMS) and Office of the National Coordinator for Health Information Technology (ONC) today released final rules that simplify requirements and add new flexibilities for providers to make electronic health information available when and where it matters most and for health care providers and consumers to be able to readily, safely, and securely exchange that information. The final rule for 2015 Edition Health IT Certification Criteria (2015 Edition) and final rule with comment period for the Medicare and Medicaid Electronic Health Records (EHRs) Incentive Programs will help continue to move the health care industry away from a paper-based system, where a doctor’s handwriting needed to be interpreted and patient files could be misplaced.

“We have a shared goal of electronic health records helping physicians, clinicians, and hospitals to deliver better care, smarter spending, and healthier people.  We eliminated unnecessary requirements, simplified and increased flexibility for those that remain, and focused on interoperability, information exchange, and patient engagement. By 2018, these rules move us beyond the staged approach of ‘meaningful use’ and focus on broader delivery system reform,” said Dr. Patrick Conway, M.D., M.Sc., CMS deputy administrator for innovation and quality and chief medical officer. “Most importantly we are seeking additional public comments and plan for active engagement of stakeholders so we take time to get broad input on how to improve these programs over time.”

HHS heard from physicians and other providers about the challenges they face making this technology work well for their individual practices and for their patients. In recognition of these concerns, the regulations announced today make significant changes in current requirements. They will ease the reporting burden for providers, support interoperability, and improve patient outcomes.  Providers can choose the measures of progress that are most meaningful to their practice and have more time to implement changes to program requirements. Providers are encouraged to apply for hardship exceptions if they need to switch or have other technology difficulties with their EHR vendor. Additionally, the new rules give developers more time to create user-friendly technologies that give individuals easier access to their information so they can be engaged and empowered in their care.

As part of today’s regulations, CMS announced a 60-day public comment period to gather additional feedback about the EHR Incentive Programs going forward, in particular with the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), which established the Merit-based Incentive Payment System and consolidates certain aspects of a number of quality measurement and federal incentive programs into one more efficient framework. We will use this feedback to inform future policy developments for the EHR Incentive Programs, as well as consider it during rulemaking to implement MACRA, which we expect to release in the spring of 2016.

In addition to the final rule for the EHR Incentive Programs, ONC is also announcing the final rule for the 2015 Edition Health IT Certification Criteria. This rule focuses on increasing interoperability – a secure but seamless flow of electronic health information – and improving transparency and competition in the health IT marketplace.

“This rule is a key step forward in our work with the private sector to realize the shared goal of making actionable electronic health information available when and where it matters most to transform care and improve health for the individual, community and larger population.   It will bring us closer to a world in which health care providers and consumers can readily, safely and securely exchange electronic health information,” said Karen B. DeSalvo, M.D., M.P.H., M.Sc., national coordinator for health IT.

For more information about today’s announcement visit: http://cms.gov/Newsroom/MediaReleaseDatabase/Fact-sheets/2015-Fact-sheets-items/2015-10-06.html

For more information on the CMS final rule with comment period, click here:http://cms.gov/Newsroom/MediaReleaseDatabase/Fact-sheets/2015-Fact-sheets-items/2015-10-06-2.html

For more information on ONC’s editions of certification criteria visit:
https://www.healthit.gov/sites/default/files/factsheet_draft_2015-10-06.pdf

October 6, 2015 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

WEDI Extends Use of ICD-10 Issue Reporting Database beyond Implementation Deadline

Searchable database of industry submitted questions answered by leading associations and organizations assists industry beyond transition

RESTON, Va. — October 1, 2015 The Workgroup for Electronic Data Interchange (WEDI), the nation’s leading nonprofit authority on the use of health IT to create efficiencies in healthcare information exchange, in partnership with the Centers for Medicare and Medicaid Services (CMS) and other industry associations and partners, announced its searchable ICD-10 Issue Reporting Database – originally launched in early 2014 as part of its ICD-10 Implementation Success Initiative – will continue operation after the transition to ICD-10. Through this database, WEDI, CMS and additional partners help to triage issues and provide valuable information and resources to support healthcare organizations in understanding how the new codes and coding standards will impact diagnosis and inpatient procedures.

Once an issue has been submitted into the ICD-10 Issue Reporting Database, it is reviewed by WEDI staff and submitted on to the appropriate resource. After review, answers are made available online in the searchable database to help other healthcare organizations that may be facing similar issues. If name and contact information is provided, WEDI will also follow up directly.

“This tool has been an important component in our goal of ensuring a successful ICD-10 implementation for healthcare providers, payers, clearinghouses and vendors,” said Devin Jopp, Ed.D, president and CEO of WEDI. “As we’ve neared the implementation deadline, questions are coming in at a feverish pace. Because of this, it is important that all healthcare industry stakeholders have continued access to this valuable resource well beyond the transition deadline of October 1.”

Members of the health IT community may continue to send their implementation challenges to the searchable database of ICD-10 issues, which is open to the public for submission. This service is intended for broad-based, ICD-10 transition-related questions and challenges that are encountered, rather than specific consulting code mapping for individual patient cases. Issues can be submitted anonymously, but WEDI highly encourages submitters to provide full contact information so that WEDI can contact the submitter directly once it has a resolution to the issue.

For more information on this and other WEDI ICD-10 initiatives and resources, visit the ICD-10 Workgroup information page.

About WEDI

The Workgroup for Electronic Data Interchange (WEDI) is the leading authority on the use of health IT to improve healthcare information exchange in order to enhance the quality of care, improve efficiency, and reduce costs of our nation’s healthcare system. WEDI was formed in 1991 by the Secretary of Health and Human Services (HHS) and was designated in the 1996 HIPAA legislation as an advisor to HHS. WEDI’s membership includes a broad coalition of organizations, including: hospitals, providers, health plans, vendors, government agencies, consumers, not-for-profit organizations, and standards development organizations. To learn more, visit www.wedi.org and connect with us on Twitter, Facebook and LinkedIn.

October 1, 2015 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

WEDI Survey Suggests Mixed Industry ICD-10 Readiness

Responses from more than 1,100 vendors, health plans and providers indicate ICD-10 delay has slowed some readiness activities; compliance date uncertainty cited as top obstacle

RESTON, Va. — April 6, 2015 The Workgroup for Electronic Data Interchange (WEDI), the nation’s leading nonprofit authority on the use of health IT to create efficiencies in healthcare information exchange, announced the release of its findings from its February 2015 ICD-10 Industry Readiness Survey.  In its March 31 letter to the HHS Secretary, WEDI reported concern with the current level of industry preparedness noting that many organizations did not take full advantage of the additional time afforded by the one-year delay.

“Unless all industry segments take the initiative to make a dedicated effort and move forward with their implementation work, there will be significant disruption on Oct. 1, 2015,” said Devin Jopp, Ed.D, president and CEO of WEDI.

Highlights from the latest survey findings include:

  • Compliance date uncertainty: Uncertainty around further delays was listed as a primary obstacle to implementation, appearing on more than 50 percent of all responses for vendors, health plans and providers.
  • Health plan testing: More than 50 percent of health plans have begun external testing, and of these, a few have completed testing. This is a slight improvement from the prior survey.
  • Vendor product availability: About 60 percent indicated their vendor products were available or they had started customer testing. This is a slight decrease from about two-thirds in the August 2014 survey. However, the number that responded ‘unknown’ decreased from one eighth to just a handful.
  • Provider testing: Only 25 percent of provider respondents had begun external testing and only a few others had completed this step. This is actually a decrease from the about 35 percent of provider respondents that had begun external testing in the August 2014 survey.

“Based on the survey results, it appears the delay has had a negative impact on some readiness activities—especially external testing. Uncertainty over further delays was listed as a top obstacle across all industry segments,” said Jim Daley, WEDI past-chair and ICD-10 Workgroup co-chair. “While the delay provided more time for the transition to ICD-10, many organizations did not take full advantage of this additional time and many providers are falling further behind.”

About the Survey
The survey results are based on responses from 1,174 respondents, consisting of 796 providers, 173 vendors and 205 health plans. The number of responses more than doubled from the last ICD-10 survey WEDI conducted in August 2014.

This is the tenth ICD-10 readiness survey WEDI has conducted since 2009, all of which were done in an effort to gain a broad perspective on the readiness status for different sections of the industry, and to gauge how quickly they are progressing towards the Oct. 1, 2015 implementation deadline. The full survey results are contained in WEDI’s letter to the Department of Health and Human Services (HHS). More information on WEDI events and ICD-10 work products are also available on the WEDI website atwww.wedi.org/workgroups/icd-10.

About WEDI

The Workgroup for Electronic Data Interchange (WEDI) is the leading authority on the use of health IT to improve healthcare information exchange in order to enhance the quality of care, improve efficiency, and reduce costs of our nation’s healthcare system. WEDI was formed in 1991 by the Secretary of Health and Human Services (HHS) and was designated in the 1996 HIPAA legislation as an advisor to HHS. WEDI’s membership includes a broad coalition of organizations, including: hospitals, providers, health plans, vendors, government agencies, consumers, not-for-profit organizations, and standards development organizations. To learn more, visit www.wedi.org and connect with us on Twitter, Facebook and LinkedIn.

April 6, 2015 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

U.S. Supreme Court Will Not Hear Challenge to Affordable Care Act’s Independent Payment Advisory Board at This Time

Goldwater Institute will renew challenge to price-setting board when it makes its first decisions

Washington, D.C.—Today the U.S. Supreme Court announced it would not hear a Goldwater Institute challenge to the Independent Payment Advisory Board created by the Affordable Care Act.

“This case is not dead; we’re simply in a holding pattern,” said Christina Sandefur, a senior attorney at the Goldwater Institute. “We will bring this challenge again once the Independent Payment Advisory Board takes action.”

The Independent Payment Advisory Board is a 15-member board created to set reimbursement rates for Medicare. In reality, it has the power to govern decisions about public and private health care, and to determine which procedures, treatments and drugs will and will not be covered by the government programs that pay for the medical treatment of more than 48 million Americans. IPAB’s decisions automatically become law and cannot be challenged in court. The ACA was written so that the Board cannot be repealed without an unprecedented congressional supermajority, and only during a short window in 2017.

These features are unique to the Independent Payment Advisory Board. Never in American history has another board been created with such broad authority to make law without Congress’s vote or the president’s signature, and that cannot be challenged in court or repealed.

This consolidation of power into one unelected agency was the main aspect of the Goldwater Institute’s challenge. But because the Board has not yet been appointed, or made any decisions, the Ninth Circuit Court of Appeals said the case was not ripe for review at this time.  Today, the Supreme Court did not disturb that ruling.

According to the ACA, as long as IPAB remains unstaffed, the Secretary of Health and Human Services wields the Board’s vast powers alone. And while the Board must act when Medicare costs rise higher than a designated percentage of inflation in a single year, nothing stops it from taking whatever action its members consider to be “related to the Medicare program.”

“We are disappointed we have to wait to bring this challenge before the Court—Americans are subject to IPAB’s limitless decision-making with no recourse,” said Sandefur. “Because the Board is completely insulted from constitutional checks and balances, without Supreme Court action now, it may be too late to decide the case later.”

Congressman Phil Roe (R-TN) has introduced legislation in the U.S. House of Representatives to repeal the Independent Payment Advisory Board. His bill has received dozens of co-sponsors, including several Democrats. Former Congressman Barney Frank (D-NY) has been a vocal critic of the Independent Payment Advisory Board and has also called for its repeal. Twenty-five members of Congress filed an amicus brief asking the Court to hear the Goldwater Institute challenge to IPAB.

Read more about Coons v. Lew here.

###

About the Goldwater Institute

The Goldwater Institute drives results by working daily in courts, legislatures and communities to defend and strengthen the freedom guaranteed to all Americans in the constitutions of the United States and all 50 states. With the blessing of its namesake, the Goldwater Institute opened in 1988. Its early years focused on defending liberty in Barry Goldwater’s home state of Arizona. Today, the Goldwater Institute is a national leader for constitutionally limited government respected by the left and right for its adherence to principle and real world impact. No less a liberal icon than the New York Times calls the Goldwater Institute a “watchdog for conservative ideals” that plays an “outsize role” in American political life.

March 30, 2015 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

WEDI Releases ICD-10 Readiness Survey for Industry Participation

Providers, health plans, vendors and clearinghouses to submit responses before March 6 

RESTON, Va. — February 12, 2015— The Workgroup for Electronic Data Interchange (WEDI), the nation’s leading nonprofit authority on the use of health IT to create efficiencies in healthcare information exchange, announced the release of an ICD-10 readiness survey to determine how well the healthcare industry is progressing towards the Oct. 1, 2015 implementation deadline. The survey results will be evaluated and compiled into a report for the industry.

Providers, health plans, vendors and clearinghouses are invited to participate in this important initiative to help monitor progress as we move closer toward the implementation deadline. The survey is available here. The final submission deadline is March 6, 2015.

“WEDI has been conducting these surveys since 2009, allowing us to gain a broad perspective on the readiness status for different sections of the industry, and to gauge how quickly they are progressing,” says Jim Daley, WEDI past-chair and ICD-10 Workgroup co-chair. “Since the shift to ICD-10 represents such a significant change to the industry, it is imperative that all organizations stay diligently focused and continue the necessary preparations in order to make the conversion in Oct. 2015 as smooth as possible. This survey is an important part of the educational and advisory roles our organization plays within the industry on ICD-10 and other health IT matters – bringing together all industry sectors to deliver a successful transition.”

As an advisor to the U.S. Department of Health and Human Services under the Health Insurance Portability and Accountability Act (HIPAA), WEDI brings to the attention of the Centers for Medicare & Medicaid Services (CMS) issues that it believes warrant review and consideration, and continually reports the results of these periodic ICD-10 readiness surveys to CMS.

WEDI will continue to conduct surveys throughout 2015, and information collected from these surveys will help determine where additional outreach and education is needed.

About WEDI
The Workgroup for Electronic Data Interchange (WEDI) is the leading authority on the use of health IT to improve healthcare information exchange in order to enhance the quality of care, improve efficiency, and reduce costs of our nation’s healthcare system. WEDI was formed in 1991 by the Secretary of Health and Human Services (HHS) and was designated in the 1996 HIPAA legislation as an advisor to HHS. WEDI’s membership includes a broad coalition of organizations, including: hospitals, providers, health plans, vendors, government agencies, consumers, not-for-profit organizations, and standards development organizations. To learn more, visit www.wedi.org and connect with us on Twitter, Facebook and LinkedIn.

February 12, 2015 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

Better, Smarter, Healthier: In historic announcement, HHS sets clear goals and timeline for shifting Medicare reimbursements from volume to value

In a meeting with nearly two dozen leaders representing consumers, insurers, providers, and business leaders, Health and Human Services Secretary Sylvia M. Burwell today announced measurable goals and a timeline to move the Medicare program, and the health care system at large, toward paying providers based on the quality, rather than the quantity of care they give patients.

HHS has set a goal of tying 30 percent of traditional, or fee-for-service, Medicare payments to quality or value through alternative payment models, such as Accountable Care Organizations (ACOs) or bundled payment arrangements by the end of 2016, and tying 50 percent of payments to these models by the end of 2018.  HHS also set a goal of tying 85 percent of all traditional Medicare payments to quality or value by 2016 and 90 percent by 2018 through programs such as the Hospital Value Based Purchasing and the Hospital Readmissions Reduction Programs.  This is the first time in the history of the Medicare program that HHS has set explicit goals for alternative payment models and value-based payments.

To make these goals scalable beyond Medicare, Secretary Burwell also announced the creation of a Health Care Payment Learning and Action Network.  Through the Learning and Action Network, HHS will work with private payers, employers, consumers, providers, states and state Medicaid programs, and other partners to expand alternative payment models into their programs.  HHS will intensify its work with states and private payers to support adoption of alternative payments models through their own aligned work, sometimes even exceeding the goals set for Medicare.  The Network will hold its first meeting in March 2015, and more details will be announced in the near future.

“Whether you are a patient, a provider, a business, a health plan, or a taxpayer, it is in our common interest to build a health care system that delivers better care, spends health care dollars more wisely and results in healthier people.  Today’s announcement is about improving the quality of care we receive when we are sick, while at the same time spending our health care dollars more wisely,” Secretary Burwell said. “We believe these goals can drive transformative change, help us manage and track progress, and create accountability for measurable improvement.”

“We’re all partners in this effort focused on a shared goal. Ultimately, this is about improving the health of each person by making the best use of our resources for patient good. We’re on board, and we’re committed to changing how we pay for and deliver care to achieve better health,” Douglas E. Henley, M.D., executive vice president and chief executive officer of the American Academy of Family Physicians said.

“Advancing a patient-centered health system requires a fundamental transformation in how we pay for and deliver care. Today’s announcement by Secretary Burwell is a major step forward in achieving that goal,” AHIP President and CEO Karen Ignagni said. “Health plans have been on the forefront of implementing payment reforms in Medicare Advantage, Medicaid Managed Care, and in the commercial marketplace. We are excited to bring these experiences and innovations to this new collaboration.”

“Employers are increasingly taking steps to support the transition from payment based on volume to models of delivery and payment that promote value,” said Janet Marchibroda, Health Innovation Director and Executive Director of the CEO Council on Health and Innovation at the Bipartisan Policy Center. “There is considerable bipartisan support for moving away from fee for service toward alternative payment models that reward value, improve outcomes, and reduce costs. This transition requires action not only by the private sector, but also the public sector, which is why today’s announcement is significant.”

“Today’s announcement will be remembered as a pivotal and transformative moment in making our health care system more patient- and family-centered,” said Debra L. Ness, president of the National Partnership for Women & Families. “This kind of payment reform will drive fundamental changes in how care is delivered, making the health care system more responsive to those it serves and improving care coordination and communication among patients, families and providers. It will give patients and families the information, tools and supports they need to make better decisions, use their health care dollars wisely, and improve health outcomes.”

The Affordable Care Act created a number of new payment models that move the needle even further toward rewarding quality.  These models include ACOs, primary care medical homes, and new models of bundling payments for episodes of care.  In these alternative payment models, health care providers are accountable for the quality and cost of the care they deliver to patients. Providers have a financial incentive to coordinate care for their patients – who are therefore less likely to have duplicative or unnecessary x-rays, screenings and tests.  An ACO, for example, is a group of doctors, hospitals and health care providers that work together to provide higher-quality coordinated care to their patients, while helping to slow health care cost growth. In addition, through the widespread use of health information technology, the health care data needed to track these efforts is now available.

Many health care providers today receive a payment for each individual service, such as a physician visit, surgery, or blood test, and it does not matter whether these services help – or harm – the patient. In other words, providers are paid based on the volume of care, rather than the value of care provided to patients. Today’s announcement would continue the shift toward paying providers for what works – whether it is something as complex as preventing or treating disease, or something as straightforward as making sure a patient has time to ask questions.

In 2011, Medicare made almost no payments to providers through alternative payment models, but today such payments represent approximately 20 percent of Medicare payments. The goals announced today represent a 50 percent increase by 2016. To put this in perspective, in 2014, Medicare fee-for-service payments were $362 billion.

HHS has already seen promising results on cost savings with alternative payment models, with combined total program savings of $417 million to Medicare due to existing ACO programs – HHS expects these models to continue the unprecedented slowdown in health care spending.  Moreover, initiatives like the Partnership for Patients, ACOs, Quality Improvement Organizations, and others have helped reduce hospital readmissions in Medicare by nearly eight percent– translating into 150,000 fewer readmissions between January 2012 and December 2013 – and quality improvements have resulted in saving 50,000 lives and $12 billion in health spending from 2010 to 2013, according to preliminary estimates.

To read a new Perspectives piece in the New England Journal of Medicine from Secretary Burwell: http://www.nejm.org/doi/full/10.1056/NEJMp1500445

To read more about why this matters: http://www.cms.gov/Newsroom/MediaReleaseDatabase/Fact-sheets/2015-Fact-sheets-items/2015-01-26-2.html

To read a fact sheet about the goals and Learning and Action Network:http://www.cms.gov/Newsroom/MediaReleaseDatabase/Fact-sheets/2015-Fact-sheets-items/2015-01-26-3.html

To learn more about Better Care, Smarter Spending, and Healthier People:http://www.cms.gov/Newsroom/MediaReleaseDatabase/Fact-sheets/2015-Fact-sheets-items/2015-01-26.html

A blog from Secretary Burwell is here: http://1.usa.gov/1CYFKAk

Participants in today’s meeting include:

  • Kevin Cammarata, Executive Director, Benefits, Verizon
  • Christine Cassel, President and Chief Executive Officer, National Quality Forum
  • Tony Clapsis, Vice President, Caesars Entertainment Corporation
  • Jack Cochran, Executive Director, The Permanente Federation
  • Justine Handelman, Vice President Legislative and Regulatory Policy, Blue Cross Blue Shield Association
  • Pamela French, Vice President, Compensation and Benefits, The Boeing Company
  • Richard J. Gilfillan, President and CEO, Trinity Health
  • Douglas E. Henley, Executive Vice President and Chief Executive Officer, American Academy of Family Physicians
  • Karen Ignagni, President and Chief Executive Officer, America’s Health Insurance Plans
  • Jo Ann Jenkins, Chief Executive Officer, AARP
  • Mary  Langowski, Executive Vice President for Strategy, Policy, & Market Development, CVS Health
  • Stephen J. LeBlanc, Executive Vice President, Strategy and Network Relations, Dartmouth-Hitchcock
  • Janet M. Marchibroda, Executive Director, CEO Council on Health and Innovation, Bipartisan Policy Center
  • Patricia A. Maryland, President, Healthcare Operations and Chief Operating Officer, Ascension Health
  • Richard Migliori, Executive Vice President, Medical Affairs and Chief Medical Officer, UnitedHealth Group
  • Elizabeth Mitchell, President and Chief Executive Officer, Network for Regional Healthcare Improvement
  • Debra L. Ness, President, National Partnership for Women & Families
  • Samuel R. Nussbaum, Executive Vice President, Clinical Health Policy and Chief Medical Officer, Anthem, Inc.
  • Stephen Ondra, Senior Vice President and Chief Medical Officer, Health Care Service Corporation
  • Andrew D. Racine, Senior Vice President and Chief Medical Officer, Montefiore Medical Center
  • Jaewon Ryu, Segment Vice President and President of Integrated Care Delivery, Humana Inc.
  • Fran S. Soistman, Executive Vice President, Government Services, Aetna Inc.
  • Maureen Swick, Representative, American Hospital Association
  • Robert M. Wah, President, American Medical Association
January 26, 2015 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

New federal health IT strategic plan sets stage for better sharing through interoperability

Federal Health IT Strategic Plan open for 60-day comment period

Following collaboration with more than 35 federal agencies, the U.S. Department of Health and Human Services’ Office of the National Coordinator for Health Information Technology (ONC) today issued the Federal Health IT Strategic Plan 2015-2020.

The Strategic Plan represents a coordinated and focused effort to appropriately collect, share, and use interoperable health information to improve health care, individual, community and public health, and advance research across the federal government and in collaboration with private industry.

The Strategic Plan, which is open for comments, serves as the broad federal strategy setting the context and framing the Nationwide Interoperability Roadmap that will be released in early 2015. The Nationwide Interoperability Roadmap will help to define the implementation of how the federal government and private sector will approach sharing health information.

The U.S. Government has led this charge as a major payer, purchaser and provider of care and associated health IT and through programs associated with the Health Information Technology for Economic and Clinical Health (HITECH) Act of 2009. HITECH accelerated the adoption of certified electronic health record (EHR) technology among hospitals and providers, with 93 percent of eligible hospitals and 76 percent of physicians and eligible professionals taking part in the first stage of the Medicare and Medicaid EHR Incentive Programs. In addition, more than 150,000 health care providers across the nation are working with the HITECH-funded regional extension centers to optimize the use of health IT.

“The 2015 Strategic Plan provides the federal government a strategy to move beyond health care to improve health, use health IT beyond EHRs, and use policy and incentive levers beyond the incentive programs,” said Karen DeSalvo, M.D., national coordinator for health IT and acting assistant secretary for health. “The success of this plan is also dependent upon insights from public and private stakeholders and we encourage their comments.”

“We are very pleased to be collaborating with Health and Human Services, and our other federal partners, on developing the Federal Health IT Strategic Plan.  This plan aligns with our health IT priorities. As a large provider and purchaser of care, we continually look for ways to expand the sharing of critical healthcare information with our healthcare partners,” said Karen S. Guice, M.D., M.P.P.,principal deputy assistant secretary of defense for health affairs, Department of Defense.

“The Federal Health IT Strategic Plan collectively represents specific goals and strategies for how interoperability will be leveraged to foster the technological advancement of health information exchange to improve quality of care for Veterans while supporting patient-provider interaction,” said Gail Graham, deputy secretary for health informatics and analytics at the Department of Veterans Affairs, Veterans Health Administration, Office of Health Information.

Beyond creating financial and regulatory incentives to encourage the use of health IT, the federal government is helping to create a competitive and innovative marketplace. This effort will help bring new tools to health IT consumers and provide tools to help strengthen health care delivery that aligns with other national strategies to improve health including safety, quality, prevention, and reducing disparities.

The Federal Health IT Strategic Plan 2015-2020 can be found on HealthIT.gov. The period to comment on the Strategic Plan ends Feb. 6, 2015.

Today’s data brief found that the ability to easily share electronic information with other care givers, an important component of chronic care management, is also a major motivation for physicians to adopt EHRs. Among physicians who adopted health IT before incentive funds were available, the ability to electronically exchange clinical information with other health care providers was the greatest motivator for adoption. More than a third of physicians who adopted EHRs after HITECH was enacted cited this capability as a major influence in their decision to adopt, and almost 4 in 10 physicians who were not using an EHR reported that the ability to electronically exchange clinical information would be a major driver in their decision to adopt.

December 8, 2014 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

CHIME Statement on Finalization of Meaningful Use ‘Modifications’ Rule

From Russell P. Branzell, FCHIME, CHCIO, President and CEO

This afternoon the Centers for Medicaid and Medicare Services (CMS) and the Office of the National Coordinator for Health IT (ONC) finalized a regulation granting providers additional flexibility in meeting Meaningful Use (MU) requirements in 2014. However, the final rule lacked a key provision that would ensure continued EHR adoption and MU participation

CHIME is deeply disappointed in the decision made by CMS and ONC to require 365-days of EHR reporting in 2015. This single provision has severely muted the positive impacts of this final rule. Further, it has all but ensured that industry struggles will continue well beyond 2014.

Roughly 50% of EHs and CAHs were scheduled to meet Stage 2 requirements this year and nearly 85% of EHs and CAHs will be required to meet Stage 2 requirements in 2015. Most hospitals who take advantage of new pathways made possible through this final rule will not be in a position to meet Stage 2 requirements beginning October 1, 2014. This means that penalties avoided in 2014 will come in 2015, and millions of dollars will be lost due to misguided government timelines.

Nearly every stakeholder group echoed recommendations made by CHIME to give providers the option of reporting any three-month quarter EHR reporting period in 2015. This sensible recommendation, if taken, would have assuaged industry concerns over the pace and trajectory of rulemaking; it would have pushed providers to meet a higher bar, without pushing them off the cliff; and it would have ensured the long-term vitality of the program itself. Now, the very future of Meaningful Use is in question.

August 29, 2014 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.