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UMMS and NASI release report on technology infrastructure development

Posted on September 20, 2012 | No Comments

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Implementation Briefs

A new report released by the University of Massachusetts Medical School (UMMS) and the National Academy of Social Insurance (NASI) examines the establishment of the information technology (IT) infrastructure to promote access to and enrollment in health plans through Exchanges and expanded Medicaid programs under the Affordable Care Act (ACA). The report reviews lessons from “Early Innovator” and other advanced states as they prepare for these ACA provisions. The report, entitled “Establishing the Technology Infrastructure for Health Insurance Exchanges Under the Affordable Care Act,” reviews issues that policymakers should consider as they develop state-based technology infrastructures.

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A recent report released by the Government Accountability Office (GAO) analyzed the progress of implementing the Affordable Care Act's (ACA) state-based and partnership Exchanges in six states and DC. GAO found that the greatest challenges to achieving complete implementation by October 1, 2103 lie in IT-related work and financing. Several of the states in the study began working on the IT component of their Exchange prior to the release of federal guidelines, meaning significant changes to IT systems may be necessary in the future. Incomplete information on the federal data hub requirements has also hindered full development of several state IT systems. GAO reported that uncertainties associated with the 2014 enrollment numbers make finances very difficult to estimate. States have also employed several different methods to obtain operating funds for 2015. For instance, Oregon will charge an administrative fee of up to 5% of premiums, based upon the number of individuals that enroll in the Exchange. Nevada, however, will charge between $7.13 and $7.78 per member per month, which will be factored into enrollee's premiums.
The Bipartisan Policy Center (BPC) released a new report detailing recommendations for the transition to electronic health records. Health information technology (IT) and electronic health information sharing will play important roles in addressing the trifecta of cost, quality, and access U.S. health care reform. The BPC report explores ways to accelerate access to patient information by clinicians and all members of the care team, regardless of care setting, while safeguarding the privacy and security of health information. To inform these findings and recommendations, BPC collaborated with Doctors Helping Doctors Transform Health Care (Doctors Helping Doctors) to conduct a survey designed to gather clinicians’ perspectives on their needs and preferences regarding electronic health information sharing, specifically to support care transitions (when a patient’s care is “handed off” from one clinician to another).
Long-term and post-acute care providers and officials from the Office of the National Coordinator (ONC) for Health Information Technology recommended that Electronic Health Records (EHRs) design requirements focus on longitudinal care plans, transitions of care and patient assessments during a roundtable discussion held in May. A report summarizing the roundtable discussion stated that federal health officials should offer long-term care providers incentives to adopt Stage 3 Meaningful Use criteria for EHR.
Health information technology (HIT) has become central to health care reform policy-making due to its potential to improve efficiency and increase the quality of health care in the United States. Adoption of these technologies has remained a priority of the federal government as evidenced by incentive programs enacted through legislation, including the American Recovery and Reinvestment Act of 2009 and the Affordable Care Act (ACA). The Robert Wood Johnson Foundation (RWJF) has released annual reports since 2006 tracking slow steady increases in the level of adoption for physicians and hospitals throughout the United States. As these incentive programs and other reform initiatives begin implementation, RWJF has continued to track the progress of the nation’s health care system toward universal adoption of electronic health records (EHRs). Mirroring the emphasis at the federal level on the use of this technology in a way that has the greatest potential to improve the overall quality and efficiency of care, this year's report expands on previous analyses by investigating health care providers’ readiness to meet program requirements and explores the role of HIT in other health care reform initiatives.
US Department of Health and Human Services (HHS) released an RFI yesterday soliciting public input on policies to further advance standards-based health information exchange to support delivery system transformation. The RFI also sets out new potential policies under consideration by HHS to accelerate exchange of patient information across settings of care to facilitate more coordinated and affordable care. Comments are due by April 22, 2013.
The Centers for Medicare & Medicaid Services (CMS) issued a proposal to collect data on licenses and other information to register and monitor health insurance brokers and agents for the federal health insurance exchange. Health insurance brokers and agents would enter basic identifying information on the exchange portal during initial registration and when registration is complete, brokers and agents would be routed to CMS's Learning Management System to complete required training and exams. CMS would use broker and agent usernames and ZIP codes to record training history and to communicate the results with the federally facilitated exchange (FFE). Under the Affordable Care Act (ACA), open enrollment in all exchanges begins Oct. 1 for plans that take effect in 2014. Comments on the proposal are due April 8.
The U.S. Department of Health and Human Services (HHS) today released a final rule establishing a unique health plan identifier. The rule also makes official that the new ICD-10 billing codes will be delayed a year, from October 1, 2013 to October 1, 2014.
The U.S. Department of Health and Human Services (HHS) released a final rule defining requirements for Stage 2 of the Electronic Health Record Incentive Program. The program creates incentives for providers who meet benchmarks in the adoption of EHR, also known as meaningful use.
Previous implementation briefs have addressed the electronic health record (EHR) incentive programs enacted by the HITECH Act, part of ARRA. These programs financially incentivize adoption of EHR technology that meets standards of interoperability and accessibility, among other criteria, and incentivize providers to use the technology to engage with patients and improve patient care. Among other goals, the EHR incentive program is intended to improve patient...
A previous Implementation Brief discussed the electronic health record (EHR) incentive program enacted by the HITECH Act, which is part of ARRA[1]. Stage 1 of that program began in 2011 and the Centers for Medicare and Medicaid Services (CMS) reports that through July 2012, more than $6 billion in Medicare and Medicaid incentive payments had been made to 132,511 physicians and hospitals that demonstrated meaningful use of EHRs[2]. On August 23, 2012, CMS published a final rule on the Stage 2 Meaningful Use criteria that eligible professionals (EPs), eligible hospitals and critical access hospitals (CAHs) must meet to qualify as meaningful users of electronic health records (EHRs) and receive incentive payments under the Medicare and Medicaid programs[3]. This final rule builds upon the Stage 2 proposed rule, released on March 7, 2012. The Stage 2 final rule also revises certain Stage 1 criteria, which were finalized in the July 28, 2010 final rule[5]. Stage 1 of the incentive program was designed to encourage providers to move key clinical data into an electronic format, and focused on establishing the functionalities of a certified EHR system[6]. With the final rule, CMS continues its incremental approach to continuing this transitional process and strikes a balance between stakeholders calling for Stage 2 to require demonstrated improvements in care as a result of EHR use and those seeking more flexibility in the rules, with incentives simply to acquire EHR technology.