Thursday, September 29, 2011
Source: Kaiser Health News Article
A report about the survey is published in the September 26 issue of Archives of Internal Medicine.
Source: Dartmouth Institute for Health Policy and Clinical Practice News Release
In a statement, DOJ stated:
“The Department has consistently and successfully defended this law in several court of appeals, and only the 11th Circuit Court of Appeals has ruled it unconstitutional. We believe the question is appropriate for review by the Supreme Court.
“Throughout history, there have been similar challenges to other landmark legislation such as the Social Security Act, the Civil Rights Act, and the Voting Rights Act, and all of those challenges failed. We believe the challenges to Affordable Care Act — like the one in the 11th Circuit — will also ultimately fail and that the Supreme Court will uphold the law.”
A Washington Post news story about the appeal may be viewed here.
Source: DOJ News Release
The U.S. Department of Health and Human Services (HHS) launched a new initiative made possible by the Affordable Care Act to help primary care practices deliver higher quality, more coordinated and patient-centered care. Under the new initiative, Medicare will work with commercial and state health insurance plans to offer additional support to primary care doctors who better coordinate care for their patients. This collaboration, known as the Comprehensive Primary Care initiative, is modeled after innovative practices developed by large employers and leading private health insurers in the private sector.
“Thanks to the Affordable Care Act, we are helping primary care doctors better coordinate care with patients so they get better care and we use our health care dollars more wisely,” said HHS Secretary Kathleen Sebelius.
The voluntary initiative will begin as a demonstration project available in five to seven health care markets across the country. Public and private health care payers interested in applying to participate in the Comprehensive Primary Care Initiative must submit a Letter of Intent by November 15, 2011. In the selected markets, Medicare and its partners will enroll interested primary care providers into the initiative.
Primary care practices that choose to participate in this initiative will be given support to better coordinate primary care for their Medicare patients.
This support will help doctors:
- Help patients with serious or chronic diseases follow personalized care plans;
- Give patients 24-hour access to care and health information;
- Deliver preventive care;
- Engage patients and their families in their own care;
- Work together with other doctors, including specialists, to provide better coordinated care.
CMS will pay primary care practices a monthly fee for these activities in addition to the usual Medicare fees that these practices would receive for delivering Medicare covered services. This collaborative approach has the potential to strengthen the primary care system for all Americans and reduce health care costs by using resources more wisely and preventing disease before it happens.
Across the country, systems which are based on comprehensive, higher-functioning primary care, similar to the strategy that CMS seeks to test in this initiative, show that patients are healthier and avoid having to seek care in more complex and expensive settings when primary care practices have the resources to better coordinate care, engage patients in their care plan, and provide timely preventive care. Large businesses have been able to make independent investments to promote more comprehensive primary care – improving the health of their employees and lowering their health care costs, thus making it easier for them to hire more workers and invest in their workforce.
“We know that when doctors have time to spend time with their patients and can better coordinate care with specialists, people are healthier and we have lower costs in the health care system,” said CMS Administrator Donald Berwick, M.D.
The Comprehensive Primary Care initiative is just one part of a wide-ranging effort by the Obama Administration to promote coordinated care and lower costs for all Americans, using important new tools provided by the Affordable Care Act. Accountable Care Organizations (ACOs) are another way that doctors, hospitals and other health care providers can work together to better coordinate care for patients, which can help improve health, improve the quality of care, and lower costs. Under the Bundled Payment initiative, payments for multiple services patients receive during an episode of care will be linked to help improve and coordinate care for patients while they are in the hospital and after they are discharged. The Partnership for Patients is bringing together hospitals, doctors, nurses, pharmacists, employers, unions, and state and federal government to keep patients from getting injured or sicker in the health care system and to improve transitions between care settings.
For more information, please see the Comprehensive Primary Care initiative web site at: http://innovations.cms.gov/areas-of-focus/seamless-and-coordinated-care-models/cpci/
For an overview fact sheet about the Comprehensive Primary Care initiative, visit: http://www.healthcare.gov/news/factsheets/2011/09/primary-care09282011a.html
Interested parties may obtain answers to specific questions by e-mailing CMS at: CPCi@cms.hhs.gov.
For more information about the CMS Innovation Center, please visit: http://www.innovations.cms.gov.
Source: HHS News Release
After several years of relatively modest premium increases, annual premiums for employer-sponsored family health coverage increased to $15,073 this year, up 9 percent from last year, according to a recently released Kaiser Family Foundation/Health Research & Educational Trust 2011 Employer Health Benefits Survey. On average, workers pay $4,129 and employers pay $10,944 toward those annual premiums.
Premiums increased significantly faster than workers’ wages (2.1 percent) and general inflation (3.2 percent). Since 2001, family premiums have increased 113 percent, compared with 34 percent for workers’ wages and 27 percent for inflation.
"This year’s nine percent increase in premiums is especially painful for workers and employers struggling through a weak recovery," Kaiser President and CEO Drew Altman, Ph.D. said.
According to Maulik Joshi, Dr.P.H., president of HRET and senior vice president for research at the American Hospital Association, "survey findings related to the impact of early provisions in health reform provide valuable insight for employers, providers, consumers, and policymakers as they prepare for additional provisions to take effect by 2014."
The 13th annual Kaiser/HRET survey of small and large employers provides a detailed picture of trends in private health insurance costs and coverage. This year’s survey also looked at employers’ experiences with several already implemented provisions of the 2010 health reform law affecting employer coverage.
In particular, the survey estimates that employers added 2.3 million young adults to their parents’ family health insurance policies as a result of the health reform provision that allows young adults up to age 26 without employer coverage on their own to be covered as dependents on their parents’ plan. Young adults historically are more likely to be uninsured than any other age group.
"The law is helping millions of young adults to obtain health coverage. In the past, many of these young adults would have lost coverage when they left home or graduated college," said study lead author Gary Claxton, a Kaiser vice president and co-executive director of the Kaiser Initiative on Health Reform and Private Insurance.
The study also finds 31 percent of covered workers are in high-deductible health plans, facing deductibles for single coverage of at least $1,000, including 12 percent facing deductibles of at least $2,000. Covered workers in smaller firms (3-199 workers) are more likely to face such high deductibles, with half of workers in smaller firms facing deductibles of at least $1,000, including 28 percent facing deductibles of $2,000 or more.
These numbers in part reflect the rise of consumer-driven plans, which are high-deductible plans that include a tax-preferred savings options such as a Health Savings Account or Health Reimbursement Arrangement. Over the past two years, more firms have started to offer these plans, and the share of covered workers enrolled in this type of plan has doubled, from 8 percent in 2009 to 17 percent in 2011. Plans that can be used with a Health Savings Account have lower premiums than other plan types, but must have annual deductibles of at least $1,200 for an individual and $2,400 for a family this year.
The survey finds that 56 percent of covered workers are in "grandfathered" plans as defined under health reform. Grandfathered plans are exempted from some health reform requirements, including covering preventive benefits with no cost sharing and having an external appeals process. To obtain this status, employers cannot make significant changes to their plans that reduce benefits or increase employee cost.
One in four covered workers (23 percent) are in plans that changed their cost-sharing requirements for preventive services as a result of a requirement of the health reform law that non-grandfathered plans provide certain preventive benefits without cost sharing. In addition, 31 percent of covered workers are in plans that changed the list of preventive services due to health reform.
Other findings from the study include:
- Worker-only coverage. Premiums for worker-only health coverage increased 8 percent in 2011 to reach $5,429 annually. Workers on average pay $921 toward this coverage.
Offer rate. The share of firms offering health insurance to their workers is 60 percent this year, comparable to the levels in 2009 and earlier years. Last year’s survey found an unexplained sharp increase in the share of the smallest firms (3-9 workers) offering coverage, boosting the overall offer rate; this year’s results suggest that the one-year bump did not reflect a change in the long-term trend.
- Cost-sharing for office visits and drugs. Covered workers facing copayments for in-network physician office visits on average pay $22 for primary care and $32 for specialty care. For covered workers with three- and four-tier drug plans, average copayments are $10 for generic drugs, $29 for preferred brand-name drugs, $49 for non-preferred brand-name drugs, and $91 for specialty drugs.
- Retiree health benefits. Among large firms (200 or more workers), about one in four (26 percent) offer retiree health benefits in 2011, unchanged from last year and down significantly from 32 percent in 2007.
Full survey results are available online at http://ehbs.kff.org.
Now in its 13th year, the survey is a joint project of the Kaiser Family Foundation and the Health Research & Educational Trust. The survey was conducted between January and May of 2011 and included 3,184 randomly selected, non-federal public and private firms with three or more employees (2,088 of which responded to the full survey and 1,096 of which responded to a single question about offering coverage). A research team at Kaiser and HRET conducted and analyzed the survey, led by Kaiser’s Gary Claxton and including researchers at the NORC at the University of Chicago (working on the project under contract to HRET). For more information on the survey methodology, please visit the Survey Design and Methods Section at http://ehbs.kff.org.
Monday, September 26, 2011
Recent reports, including the U.S. Census and the National Health Information Survey, have indicated that approximately one million additional young Americans now have insurance coverage due to the Affordable Care Act according to experts. The Patient’s Bill of Rights made it illegal for insurance companies to deny coverage to a child with a pre-existing condition or place a lifetime limit on the care they will provide. Through Affordable Care Act initiatives, 19 million seniors with Medicare have received new free preventive benefits, while efforts to cut fraud and abuse have extended the Medicare Trust Fund by 8 years, strengthening the Medicare program.
To read more about the many accomplishments of the law visit: http://www.healthcare.gov/law/resources/reports/patients-bill-of-rights09232011a.pdf
To read a blog commemorating the anniversary by Assistant Secretary for Public Affairs Richard Sorian visit: www.healthcare.gov/blog
Source: HHS News Release
Wednesday, September 21, 2011
In November 2010, HHS established the Text4Health Task Force as part of the agency’s commitment to promoting innovation at HHS. The task force, comprised of public health experts across HHS, was charged with providing recommendations for HHS’ role in encouraging and developing health text messaging initiatives which would deliver health information and resources to individuals via their mobile phones. The report recommends that: 1) HHS develop and host evidence-based health text message libraries that leverage HHS’ rich and scientifically-based information, 2) HHS develop further evidence on the effectiveness of health text messaging programs, and 3) HHS explore and develop partnerships to create, implement and disseminate health text messaging and mHealth programs.
The full HHS Text4Health Task Force recommendations are available for public comment at http://www.hhs.gov/open.
Since January 2010, and consistent with these recommendations, HHS has invested $5 million dollars to develop its eHealth/mHealth smoking cessation resources aimed at increasing quitting attempts among teens, young adults and adults. HHS launched several new initiatives that have been guided by the HHS Text4Health Task Force.
The National Cancer Institute (NCI) at the National Institutes of Health is launching the SmokeFreeTXT program, a mobile smoking cessation service specifically designed for teens and young adults across the United States. The service is an extension of the core smoking cessation website, www.smokefree.gov, which consistently achieves between 70,000 – 100,000 visits on a monthly basis. Teens and young adults in the U.S. can enroll in this program by visiting http://smokefree.gov/smokefreetxt/default.aspx.
“More than 70 percent of smokers want to quit, we are committed to providing evidence based information to smokers through emerging and innovative technology,” said HHS Secretary Kathleen Sebelius.
NCI is also launching a library of smoking cessation messages which provide the foundation for an interactive text-based intervention for adult smokers called QuitNowTXT. The QuitNowTXT text messages offer tips, motivation, encouragement and facts based on information tailored to the user’s response and are available at http://smokefree.gov/hp.aspx. These mobile texting resources will be integrated into the department’s comprehensive tobacco control strategy to further address the burden of tobacco use across our nation.
HHS is also pursuing opportunities to forge a global public-private partnership to make the QuitNowTXT program available to other countries to reach adult tobacco users. This initiative aims to collaborate with interested countries to support mHealth/text-based demonstration projects using this new text messaging resource, which are now freely available on the mHealth Alliance’s HealthUnbound.org website. Drawing on the experience gained from these demonstration projects, the countries and partners will identify and disseminate best practices for tobacco cessation mHealth/text-based interventions.
“Mobile device texting initiatives, like this one, have the potential to be a powerful tool to support tobacco cessation globally. Text messaging is widely available, inexpensive, and allows for immediate delivery of cessation information,” said HHS Chief Technology Officer Todd Park.
The QuitNowTXT initiative is consistent with the UN’s Political Declaration of the High Level Meeting on the Prevention and Control of Non-communicable Diseases, which calls upon member states to “encourage the development of multisectoral public policies that create equitable health promoting environments that empower individuals, families and communities to make healthy choices and lead healthy lives”.
A description of projects related to the HHS Text4Health Task Force recommendations can be found at: http://www.hhs.gov/open. The tobacco control message libraries, along with other libraries (smoking cessation for pregnant women, early childhood health, emergency response, etc.) will also be available to the public on HealthData.gov in the future.
Source: HHS Press Release
Monday, September 19, 2011
The focus of our nation's health care system is to improve the health of individuals and ultimately the health of the population as a whole. In order to positively impact population health, we need to be able to evaluate and react to emerging health issues and trends. In recent years, the use of distributed queries has become a growing focus of health information technology. With this approach, data are shared in aggregate and without identifying individual information, thus maintaining patient privacy and security while allowing valuable health information to be collected for analysis. This means that health care providers have an increased ability to proactively respond to disease outbreaks, understand the efficacy of drug treatments, and monitor health trends. This ability to understand large-scale health trends can contribute to reducing the cost of health care and most importantly, improving the health of our citizens.
Establishing standards and services for distributed population queries can increase the speed and lower the transaction costs for health care providers to analyze and apply important information. In this way, providers, consumers, researchers, and others can gain insight into many health issues including:
• Prevention activities – Caregivers could have access to a larger pool of data that will enable them to prioritize prevention procedures, such as administration of flu vaccines for vulnerable populations.
• Health care research – Researchers and providers could compare the effectiveness of different treatments and medications in the treatment of high cholesterol and other long–term health conditions.
• Disease outbreaks – Health care providers could monitor outbreaks of specific illnesses, such as the H1N1 virus, which spread across the nation a couple of years ago.
To learn more about Query Health, visit www.QueryHealth.org.
Source: ONC News Release
In a recent Health IT Buzz blog post, Dr. Farzad Mostashari stated:
This project aims to make progress on the persistent privacy issues raised in the PCAST report. The goal of this project is to enable the implementation and management of health information disclosure policies originating from a patient’s request, statutory and regulatory authority or organizational disclosure requirements.
There will be a “soft launch” of the Data Segmentation Initiative on Monday, September 19, 2011. It will consist of:
• Public call for participation notice emailed to Government and industry stakeholders;
• Wiki home page for initiative; and
• ONC blog post.
The formal launch of the Data Segmentation Initiative is scheduled for October 5, 2011 and will consist of a public webinar/presentation with a question and answer session.
Source: ONC Health IT Buzz Blog
Wednesday, September 14, 2011
To view the article, please click here.
Source: NYT Article
Tuesday, September 13, 2011
National Health Information Technology Week is a time to highlight the importance of efficient information systems that protect the privacy and security of personal health information while improving the delivery of health care in the United States.
The Office of the National Coordinator for Health Information Technology (ONC) is encouraging everyone to help promote National Health Information Technology Week by posting one of ONC’s new web graphics on your website, in a blog post, or tweet. Visit HealthIT.gov for instructions on how to use the new web graphics.
This White House proclamation underscores the importance of using technology to transform the nation’s health care system and improve the privacy and security of personal health information.
For more information about National Health Information Technology Week, please click here.
Source: White House News Release
Monday, September 12, 2011
The announcement came at the kick-off of the first-ever HHS Consumer Health IT Summit, which brought consumers, providers, and the public and private sectors together to discuss how best to empower consumers to be partners in their health and care through health IT.
The Notice of Proposed Rulemaking (NPRM), jointly drafted by the Centers for Medicare & Medicaid Services, the HHS Office for Civil Rights (OCR), and the Centers for Disease Control and Prevention, proposes to amend the Clinical Laboratory Improvement Amendments of 1988 (CLIA) regulations and HIPAA privacy regulations to strengthen patients’ rights to access their own laboratory test result reports. The NPRM will be published in the Federal Register on September 14, 2011; public comments on the proposal will be accepted for 60 days after publication in the Federal Register.
Secretary Sebelius also unveiled an innovative voluntary Personal Health Record (PHR) Model Privacy Notice, which creates an easy-to-read, standardized template allowing consumers to compare and make informed decisions based on their privacy and security policies and data practices about PHR products. The new template is similar to the Nutrition Facts Labels in that it presents certain complex information in a simple way to improve transparency and consumer understanding about data practices. By making this Model Privacy Notice available, PHR companies can help build greater trust in PHRs.
For more information about the proposed amendments to the CLIA and HIPAA Privacy regulations, please visit https://www.cms.gov/apps/media/fact_sheets.asp.
Source: HHS News Release
Beacon Communities receive funds through the Office of the National Coordinator for Health Information Technology (ONC) to build and strengthen their HIT infrastructure and exchange capabilities to improve care coordination, increase the quality of care, and slow the growth of health care spending. The awards from HRSA are intended to enable existing health centers located in Beacon Communities to participate in community-wide health care improvement initiatives that include a strong information technology component. Recipients include health centers in cities across the country, from Cincinnati, Ohio and Detroit, Mich. to Spokane, Wash. and San Diego, Calif.
“Beacon Communities are about empowering doctors, nurses, patients, and community leaders to come together and use technology to make tangible differences in the lives of everyday Americans,” said HRSA Administrator Mary Wakefield, Ph.D., R.N. “The health information technology they use is a vital tool in reaching and treating the vulnerable populations we serve, and the partnerships strengthened through these awards will strengthen health centers’ efforts to deliver comprehensive, high-quality primary health care.”
“These communities have already demonstrated their commitment to cutting edge health information technology,” said HHS National Coordinator for Health Information Technology Dr. Farzad Mostashari. “Today’s awards are an important step in giving these communities the resources they need to implement home-grown programs that work for them and that can be sustained for years to come.”
The awards are another part of the Obama Administration’s efforts to improve the quality of care, increase Americans’ access to information and empower them to become active participants in their health. Eligible applicants included existing Health Center Program grantees located within a Beacon Community Program service area. A list of health center Beacon community supplemental funding grantees by organization and state is available at www.hrsa.gov/about/news/2011tables/beaconawards.html.
For more information about the Office of the National Coordinator for Health Information Technology and the Beacon Community Program, please visit http://healthit.hhs.gov.
To learn more about the Affordable Care Act, visit www.healthcare.gov.
For more information about HRSA’s Community Health Center Program, visit http://bphc.hrsa.gov/about/index.html.
To find a health center in your area, visit http://findahealthcenter.hrsa.gov.
Source: HHS News Release
Friday, September 9, 2011
Source: ONC Release
Section 132 of the Medicare Improvements for Patients and Providers Act of 2008 (MIPPA) required the Secretary to establish a new reporting program for eligible professionals who are successful electronic prescribers as defined by MIPPA, beginning on January 1, 2009. While the eRx Incentive Program has similarities in structure and processes to the Physician Quality Reporting System (formerly the Physician Quality Reporting Initiative or PQRI), this program is a separate program with distinct reporting requirements and associated incentive payments and payment adjustments.
In addition to the electronic prescribing incentive payment, MIPPA called for a Medicare Physician Fee Schedule (MPFS) payment adjustment that will apply beginning in January 2012 to eligible professionals who are not successful electronic prescribers, as defined in the Calendar Year (CY) 2011 MPFS final rule. For eligible professionals who are subject to the 2012 eRx payment adjustment, the fee schedule amount for covered professional services furnished by eligible professionals during the year shall be 1 percent less than the fee schedule amount that would otherwise apply for 2012. The potential MPFS reductions in the future are a 1.5 percent reduction for 2013 and 2.0 percent reduction for 2014.
The final rule can be found at http://www.ofr.gov/OFRUpload/OFRData/2011-22629_PI.pdf.
For more information about this announcement, read the http://blog.cms.gov/2011/08/31/greater-flexibility-in-e-prescribing-means-greater-success/
Source: CMS News Release
The HITECH Act also requires that each report be made available to the public on the web site of the Department.
The reports may be viewed here.
Source: HHS OCR Posting
Key findings included the importance of engaging staff with an organization’s mission, vision, goals and objectives; and using a high-performance organizing framework, such as Six Sigma or Lean production to clarify the link with quality and safety outcomes. The report’s findings confirm the importance of high-performance work practices to organizational success in general, especially those that engage individual staff. Promoting Safety and Quality Through Human Resources Practices also lays the groundwork for future research to establish a more definitive link between high-performance work practices and quality outcomes. Select to access the report.
Source: AHRQ Release
Source: ONCIT Buzz Blog
“We need health information technology to bring our health care system into the 21st century,” said Secretary Sebelius. “These funds will help safety net providers acquire state-of-the-art health information technology systems to ensure the delivery of quality care to some of the most remote areas of our country.”
Each of 40 grantee organizations will receive about $300,000 to purchase equipment, install broadband networks and provide training for staff. The pilot program was developed as a result of the President’s Rural Health Initiative, which identifies HIT as a priority area, and the Secretary’s Rural HIT Taskforce. Funding is distributed through HHS’ Health Resources and Services Administration (HRSA) and comes from existing appropriations and authorization for the Rural Health Care Services Outreach and Rural Health Network Development Program.
“Collaboration is key to this effort. Working together, these rural health networks will be in a better position to achieve economies of scale and enhance their services and organizational capacity,” said HRSA Administrator Mary Wakefield, Ph.D., R.N.
The list of grants may be viewed here.
For more information on the Rural Health Information Technology Initiative, please visit http://healthit.hhs.gov/portal/server.pt?open=512&mode=2&objID=3769
For more information on the Federal Office of Rural Health Policy, please visit http://www.hrsa.gov/ruralhealth/index.html
For more information on CMS EHR incentive payments, please visit http://www.cms.gov/ehrincentiveprograms/
Source: HHS News Release
Source: TJC News Release
HHS Awards $40 million to Boost Public Health Infrastructure, Prepare Tomorrow’s Public Health Workforce
“These funds will help health departments around the country maximize the impact of the essential services they provide every day, and build the public health workforce to ensure we’re ready to meet the public health challenges of tomorrow,” said Secretary Sebelius. “Strengthening our nation’s public health system is critical to protecting the health of all Americans.”
The grants will fund key state and local public health programs supported through the Centers for Disease Control and Prevention (CDC) and the Health Resources and Services Administration (HRSA). Most of these grant dollars come from the Prevention and Public Health Fund created by the Affordable Care Act. Additional HRSA dollars supplement this investment.
This is the second year of CDC’s 5-year program known as the National Public Health Improvement Initiative (NPHII) Strengthening Public Health Infrastructure for Improved Health Outcomes grant program. Over 100 people have already been hired through the NPHII and an additional 116 positions are expected to be filled through today’s awards.
The NPHII funding allows health departments to improve the delivery and impact of the public health services they provide by improving how they track the performance of their programs; fostering the identification, dissemination and adoption of public health’s best and most promising practices; building a network of performance improvement managers across the country that share strategies for improving the public health system; and maximizing cohesion across states’ and communities’ public health systems to ensure seamless and coordinated services for residents.
“A strong, efficient, and effective public health system is critical for building a healthy society,” said CDC Director, Thomas R. Frieden, M.D., M.P.H. “Investing in preventive services, system improvement and comprehensive interventions is essential to reducing the burden of health care costs in the future.”
The awards will also support 10 Public Health Training Centers at accredited schools of public health and other public or non-profit institutions, bringing the total number of Public Health Training Centers to 37 across the country. HRSA’s Public Health Training Center (PHTC) Program provides our nation’s public health workforce education and training in areas such as environmental health, public health leadership, nutrition, and cultural competency. This expanded national educational network will provide highly-skilled training to nearly 500,000 public health and related healthcare practitioners.
“In a challenging economy, public health training and education are vital in our efforts to ensure access to affordable, high-quality health care,” said Mary K. Wakefield, Ph.D., R.N., HRSA administrator. “These grants provide learning opportunities that enhance technical, scientific, managerial, and leadership skills of public health workers, and help build a strong, well-rounded public health workforce for the future.”
The announcement is another part of the Obama Administration’s broader effort to improve the health and well-being of our communities through initiatives such as the President’s Childhood Obesity Task Force, the First Lady’s Let’s Move! campaign, the National Quality Strategy, and the National Prevention Strategy.
For a full list of grantees, please visit: http://www.hhs.gov/news/press/2011pres/08/state_workforce_grants.html
For more information on CDC’s National Public Health Improvement Initiative (NPHII), please visit http://www.cdc.gov/ostlts/nphii
For more information on HRSA’s Public Health Training Center (PHTC) Program, please visit: http://bhpr.hrsa.gov/grants/publichealth/index.html
Source: HHS News Release