NAHAM News

Innovation Center Report Released

2012-01-30T14:31:00.002-05:00

A national center set up a year ago to test and implement new ways to improve patient care while cutting costs has delivered its first report. The Center for Medicare and Medicaid Innovation was created by the health care reform act.

It has funded 16 initiatives since it began operations, primarily focused on incentives for delivering care to Medicare, Medicaid, and the Chilren's Health Insurance Program (CHIP).

Source: The Washington Post Article

ONC Launches Health IT Challenge to Improve Hospital Discharge Care

2012-01-30T14:20:00.002-05:00

The National Coordinator for Health Information Technology announced a Discharge Follow-Up Appointment care transitions challenge – the second as part of the Office of the National Coordinator for Health Information Technology (ONC) Investing in Innovation (i2) Initiative. With the support of Health 2.0 and Partnership for Patients, ONC launched the Discharge Follow-Up Appointment challenge in support of ONC’s Investing in Innovation (i2) program.

The i2 Initiative is a bold new effort to spur innovations in health IT. The program utilizes prizes and challenges to facilitate innovation and obtain solutions to intractable health IT problems. Aligned with the Obama administration’s innovation agenda, i2 is the first federal program to operate under the authority of the America COMPETES Reauthorization Act of 2010.

The challenge aims to stimulate the use of simple, information technology-enabled processes and tools to make transitions easier and safer for patients, caregivers and providers, particularly when a patient is discharged from a hospital. The first health IT challenge, Ensuring Safe Transitions from Hospital to Home , called upon developers to create a web-based application that could empower patients and caregivers to better navigate and manage a transition from a hospital.

The scheduling of follow-up appointments and post-discharge testing before leaving the hospital helps ensure safer and more effective transitions. Unfortunately, most patients across the country continue to leave the hospital without confirmed appointments and many providers remain frustrated by a highly manual and unreliable system. The Discharge Follow-Up Appointment challenge will focus on promoting effective care transitions.

“This challenge is an enormous opportunity for software developers to develop solutions, and pursue models that can be adopted across a community,” said Farzad Mostashari, M.D., Sc.M., national coordinator for health information technology. “Scheduling post-discharge follow-up appointments is critical, but not easy for patients or providers and we’re excited by the possibilities that will stem from this challenge.”

For additional information about ONC or on the i2 program, visit http://HealthIT.HHS.gov.

For more information about Health 2.0, which helps support the i2 challenge program, visit www.Health2Con.com .

For more information about Partnership for Patients, which also supports the i2 challenge program, visit http://www.healthcare.gov/compare/partnership-for-patients/index.html .
F
or more information about U. S. Department of Health and Human Services’ Recovery Act programs, see www.hhs.gov/recovery.

Source: HHS News Release

Privacy and Security Mobile Device Good Practices Project Launched

2012-01-30T14:14:00.002-05:00

The Office of the National Coordinator for Health Information Technology's (ONC) Office of the Chief Privacy Officer (OCPO), in working with the U.S. Department of Health and Human Services (HHS) Office for Civil Rights (OCR), recently launched a Privacy & Security Mobile Device project.

The project goal is to develop an effective and practical way to bring awareness and understanding to those in the clinical sector to help them better secure and protect health information while using mobile devices (e.g., laptops, tablets, and smartphones). Building on the existing HHS HIPAA Security Rule - Remote Use Guidance, the project is designed to identify privacy and security good practices for mobile devices. Identified good practices and use cases will be communicated in plain, practical, and easy to understand language for health care providers, professionals, and other entities.

HHS will be looking for public input. Stay tuned for a public roundtable this Spring.

For information about other HHS mHealth activities, please visit the mHealth Initiative website: http://www.hhs.gov/open/initiatives/mhealth/index.html.

Source: ONC News Release

Weigh In: WSJ Discussion on Patient Unique IDs

2012-01-24T16:20:00.002-05:00

A robust debate has begun in the Wall Street Journal regarding Should Every Patient Have a Unique ID Number for All Medical Records?

NAHAM members are encouraged to weigh in.

Source: WSJ Article

HHS OIG: Most Hospital Errors Unreported

2012-01-24T12:54:00.002-05:00

A report by the U.S. Department of Health and Human Services (HHS) Office of the Inspector General (OIG) says that only 1 out of seven hospital errors are reported. The report, Hospital Incident Reporting Systems Do Not Capture Most Patient Harm, also indicates that even after hospital errors are reported, rarely are corrective actions taken to ensure these adverse events do not occur again.

Source: New York Times article

AHRQ Seeks Input from Health IT Community

2012-01-23T10:04:00.001-05:00

The Agency for Healthcare Research and Quality (AHRQ) is seeking input from health IT researchers and implementers who have experience using the Health IT Survey Compendium.

The Health IT Survey Compendium is a tool for health IT researchers and implementers who are looking for Health IT related surveys to help support their implementation and evaluation needs.

If you are a health IT researcher or implementer with prior experience using the AHRQ Health IT Survey Compendium, and you are interested in participating in this AHRQ research effort, please email Westat at AHRQ_HIT_Tool_Eval@westat.com. If you prefer, you can also call Westat toll-free at 888-789-8869. Westat will then contact you for some additional information. If you are selected to participate, Westat will schedule a time with you and send you a confirmation in advance. Your participation would include participating in an online interview and will take approximately 60-90 minutes of your time and does not require any travel. No advance preparation is required and you will receive a payment of $75 to thank you for your time.

Please contact Westat by February 2, 2012 to schedule a call.

Source: AHRQ News Release

EHNAC Announces 2012 Criteria for All Accreditation Programs

2012-01-20T14:41:00.000-05:00

The Electronic Healthcare Network Accreditation Commission (EHNAC), a non-profit standards development organization and accrediting body, announced the adoption of new program criteria for 2012.

Following the standard, 60-day public comment period, EHNAC has incorporated feedback to finalize and adopt the enhanced criteria versions for the following programs:
ePAP – e-Prescribing Accreditation Program (Version 6.3)
FSAP EHN – Financial Services Accreditation Program for Electronic Health Networks (Version 2.3)
FSAP Lockbox – Financial Services Accreditation Program for Lockbox Services (Version 2.3)
HIEAP – Health Information Exchange Accreditation Program (Version 1.1)
HNAP-70 – Healthcare Network Accreditation Plus Select SAS 70©1 Criteria Program (Version 1.3)
HNAP EHN – Healthcare Network Accreditation Program for Electronic Health Networks (Version 10.3) 2
HNAP Medical Biller – Healthcare Network Accreditation Program for Medical Billers (Version 1.2)
HNAP TPA – Healthcare Network Accreditation Program for Third Party Administrators (Version 1.2)
MSOAP – Management Service Organization Accreditation Program (Version 1.1)
OSAP – Outsourced Services Accreditation Program2 (Version 1.2)
OSAP HIE – Outsourced Services Accreditation Program for Health Information Exchange Services (Version 1.1)

“The continued evolution and improvement of our accreditation programs is vital to support the dynamic climate of healthcare reform and industry standards,” says Mark Gingrich, EHNAC Commissioner and Criteria Committee Chair. “EHNAC is fully committed to regularly adjusting our program criteria for accreditation in all areas that affect health data processing to set the bar for the industry standards of today.”

EHNAC accreditation recognizes excellence in health data processing and transactions, and confirms compliance with industry-established standards and HIPAA regulations. Organizations that apply for accreditation or re-accreditation after Jan. 1, 2012 will now need to adhere to the enhanced criteria standards. Criteria for all EHNAC programs are posted online.

Source: EHNAC News Release

New National Biodefense Science Board to Advise HHS

2012-01-20T14:32:00.000-05:00

Seven experts from outside the federal government will join the National Biodefense Science Board (NBSB), a federal advisory committee which provides expert advice and guidance on preventing, preparing for, and responding to adverse health effects of public health emergencies to the HHS Secretary and the HHS Assistant Secretary for Preparedness and Response (ASPR). The new members replace members whose 4-year terms expire Jan. 31.

The ASPR serves as the Secretary’s principal advisor on bioterrorism and other public health emergencies and coordinates the federal public health and medical response to disasters.

“NBSB members bring a broad range of perspectives and experiences, and over the past four years, the board has helped us improve federal policies and practices in disaster preparedness and response,” said Assistant Secretary Nicole Lurie. “I look forward to working with the new members as we forge ahead in helping communities across the country become more resilient to all hazards.”

The board was created under the Pandemic and All-Hazards Preparedness Act of 2006 and chartered in May 2007. Since then, the board has provided recommendations on a variety of federal disaster preparedness and response issues. The issues include, the effectiveness of the National Disaster Medical System and federal management of the research and development medical countermeasures – the medicines, vaccines and equipment needed to protect health from bioterrorism and pandemic disease.

In addition, the board assessed the department’s progress in integrating behavioral health into emergency preparedness and response activities. HHS incorporated the NBSB recommendations in the first federal disaster behavioral health concept of operations which ASPR recently released. The board also has recommended ways to improve the nation’s ability to mobilize scientific resources quickly and comprehensively in support of public health emergency response.

By statute, the board has 13 voting members with a broad range of expertise in science, medicine, and public health. Additionally, there are non-voting members from federal and state government agencies as deemed appropriate by the Secretary.

The next meeting of the board and the first for new members will take place Feb. 2. Information about the meeting and the National Biodefense Science Board is available at http://www.phe.gov/Preparedness/legal/boards/nbsb/Pages/default.aspx.

Incoming members are as follows:
John S. Parker, M.D., major general (retired) U.S. Army, senior vice president, Science Applications International Corporation, re-nominated to serve as NBSB chair
John S. Bradley, M.D., director, Division of Infectious Diseases, Rady Children’s Hospital
Nelson J. Chao, M.D., M.B.A., chief, Division of Cellular Therapy/Bone Marrow Transplantation, Duke University
Emilio A. Emini, Ph.D., chief scientific officer, Vaccine Research, Pfizer, Inc.
Manohar R. Furtado, Ph.D., vice president, Research and Development, Life Technologies/Applied Biosystems
Steven E. Krug, M.D., head, Division of Emergency Medicine at Children’s Memorial Hospital
Sarah Y. Park, M.D., state epidemiologist and chief, Disease Outbreak Control Division, Hawaii Department of Health
The following members’ terms are expiring:
NBSB Chair Patricia Quinlisk, M.D., M.P.H., state epidemiologist and medical director, Iowa Department of Public Health
Ruth L. Berkelman, M.D., Rollins professor and director, Center for Public Health Preparedness and Research, Rollins School of Public Health, Emory University
Stephen V. Cantrill, M.D., BNICE Training Center, Department of Emergency Medicine, Denver Health Medical Center
John D. Grabenstein, R.Ph., Ph.D., senior medical director, Adult Vaccines, Merck Vaccine Division
Thomas J. MacVittie, Ph.D., professor, Departments of Radiation Oncology and Pathology, University of Maryland School of Medicine
John S. Parker, M.D., major general (retired), senior vice president, Scientific Applications International Corporation – re-nominated to serve as NBSB chair
Patrick J. Scannon, M.D., Ph.D., executive vice president and chief, Biotechnology, Officer XOMA, Ltd.
The following members are continuing with the NBSB:
Georges Benjamin, M.D., executive director, American Public Health Association
Jane Delgado, Ph.D., M.S., president and chief executive officer, National Alliance for Hispanic Health
David Ecker, Ph.D., divisional vice president and site general manager, Ibis Biosciences
Daniel Fagbuyi, M.D., medical director, Disaster Preparedness and Emergency Management, Children’s National Medical Center
Kevin Jarrell, Ph.D., chief executive officer, Modular Genetics, Inc.
Betty Pfefferbaum, J.D., M.D., professor and chair, Department of Psychiatry and Behavioral Sciences, University of Oklahoma Sciences Center

Source: HHS News Release

Doctors Are Cautious, Patients Enthusiastic About Sharing Medical Notes

2012-01-13T14:47:00.005-05:00

Patients are overwhelmingly interested in exploring the notes doctors write about them after an office visit, but doctors worry about the impact of such transparency on their patients and on their own workflow, a Beth Israel Deaconess Medical Center (BIDMC) study suggests.

In a study published in the Dec. 20 issue of the Annals of Internal Medicine, patient and doctor attitudes were surveyed extensively prior to the launch of the OpenNotes trial in which patients at BIDMC, Geisinger Health System of Danville, PA, and Harborview Medical Center in Seattle were offered online access to their doctors’ notes written after office visits. Such notes have long been primarily within the doctors’ domain, even though patients have the legal right to obtain them.

"Doctors were divided in many of their expectations, and the issues we highlight have important consequences for both their work life and quality of care," writes lead author Jan Walker, RN, MBA, of BIDMC’s Division of General Medicine and Primary Care.

While many of the more than 100 primary care doctors who volunteered to participate in this experiment predicted possible health benefits from allowing patients to read their notes, the majority of those who declined participation were doubtful about positive impacts. And among the 173 doctors completing surveys, the majority expressed concerns about confusing or worrying patients with the content. Doctors also anticipated that they would write their notes less candidly and that responding to patient questions might be exceedingly time-consuming.
In contrast to the doctors surveyed, the nearly 38,000 patients who completed the baseline survey were almost uniformly optimistic about OpenNotes, and few anticipated being confused or worried

"The enthusiasm of patients exceeded our expectations," wrote Walker. "Most of them were overwhelmingly positive about the prospect of reading visit notes, regardless of demographic or health characteristics."

More than 90 percent favored making the notes available. Well over half anticipated improved adherence to their medications, 90 percent expected to feel more in control of their care, and four out of five predicted they would take better care of themselves.

"We know a lot more about our cars than our own bodies," responded one patient. "We leave all of that to the clinicians. I think by having access to our notes, we can take control, and that’s important."

In addition, half of patients surveyed reported that they would consider sharing their notes with other people, including other doctors.

"As I help my aging mother with her medical needs, I wish I could see the notes her doctors have made," wrote one patient. "I think it would help me in caring for her."

In an accompanying editorial, Thomas W. Feeley, MD, of the MD Anderson Cancer, and Kenneth I. Shine, MD, of the University of Texas, urged that electronic health records be used to engage participants in all parts of the health care delivery system.

"Expanding who uses the records and how they use them promises to facilitate communication, decrease redundant testing, and enhance our care delivery in ways we have yet to imagine."

The year-long OpenNotes study period has now ended, and Walker and her colleagues in the three diverse sites are eager to learn how the baseline expectations will play out. They are currently evaluating reports from follow-up surveys completed by participating doctors and patients and analyzing other metrics, such as how often patients reviewed their notes, shared them with others, or corrected errors their doctors may have made.

"They said they wanted the notes. They said they’d use them, but we have no idea if they actually went online and read them," said Walker. "And if they did read them, we don’t know yet what impact that had on the patients or the doctors."

"Patients want to look into the doctor’s black box, and many doctors are a bit nervous about what they’ll find," said Tom Delbanco, MD, senior author and co-principal investigator of OpenNotes. "But I expect that over time everyone will benefit enormously from such transparency."

"While OpenNotes represents a simple change of practice, the effect on the patient-doctor relationship could be profound. The fact that there’s such a gap between how most patients and many doctors expect that patients will handle the information contained in these notes hints at just how profound that effect might be," added Steve Downs, Robert Wood Johnson Foundation’s Chief Technology and Information Officer. In addition to Walker and Delbanco, the study’s co-authors include: Henry Feldman, MD and Long Ngo, PhD, BIDMC; Suzanne G. Leveille, PhD, RN, University of Massachusetts Boston; Jonathan D. Darer, MD, MPH, Marc J. Lichtenfeld, PhD, Geisinger Health System, Pennsylvania; Shireesha Dhanireddy, MD, Joann G. Elmore, MD, MPH, Natalia Oster, MPH, Elisabeth Vodicka, BA; Harborview Medical Center, Seattle; James D. Ralston, MD, MPH, Group Health Research Institute, Seattle; and Stephen E. Ross, MD, University of Colorado Health Sciences Center.

Source: OpenNotes Press Release

Health Care Reform Law's Rate Review Provision Holding Insurance Rates Down

2012-01-13T14:42:00.002-05:00

Health insurance premium increases in five states have been deemed “unreasonable” by the U.S. Department of Health and Human Services, HHS Secretary Kathleen Sebelius announced .

After independent expert review, HHS determined that Trustmark Life Insurance Company has proposed unreasonable health insurance premium increases in five states—Alabama, Arizona, Pennsylvania, Virginia, and Wyoming. The excessive rate hikes would affect nearly 10,000 residents across these five states.

To make these determinations, HHS used its “rate review” authority from the Affordable Care Act (the health care reform law of 2010) to determine whether premium increases of over 10 percent are reasonable.

"Before the Affordable Care Act, consumers were in the dark about their health insurance premiums because there was no nationwide transparency or accountability," said Secretary Kathleen Sebelius. "Now, insurance companies are required to disclose rate increases over 10 percent and justify these increases. It’s time for Trustmark to immediately rescind the rates, issue refunds to consumers or publicly explain their refusal to do so."

In these five states, Trustmark has raised rates by 13 percent. For small businesses in Alabama and Arizona, when combined with other rate hikes made over the last 12 months, rates have increased by 27.2 percent and 18.1 percent, respectively. These increases were reviewed by independent experts to determine whether they are reasonable. In this case, HHS determined that the rate increases were unreasonable because the insurer would be spending a low percent of premium dollars on actual medical care and quality improvements, and because the justifications were based on unreasonable assumptions.

In addition to the review of rate increases, many states have the authority to reject unreasonable premium increases. Since the passage of the health care reform law, the number of states with this authority increased from 30 to 37, with several states extending existing “prior authority” to new markets.

Examples of how states have used this authority include:
- In New Mexico, the state insurance division denied a request from Presbyterian Healthcare for a 9.7 percent rate hike, lowering it to 4.7 percent;
- In Connecticut, the state stopped Anthem Blue Cross Blue Shield, the state’s largest insurer, from hiking rates by a proposed 12.9 percent, instead limiting it to a 3.9 percent increase;
In Oregon, the state denied a proposed 22.1 percent rate hike by Regence, limiting it to 12.8 percent.
- In New York, the state denied rate increases from Emblem, Oxford, and Aetna that averaged 12.7 percent, instead holding them to an 8.2 percent increase.
- In Rhode Island, the state denied rate hikes from United Healthcare of New England ranging from 18 to 20.1 percent, instead seeing them cut to 9.6 to 10.6 percent.
- In Pennsylvania, the state held Highmark to rate hikes ranging from 4.9 to 8.3 percent, down from 9.9 percent.

HHS' announcement comes the same week that a report showed that health care spending has grown at remarkably low rates. According to an analysis done each year by the Centers for Medicare & Medicaid Services (CMS), U.S. health care spending experienced historically low rates of growth in 2009 and 2010. A recent study released by Mercer Consulting also showed a slow-down in the average employee health benefit cost to businesses.

The Affordable Care Act includes several policies, including rate review, to continue this slow growth. By fighting fraud, better coordinating care, preventing disease and illness before they happen and creating a new state-based insurance marketplace, it helps keep health care cost growth low.

For more information on the specific determinations made today, please visit http://companyprofiles.healthcare.gov/

For general information about rate review, visit: http://www.healthcare.gov/law/features/costs/rate-review/

Source: HHS News Release

CMS Selects Innovation Advisors

2012-01-10T10:44:00.002-05:00

The Centers for Medicare and Medicaid Services (CMS) announced that it has selected 73 individuals from 27 States and the District of Columbia for its Innovation Advisors program.

A list of Innovation Advisors can be found at http://www.cms.gov/apps/media/press/factsheet.asp?Counter=4240.

The initiative, launched by the CMS Innovation Center in October 2011, will help health professionals deepen skills that will drive improvements to patient care and reduce costs. After an initial orientation phase, Innovation Advisors will work with the CMS Innovation Center to test new models of care delivery in their own organizations and communities. They will also create partnerships to find new ideas that work and share them regionally and across the United States.

Funding for this initiative was made possible by the Affordable Care Act.

“There has been an incredible groundswell of interest in becoming an Innovation Advisor. It’s clear that doctors, hospitals and health care providers are enthusiastic about implementing the Affordable Care Act and strengthening our health care system,” said CMS Acting Administrator Marilyn Tavenner.

The 73 individuals were selected from 920 applications through a competitive process, and include clinicians, allied health professionals, health administrators and others. By attending in-person meetings as well as remote sessions to expand their skills and applying what they learn, the Advisors will be able to deepen their knowledge in health care economics and finance, population health, systems analysis, and operations research.

“We’re looking to these Innovation Advisors to be our partners—we want them to discover and generate new ideas that will work and help us bring them to every corner of the United States,” said CMS Innovation Center Director Rick Gilfillan, M.D.

Among other duties, the Advisors will be expected to support the Innovation Center in testing new models of care delivery, to form partnerships with local organizations to drive delivery system reform, and to improve their own health systems so their communities will have better health and better care at a lower cost.

Each Innovation Advisor’s home organization will receive a stipend of up to $20,000. The stipend will support an individual’s activities while serving as an Innovation Advisor.

More information about the Innovation Advisors Program, including a fact sheet and list of participants and their home organization, can be found at: http://innovations.cms.gov/initiatives/innovation-advisors/index.html.

Report on Identifying Health Care Quality Measures in Medicaid-Eligible Adults Released

2012-01-10T10:39:00.001-05:00

The Agency for Healthcare Research and Quality (AHRQ) released a background report documenting the process, deliberations, and results of AHRQ's National Advisory Council Subcommittee for Identifying Health Care Quality Measures for Medicaid-Eligible Adults.
The Affordable Care Act requires the Secretary of the Department of Health and Human Services to identify and publish a core set of health quality measures for Medicaid-eligible adults.

Source: AHRQ Release

AHRQ Releases Podcast on e-Rx

2012-01-10T10:34:00.002-05:00

The Agency for Healthcare Research and Quality (AHRQ) has released a new podcast that highlights findings of a recent AHRQ-funded study on e-prescribing as part of the Agency’s Healthcare 411 podcast series.

The study found electronic prescribing is safe and efficient but barriers to its use remain. In the segment, AHRQ Health IT expert, Teresa Zayas-Caban, Ph.D shares some highlights of the study, which overall found that while physician practices and pharmacies generally view electronic prescribing as an important tool to improve patient safety and save time, there are still barriers to realizing the technology's full benefit.

To listen to the podcast and access other related resources, visit: http://www.healthcare411.ahrq.gov/radiocast.aspx?id=887.

Source: AHRQ News Release

HHS Launches Consumer HIT Video Challenge of 2012

2012-01-10T10:30:00.002-05:00

The National Coordinator for Health Information Technology (ONC) announced a nationwide, open call for entries in the Healthy New Year Video Challenge, highlighting personal stories of patients and families using health technology to improve health. The video challenge, launched by the Office of the National Coordinator for Health Information Technology (ONC), kicks off the first in a series of consumer video contests in 2012 as a way to engage consumers to integrate technology into their health care.

"In order to empower individuals to be more active partners in their health, they need access to their information and tools they can use,” said Farzad Mostashari, M.D., Sc.M., national coordinator for health information technology. “We are excited to harness the creativity of ordinary Americans to help promote the positive impact of the myriad health information technology tools and services on health and health care.”

Submissions for the Healthy New Year Video Challenge will be accepted through February 16 and can range from creative and innovative ways of e-mailing your doctor, using an online patient-portal to manage your health information, or downloading a mobile application that sends medication reminders. All videos must meet certain eligibility criteria.

The winning entries will be determined from public votes and a panel of judges will ultimately select the top winners in each category. ONC will award winners a portion of $5,000 in prize money and feature the videos on its consumer-facing website, www.HealthIT.gov, as a way to motivate and inspire everyone to use health information technology to be more engaged partners in improving health and health care.

For more details, including contest rules on the Health New Year Video Challenge, visit http://healthynewyear.challenge.gov.

For more information about ONC, visit http://HealthIT.gov.

Source: HHS News Release

TJC 2012 Health Care Staffing Review Process Guide Available

2012-01-10T10:26:00.002-05:00

The Joint Commission (TJC) has released its updated 2012 Health Care Staffing Certification Review Process Guide. The guide is designed to provide guidance for onsite certification review.

Source: TJC Release

Hospitals Slow to Embrace Tablet Computers

2012-01-05T14:56:00.002-05:00

According to a recent article from Kaiser Health News, hospitals have been slow to adopt tablet computer technologies and other mobile devices in providing every day care to patients.

Jonathan Mack of the West Wireless Health Institute says that less than 1 percent of hospitals are using tablet computers, such as iPads, and very few of these devices have apps that allow doctors to record their notes as they can on a desktop or laptop computer.

For Hospitals, There's No App for Adopting Tablet Computers by Jenny Gold, may be viewed here.

Source: Kaiser Health News

Study: U.S. Needs to Strengthen Privacy Safeguards for EHRs

2012-01-05T10:51:00.003-05:00

Electronic health records can potentially save billions of dollars in health care costs and increase patient safety, but have considerable risks to individual privacy in the United States, more so than the European Union, says a new study co-authored by Pamplin College of Business professor Janine Hiller.

“EU countries have adopted electronic health records and systems, or EHRs, and legally protected privacy at the same time,” Hiller says. EHRs include a wide range of patient medical information collected in digital format and accessible via computer, most often over a network.

Strengthening the legal and technical safeguards, she says, would significantly minimize the privacy and security risks and address public concerns in the U.S. about EHRs. Her study examines their benefits and drawbacks, the adequacy of U.S. laws to meet the challenges posed by the privacy risks and concerns, and compares the EU’s legal approach to EHRs.

The U.S. legal framework for health care privacy, she says, is “a hodgepodge of constitutional, statutory, and regulatory law at the federal and state levels.” Hiller and her co-authors believe that though federal efforts to protect privacy seem to be a step up from inconsistent state laws, Americans currently still “have no real control over the collection of sensitive medical information if they want to be treated,” in contrast to the choice accorded to EU residents.

Their study, Hiller says, makes it clear that the privacy issue should be central to any discussion of EHR implementation in the U.S. and the technical and policy framework that guides it. Her recent research in Sweden, she says, showed her “that the legal and technical frameworks cannot stand alone; that they should be developed hand in hand in order to design systems that will effectively protect patient privacy.”

Until then, she says, “public confidence and trust in EHRs is unlikely.”

The study, titled Privacy and Security in the Implementation of Health Information Technology (Electronic Health Records): U.S. and E.U. Compared, appears in the winter 2011 issue of the Journal of and may be viewed here. An article about the study, Privacy or Savings? published in the Virginia Tech Pamplin College of Business Magazine, may be viewed here.

Source: VA Tech News Release

New HHS Regs Streamline Health Electronic Funds Transfer; Cut Red Tape

2012-01-05T10:34:00.004-05:00

New standards for electronic funds transfers in health care, required by the Affordable Care Act, will reduce up to $4.5 billion off administrative costs for doctors and hospitals, private health plans, states, and other government health plans, over the next ten years, according to estimates included in new rules published by the U.S. Department of Health and Human Services (HHS).

The standards build upon regulations published in 2011 that set industry-wide standards for how health providers use electronic systems to quickly and easily determine a patient’s eligibility for health coverage and check on the status of a health claim.

Together, the two regulations implementing the Administrative Simplification provisions of the Affordable Care Act and the Health Insurance Portability and Accountability Act (HIPAA) are projected to save the health care industry more than $16 billion over the next 10 years. These savings come from the adoption of electronic standards that will help eliminate inefficient manual processes and reduce costs.

“Thanks to the Affordable Care Act, health care professionals will spend less time filling out paperwork and more time focusing on delivering the best care for patients,” said HHS Secretary Kathleen Sebelius.

A May 2010 study in the journal Health Affairs found that physicians spend nearly 12 percent of every dollar they receive from patients to cover the costs of filling out forms and performing other excessively complex administrative tasks. The study found that simplifying these systems could save four hours per week of professional time per physician and five hours of support staff time every week – time that could be better spent on patient care.

“As a nurse, I know the importance of giving health care professionals time to focus on patient care,” said CMS Acting Administrator Marilyn Tavenner. “The less time a physician has to spend on paperwork is that much more time that can be devoted to patient care. Having standardized procedures across the health care industry can only lead to lower costs and greater efficiencies all around.”

The rule—the Adoption of Standards for Health Care Electronic Funds Transfers and Remittance Advice — adopts streamlined standards for the format and data content of the transmission a health plan sends to its bank when it wants to pay a claim to a provider electronically (through an electronic funds transfer) and to issue a Remittance Advice notice. Remittance Advice is a notice of payment sent to providers that may or may not accompany the payment the provider receives.

For example, currently when a provider submits a claim electronically for payment, a health plan often sends a Remittance Advice separately from the Electronic Funds Transfers payment. The disconnect between the two makes it difficult or sometimes impossible for the provider to match up the bill and the corresponding payment. The rule addresses this by requiring the use of a trace number that automatically matches the two. The new tracking system will allow health care providers to eliminate costly manual reconciliation that must currently be done.

Future administrative simplification rules will address adoption of:
- A standard unique identifier for health plans;
- A standard for claims attachments; and
- Requirements that health plans certify compliance with all HIPAA standards and operating rules.

The regulation is effective January 1, 2012. All health plans covered under HIPAA must comply by January 1, 2014.

To view the Interim Final Regulation with comment period, go to: http://www.regulations.gov

For more information on the June 2011 HIPAA Administrative regulation: Adoption of Operating Rules for Eligibility for a Health Plan and Health Care Claim Status, visit: http://www.hhs.gov/news/press/2011pres/06/20110630a.html

Source: HHS News Release

Final Health IT Innovators Win Funding for Cancer Treatment Apps

2012-01-05T10:23:00.003-05:00

Innovative winners of a U.S. Department of Health and Human Services (HHS) public data and cancer challenge have created health IT applications that use public data and existing technology to help patients and health care professionals prevent, detect, diagnose and treat cancer. The two winners presented their submissions during a special symposium at the Hawaii International Conference on Systems Sciences and were each awarded $20,000 by the Office for the National Coordinator for Health Information Technology (ONC).

The two winning applications include:
- Ask Dory! – submitted by Chintan Patel, Ph.D.; Sharib Khan, M.D., M.A., M.P.H.; and Aamir Hussain of Applied Informatics LLC – helps patients find information about clinical trials for cancer and other diseases, integrating data from www.ClinicalTrials.gov and making use of an entropy-based, decision-tree algorithm. A functional demonstration of the application is available at http://Dory.trialx.com .

- My Cancer Genome – submitted by Mia Levy, Ph.D., M.D., of the Vanderbilt University Medical Center – provides therapeutic options based on the individual patient’s tumor gene mutations, making use of the NCI’s physician data query clinical trial registry data set and information on genes being evaluated in therapeutic clinical trials. The app is in operation at www.MyCancerGenome.org .

Information on the four semifinalist teams can be found at http://go.USA.gov/5DA.

With the support of the National Cancer Institute, part of the National Institutes of Health, ONC launched the “Using Public Data for Cancer Prevention and Control: From Innovation to Impact” challenge during the summer of 2011 in support of ONC’s Investing in Innovation (i2) program. The i2 program utilizes prizes and challenges to facilitate innovation and obtain solutions to intractable health IT problems. Aligned with the Obama administration’s innovation agenda, i2 is the first federal program to operate under the authority of the America COMPETES Reauthorization Act.

“What makes these health IT challenges so powerful is their ability to catalyze the expertise and creativity of innovators both in and out of health care,” said Wil Yu, ONC’s special assistant for innovations. “We seek breakthrough solutions to nuanced issues; some are ready for the marketplace and some are prototypes, but all will have a great potential to benefit Americans. Ask Dory and My Cancer Genome are examples of results that innovation challenges can incentivize and deliver – we’re really excited to see their impact.”

For additional details on the “Using Public Data for Cancer Prevention and Control” challenge, visit www.Health2Challenge.org/using-public-data-for-cancer-prevention-and-control-from-innovation-to-impact-2.

For additional information about ONC or on the Investing in Innovation (i2) program, visit http://HealthIT.HHS.gov.

Source: HHS News Release

Choosing Wisely Campaign Launches to Help Physicians Better Manage Health Care

2012-01-04T12:46:00.002-05:00

Recognizing that patients often ask for tests and treatments that are not necessarily in their best
interest, and physicians often struggle with decisions about prescribing tests and procedures as a way of covering all possible bases, the ABIM Foundation has joined with nine leading medical specialty societies to develop evidence-based lists of tests and procedures for patients and physicians to question as part of Choosing Wisely TM.

The goal of the campaign is to help physicians, patients and other health care stakeholders think and talk about overuse or misuse of health care resources in the United States.

Consumer Reports, the nation’s leading expert, independent, nonprofit consumer organization, has also joined the campaign to provide resources for consumers and physicians to engage in these important conversations. The campaign is part of the ABIM Foundation’s goal of promoting wise choices by clinicians in order to improve health care outcomes, provide patient-centered care that avoids unnecessary and even harmful interventions and reduce the rapidly-expanding costs of the health care system. The lists of Five Things Physicians and Patients
Should Question is modeled after the successful National Physicians Alliance (NPA) project titled “Five Things You Can Do in Your Practice,” which was funded by the ABIM Foundation in 2009.
As part of Choosing Wisely, each participating specialty society will identify its own list of five common tests or procedures whose use in their profession should be discussed or questioned. The lists will be unveiled in April 2012. The societies were given the following parameters to develop the lists:
- Each item should be within the specialty’s purview and control;
- Procedures should be used frequently and/or carry a significant cost; and
- There needs to be evidence to support each recommendation.

“Physicians play a leading role in addressing problems with our nation’s health care system. That is why the ABIM Foundation is proud to be working with specialty societies that have proactively decided to address some of the most important issues in health care head on,” said Christine K. Cassel, MD, president and CEO of the ABIM Foundation. “By identifying specific procedures or tests that may commonly be ordered, but not always necessary to improving patient care, we’re kicking off an important and overdue conversation about making wise choices in health care. Everyone – providers, patients and others – plays a part in being better stewards of the system’s finite resources.”

The Congressional Budget Office estimates that up to 30 percent of care delivered in America goes toward unnecessary tests, procedures, medical appointments, hospital stays and other services that may not improve people’s health – and in fact may actually cause harm. If current trends remain unchanged, the Centers for Medicare & Medicaid Services project U.S. health care spending will reach $4.3 trillion and account for 19.3 percent of the nation’s gross domestic product by 2019.

First announced in March 2011, Choosing Wisely is part of a multi-year effort led by the ABIM Foundation to support and engage physicians in being better stewards of finite health care resources. It is part of the ABIM Foundation’s long history of advancing medical professionalism and supporting similar initiatives. In 2002 the Foundation, along with the American College of Physicians Foundation and European Federation of Internal Medicine, authored Medical Professionalism in the New Millennium: A Physician Charter. The Physician Charter has as its fundamental principles the primacy of patient welfare, patient autonomy and social justice and articulates professional responsibilities of physicians, including a commitment to improving quality and access to care, advocating for a just and cost-effective distribution of finite resources and maintaining trust by managing conflicts of interest.

To learn more about Choosing Wisely visit www.ChoosingWisely.org.

Source: Choosing Wisely News Release

TJC Seeks Organizations for New Intracycle Monitoring Pilot

2012-01-04T12:39:00.002-05:00

The Joint Commission (TJC) is seeking accredited organizations to begin pilot testing
a new Intracycle Monitoring process from February through May of 2012.

The Intracycle Monitoring process is planned for implementation in January 2013. For more information about the process, send an e-mail to intracycle@jointcommission.org.

For more information, please click here.

Source: TJC News Release

TJC Releases 2012 Survey Activity Guide

2012-01-04T10:46:00.002-05:00

The Joint Commission (TJC) recently released its 2012 Survey Activity Guide for use in preparing for an accreditation on-site survey.

For more information, please click here.

Source: TJC News Release

HHS Announces New National Health Promotion & Disease Prevention Agenda

2012-01-03T16:19:00.002-05:00

The U.S. Department of Health and Human Services unveiled Healthy People 2020, the nation‟s new 10-year goals and objectives for health promotion and disease prevention, and "myHealthyPeople," a new challenge for technology application developers.

For the past 30 years, Healthy People has been committed to improving the quality of our Nation‟s health by producing a framework for public health prevention priorities and actions.

"The launch of Healthy People 2020 comes at a critical time," said HHS Secretary Kathleen Sebelius. "Our challenge and opportunity is to avoid preventable diseases from occurring in the first place."

Chronic diseases, such as heart disease, cancer and diabetes, are responsible for seven out of every 10 deaths among Americans each year and account for 75 percent of the nation‟s health spending. Many of the risk factors that contribute to the development of these diseases are preventable.

"Too many people are not reaching their full potential for health because of preventable conditions," said Assistant Secretary for Health Howard K. Koh, M.D., M.P.H. "Healthy People is the nation‟s roadmap and compass for better health, providing our society a vision for improving both the quantity and quality of life for all Americans."

The Healthy People initiative is grounded in the principle that setting national objectives and monitoring progress can motivate action, and indeed, in just the last decade, preliminary analyses indicate that the country has either progressed toward or met 71 percent of its Healthy People targets. Healthy People 2020 is the product of an extensive stakeholder feedback process that is unparalleled in government and health. It integrates input from public health and prevention experts, a wide range of federal, state and local government officials, a consortium of more than 2,000 organizations, and perhaps most importantly, the public. More than 8,000 comments were considered in drafting a comprehensive set of Healthy People 2020 objectives.

Healthy People is also issuing a special challenge to encourage developers to create easy-to-use applications for professionals who are working with the new national health objectives and state- and community-level health data.

"This milestone in disease prevention and health promotion creates an opportunity to leverage information technology to make Healthy People come alive for all Americans in their communities and workplaces," said Chief Technology Officer Todd Park. "The 'myHealthyPeople' apps challenge will help spur innovative approaches to helping communities track their progress using Healthy People objectives and targets as well as develop an agenda for health improvement."

HHS is also launching a newly redesigned Healthy People Web site that allows users to tailor information to their needs and explore evidence-based resources for implementation.
The Web site is located at: www.healthypeople.gov.

For more information about myHealthyPeople, go to www.challenge.gov/.

Source: HHS News Release

Affordable Care Act “Sunshine” Rule Released

2012-01-03T16:02:00.002-05:00

The Centers for Medicare & Medicaid Services (CMS) announced a proposed rule that will increase public awareness of financial relationships between drug and device manufacturers and certain health care providers. This is one of many steps under the Affordable Care Act designed to increase transparency in the health care system, which can lead to better care at lower costs.

“When people are faced with the difficult task of choosing the right doctor, they need all the information they can gather. If your doctor is taking money from manufacturers of prescription drugs, suppliers of wheelchairs or other devices, you deserve to know about it,” said Peter Budetti, M.D. CMS deputy administrator for Program Integrity. “Disclosure of these relationships will discourage the inappropriate influence on clinical decision-making that sometimes occurs while still allowing legitimate partnerships.”

The proposed rule would require manufacturers of drugs, devices, biologicals, and medical supplies covered by Medicare, Medicaid, or the Children’s Health Insurance Program to report to CMS payments or other transfers of value they make to physicians and teaching hospitals. The proposed rule would also require manufacturers and group purchasing organizations (GPOs) to disclose to CMS physician ownership or investment interests.

This increased transparency is intended to help reduce the potential for conflicts of interest that physicians or teaching hospitals might face as a result of their relationships with manufacturers.

Drug and biologic manufacturers, medical device or supply manufacturers, and GPOs would be affected by the new reporting requirements. These organizations, as well as the physicians and teaching hospitals, would be allowed an opportunity to review and correct information prior to its publication.

The Affordable Care Act provides that violators of the reporting requirements will be subject to civil monetary penalties (CMPs), capped at $150,000 annually for failing to report, and $1,000,000 for knowingly failing to report.

CMS is proposing that data collection will not begin on Jan. 1, 2012 and that manufacturers and GPOs do not need to begin data collection until final regulations are issued. Depending on the timing of the final rule, CMS is proposing that manufacturers and GPOs will be required to submit a partial year on Mar. 31, 2013. Once the data has been submitted, CMS will aggregate manufacturer submissions at the individual physician and teaching hospital level, provide them with a 45-day period to confidentially review and, if necessary, correct the data, and make the data publicly available by Sep. 30, 2013.

CMS will accept comments on the proposed rule until Feb. 17, 2012, and will respond to them in a final rule to be published in 2012.

The proposed rule can be downloaded at:
https://s3.amazonaws.com/public-inspection.federalregister.gov/2011-32244.pdf

Source: CMS News Release

TJC Issues Call to Action to Prevent Healthcare Worker Fatigue

2011-12-15T13:53:00.002-05:00

The link between health care worker fatigue and adverse events is well documented, prompting The Joint Commission (TJC) to issue a new Sentinel Event Alert: Health care worker fatigue and patient safety.

The Alert urges greater attention to preventing fatigue among health care workers and suggests specific actions for health care organizations to mitigate the risks. An article in the November 2007 issue of The Joint Commission Journal on Quality and Patient Safety reported that nurses who work more than 12-hour shifts and residents working recurrent 24-hour shifts were involved in three times more fatigue-related preventable adverse events. In addition, health care professionals who work long hours are at greater risk of injuring themselves on the job.

“Health care is a round-the-clock job, and safety has to be the priority,” says Mark R. Chassin, M.D., FACP, M.P.P., M.P.H., president, The Joint Commission. “The recommendations in this Alert give health care organizations the strategies to help mitigate the risks of fatigue that result from extended work hours – and, thereby, reduce the likelihood that fatigue will contribute to preventable patient harm."

The Alert addresses the effects and risks of an extended work day and of cumulative days of extended work hours. The Joint Commission Alert recommends that health care organizations:
- Assess fatigue-related risks such as off-shift hours, consecutive shift work and staffing levels.
- Examine processes when patients are handed off or transitioned from one caregiver to another, a time of risk that is compounded by fatigue.
- Seek staff input on how to design work schedules that minimize the potential for fatigue and provide opportunities for staff to express concerns about fatigue.
- Create and implement a fatigue management plan that includes scientific strategies for fighting fatigue such as engaging in conversation, physical activity, strategic caffeine consumption and short naps.
- Educate staff about good sleep habits and the effects of fatigue on patient safety.

The Joint Commission also suggests that health care organizations encourage teamwork as a strategy to support staff who work extended work shifts or hours. For example, use a system of independent second checks for critical tasks or complex patients. Also, organizations should consider fatigue as a potentially contributing factor when reviewing all adverse events, and educate employees on the importance of good sleep habits, including ensuring their rest environment is conducive to sleeping.

The warning about health care worker fatigue is part of a series of Alerts issued by the Joint Commission. Previous Alerts have addressed diagnostic imaging risks, violence in health care facilities, maternal deaths, health care technology, anticoagulants, wrong-site surgery, medication mix-ups, health care-associated infections, and patient suicides, among others.

Source: TJC News Release

Partnership for Patients Initiative to Improve Hospital Care

2011-12-15T13:50:00.003-05:00

Hospitals across the country will have new resources and support to make health care safer and less costly by targeting and reducing the millions of preventable injuries and complications from healthcare acquired conditions, the U.S. Department of Health and Human Services (HHS) announced. As a part of the Partnership for Patients initiative, a nationwide public-private collaboration to improve the quality, safety, and affordability of health care for all Americans, $218 million will go to 26 state, regional, national, or hospital system organizations.

Source: HHS News Release

New Data Indicates Affordable Care Act Provision Has Given 2.5m Young Adults Health Insurance

2011-12-15T13:43:00.003-05:00

The National Center for Health Statistics at the Centers for Disease Control and Prevention (CDC) released data illustrating that the Affordable Care Act continues to significantly increase the number of young adults who have health insurance.

Because of the health care law, young adults can stay on their parents' insurance plans through age 26. This policy took effect in September 2010. Data from the National Health Interview Survey (NHIS) shows that since September 2010, the percentage of adults aged 19-25 covered by a private health insurance plan increased significantly, with approximately 2.5 million more young adults with insurance coverage compared to the number of young adults who would have been insured without the law.

“Thanks to the Affordable Care Act, 2.5 million more young adults don’t have to live with the fear and uncertainty of going without health insurance,” said Secretary Kathleen Sebelius. “Moms and dads around the country can breathe a little easier knowing their children are covered.”

The numbers show a continuation of the coverage gains due to the health care law as students graduate from high school and college in May and June and otherwise would have lost coverage.

The data is consistent with estimates from surveys released earlier in the year. Those surveys have shown an increase in the number and percentage of young adults 19 to 25 with health insurance coverage. Specifically, the Census Bureau and the Gallup-Healthways Well-Being Index Survey, as well as the NHIS release of data through March 2011, reported similar trends through early 2011.

The results, highlighted in an HHS issue brief, show that the initial gains from the health care law have continued to grow.

“The data announced today show that, because of the health care law, there is a continued and consistent pattern of improved health coverage among young adults,” said Sherry Glied, Ph.D., HHS assistant secretary for planning and evaluation. “The Affordable Care Act has helped literally millions of young adults get the health insurance they need so they can begin their careers with the peace of mind that they’re covered.”

For more information about this announcement, please see the HHS Issue Brief at http://aspe.hhs.gov/health/reports/2011/YoungAdultsACA/ib.shtml

For more information about the CDC NHIS data released today, please visit http://www.cdc.gov/nchs/data/nhis/earlyrelease/insur201112.pdf

Source: HHS News Release

Health Care Fraud Crackdown Recovers $2.9b

2011-12-13T15:34:00.002-05:00

Vice President Joe Biden, the U.S. Department of Health and Human Services (HHS) and the U.S. Department of Justice (DOJ) are teaming up to crack down on fraud. HHS and DOJ recovered $2.9 billion in health care fraud in 2011. HHS also announced it was taking more steps to prevent Medicare prescription drug fraud.

Source: HHS News Release

AHRQ Releases Medication Reconciliation Toolkit

2011-12-13T15:28:00.002-05:00

The Agency for Healthcare Research and Quality (AHRQ) of the U.S. Department of Health and Human Services (HHS) released a new toolkit to help hospitals improve their medication reconciliation processes to reduce adverse drug events.

The Medications at Transitions and Clinical Handoffs (MATCH) Toolkit provides step-by-step instructions on how to improve a medication reconciliation process, from planning—including how to get leadership support—to pilot testing, implementation, and evaluation. Included is a workbook that helps users implement the Toolkit. The Toolkit is available at: http://www.ahrq.gov/qual/match/.

Source: AHRQ News Release

CMS Issues Rule on Availability of Medicare Data for Performance Measurement

2011-12-13T15:21:00.003-05:00

Consumers and employers will have the health care information they need to make more informed choices about their care, thanks to the Affordable Care Act, the Centers for Medicare & Medicaid Services (CMS) announced in a final rule.

The rule gives qualified organizations, like employers and consumer groups, access to data that can help them identify high quality health care providers or create online tools to help consumers make educated health care choices. Information that could identify specific patients, however, will not be publicly released and strong penalties will be in place for any misuse of data.
“This is a giant step forward in making our health care system more transparent and promoting increased competition, accountability, quality and lower costs,” said Marilyn Tavenner, Acting CMS Administrator. “This provision of the health care law will ensure consumers have the access they deserve to information that will help them receive the highest quality care at the best value for their dollar.”

For years, employers, consumers, and health care quality advocates have expressed frustration about the limited and piecemeal availability of Medicare data that could be used to help evaluate health care provider or supplier performance. Although many health plans have created provider and supplier performance reports, these reports are based solely on the health plans' own claims, and do not reflect information from other health plans, including Medicare.

Providers, too, have expressed frustration at receiving performance reports that are piecemeal and produced without an opportunity for review and correction. This final rule creates a framework for providers to receive a single, actionable performance report covering all or most of their practice.

The final rule makes a number of important changes from the original proposed rule. The final rule makes this data less costly for qualified entities, gives qualified organizations more flexibility in their use of Medicare data to create performance reports for consumers, and extends the time period for health care providers to confidentially review and appeal performance reports before they become public. The rule also includes strict privacy and security requirements to protect patients, health care providers, and suppliers as well as stringent penalties for any misuse of Medicare data.

Click here for more information on the final rule.

The final rule on Availability of Medicare Data for Performance Measurement may be viewed here: http://www.ofr.gov/OFRUpload/OFRData/2011-31232_PI.pdf

Source: CMS News Release

Webcast of ONC Annual Meeting Available

2011-12-08T14:55:00.002-05:00

The Office of the National Coordinator for Health Information Technology (ONC) held its 2011 ONC Grantee and Stakeholder Summit on November 17, 2011.

An archived webcast of this event is now available at: http://www.healthit.gov/oncmeeting2011/.

Key speakers included:
Aneesh Chopra, United States Chief Technology Officer, Office of Science and Technology Policy, Executive Office of the President
Farzad Mostashari, MD, ScM, National Coordinator for Health Information Technology
David Blumenthal, MD, Samuel O. Thier Professor of Medicine and Professor of Health Care Policy at Massachusetts General Hospital/Partners HealthCare System and Harvard Medical School
Leon Rodriguez, Director, HHS Office for Civil Rights
Rick Gilfillan, MD, Acting Director, Center for Medicare & Medicaid Innovation (CMMI), Centers for Medicare and Medicaid Services
Jay Walker, Curator, TEDMED Conference

Source: ONC News Release

Obama Administration Takes New Steps to Encourage Doctors, Hospitals to Adopt HIT

2011-12-07T14:51:00.002-05:00

U.S. Department of Health and Human Services (HHS) Secretary Kathleen Sebelius released a report showing that doctors’ adoption of health information technology (IT) doubled in two years. HHS also announced new actions to speed the use of health IT in doctors’ offices and hospitals nationwide, which will improve health care and create jobs nationwide.

While protecting confidential personal information, health IT can improve access to care, help coordinate treatments, measure outcomes and reduce costs. The new administrative actions announced today, which were made possible by the HITECH Act, will make it easier for doctors and other health care professionals to receive incentive payments for adopting and meaningfully using health IT.

“When doctors and hospitals use health IT, patients get better care and we save money,” said Secretary Sebelius. “We’re making great progress, but we can’t wait to do more. Too many doctors and hospitals are still using the same record-keeping technology as Hippocrates. Today, we are making it easier for health care providers to use new technology to improve the health care system for all of us and create more jobs.”

In addition to improving the health care system, data indicate that the national transition to health IT is creating jobs. Over 50,000 health IT-related jobs have been created since the enactment of the HITECH Ac. According to the Bureau of Labor Statistics, the number of health IT jobs across the country is expected to increase by 20 percent from 2008 to 2018, much faster than the average for all occupations through 2018.

HHS also announced its intent to make it easier to adopt health IT. Under the current requirements, eligible doctors and hospitals that begin participating in the Medicare EHR (electronic health record) Incentive Programs this year would have to meet new standards for the program in 2013. If they did not participate in the program until 2012, they could wait to meet these new standards until 2014 and still be eligible for the same incentive payment. To encourage faster adoption, the Secretary announced that HHS intends to allow doctors and hospitals to adopt health IT this year, without meeting the new standards until 2014. Doctors who act quickly can also qualify for incentive payments in 2011 as well as 2012.

These policy changes are accompanied by greater outreach efforts that will provide more information to doctors and hospitals about best practices and to vendors whose products allow health care providers to meaningfully use EHRs. For example, in communities across the country HHS will target outreach, education and training to Medicare eligible professionals that have registered in the EHR incentive program but have not yet met the requirements for meaningful use. Meaningful use is the necessary foundation for all impending payment changes involving patient-centered medical homes, accountable care organizations, bundled payments, and value-based purchasing.

These efforts will complement existing outreach efforts to doctors and hospitals including the Obama Administration’s work to create a nationwide network of 62 Regional Extension Centers. The extension centers are comprised of local nonprofits that provide guidance and resources to help eligible health care providers participate in the Medicare and Medicaid EHR Incentive Programs and meaningfully use health IT.

Also released, a new Centers for Disease Control and Prevention (CDC) survey found 52 percent of office-based physicians in the U.S. now intend to take advantage of the incentive payments available for doctors and hospitals through the Medicare and Medicaid EHR Incentive Programs. EHR incentive payments for eligible health care professionals can total as much as $44,000 under the Medicare EHR Incentive Program and $63,750 under the Medicaid EHR Incentive Program. The CDC data also show the percentage of physicians who have adopted basic electronic health records in their practice has doubled from 17 to 34 percent between 2008 and 2011 (with the percent of primary care doctors using this technology nearly doubling from 20 to 39 percent).

To meet the demand for workers with health IT experience and training, the Obama Administration has launched four workforce development programs that help train the new health IT workforce. The training is provided through 82 community colleges and nine universities nationwide. As of October 2011, community colleges have had 5,717 professionals successfully complete their training in health information technology. Currently there are 10,065 students enrolled in the training programs across the nation. As of November 2011, universities have graduated over 500 post-graduate and masters-level health IT professionals, with over 1700 expected to graduate by July 2013.

While improving the health care system, health IT can help keep information private and secure. Federal laws require key persons and organizations that handle health information to have policies and security safeguards in place to protect health information—whether it is stored on paper or electronically.

For more information on how health IT can lead to safer, better, and more efficient care, and for a fact sheet about today’s announcement, visit http://www.healthit.gov/

For more information about the Medicare and Medicaid EHR Incentive Programs, see http://www.cms.gov/EHRIncentivePrograms

For more information on the 2011 CDC survey data referenced above, seehttp://www.cdc.gov/nchs/surveys.htm

For more information about the HHS Recovery Act health IT programs, see http://www.hhs.gov/recovery/announcements/by_topic.html#hit

Source: HHS News Release

CMS Issues Final Medical Loss Ratio Rule

2011-12-05T16:22:00.002-05:00

The Centers for Medicare & Medicaid Services (CMS) issued a final regulation that will ensure health insurance companies spend at least 80 percent of consumers’ health insurance premiums on medical care, not income, overhead and marketing. Insurance companies that fail to meet the new standard are required to provide a rebate to consumers.

Known as the Medical Loss Ratio (MLR), this rule provides unprecedented transparency and accountability of health insurance companies for customers. Created by the Affordable Care Act, the MLR requirements provide protection and value to approximately 74.8 million insured Americans. Estimates from last year indicate that, starting in 2012, up to nine million Americans could receive rebates worth from $0.6 to $1.4 billion. However, early reports suggest insurers lowered premium growth rather than face the prospect of providing rebates – a win-win for consumers.

“Under the Affordable Care Act, consumers are already seeing better value from their health insurance companies,” said CMS Acting Administrator Marilyn Tavenner. “If your insurance company doesn’t spend enough of your premium dollars on medical care or quality improvement this year, they’ll have to give you rebates next year. This will bring costs down and give insurance companies the incentive to focus on what matters for patients – high quality health care.”

MLR rules took effect on January 1, 2011 but the final rule makes modifications and provides certainty to how the MLR is calculated. These modifications are based on public comments solicited in an earlier version of the rule published by CMS in the spring.

The modifications made in the new rule:
- Make the MLR rebate tax free: Rather than having insurers send checks that could be taxed, workers in group health plans can receive rebates in a way that is not taxable.
- Increase transparency: Consistent with comments from consumer groups, the new regulation proposes that all consumers receive a notice, showing not just the amount of any rebate, but what the insurer’s MLR means regardless of whether there is a rebate, and how the insurer’s MLR has improved under the new law. In addition, data on the special types of plans, mini-meds and ex-patriate plans, will be publicly posted in the Spring.
- Keep strong policies on how MLR is calculated: The final rule makes only a minor change to a quality improvement definition to promote insurer improvements in defining or coding of medical conditions for a limited window of time.
- Phase down the special circumstances adjustment for mini-med plans: In 2011, so-called mini-med plans received a special circumstances adjustment to their MLR in the form of a multiplier of 2.0 for 2011. The final rule phases it down from 1.75 in 2012 to 1.5 in 2013 to 1.25 in 2014. Mini-med plans will be banned by the prohibition on annual limits in the Affordable Care Act starting in 2014.
- Recognize circumstances of special types of plans: The final rule, after reviewing data, keeps the ex-patriate plan multiplier adjustment at 2.0 due to their unique structure. It also levels the playing field between non-profit and for-profit insurers in states with premium taxes.

For more information on the final rule, visit:
http://cciio.cms.gov/resources/factsheets/mlrfinalrule.html

Source: CMS News Release

Timeline for Health Care Reform

2011-12-05T10:22:00.002-05:00

According to a recently published timeline for the implementation of the Affordable Care Act (health care reform), in 2012, Affordable Care Organizations will be voluntarily formed by health care providers to assume care for groups of 5000 or more Medicare patients.

The goal of the initiative is to lower the cost of health care without sacrificing quality.

Source: Article in Times Free Press

Study: E-prescribing Is Safe, Efficient, but Barriers Remain

2011-12-01T16:30:00.003-05:00

Physician practices and pharmacies generally view electronic prescribing as an important tool to improve patient safety and save time, but both groups face barriers to realizing the technology's full benefit, according to a study funded by the U.S. Department of Health and Human Services' (HHS) Agency for Healthcare Research and Quality (AHRQ). The study is published online in the Journal of the American Medical Informatics Association.

Electronic prescribing, or e-prescribing, has multiple potential benefits, including helping to reduce the risk of medication errors caused by illegible or incomplete handwritten prescriptions. The study focused on a key aspect of e-prescribing: the electronic exchange of prescription data between physician practices and pharmacies, which can save time and money by streamlining the way in which new prescriptions and renewals are processed.

Physician practices and pharmacies generally were positive about the electronic transmission of new prescriptions, the study found. However, prescription renewals, connectivity between physician offices and mail-order pharmacies, and manual entry of certain prescription information by pharmacists—particularly drug name, dosage form, quantity, and patient instructions—continue to pose problems.

"Physicians and pharmacies have come a long way in their use of e-prescribing, and that's a very positive trend for safer patient care and improved efficiency," said AHRQ Director Carolyn M. Clancy, M.D. "This study identifies issues that need attention to improve e-prescribing for physicians, pharmacies, and patients."

Researchers at the Center for Studying Health System Change, Washington, D.C., conducted 114 interviews with representatives of 24 physician practices, 48 community pharmacies and three mail-order pharmacies using e-prescribing. Community pharmacies were divided between local and national companies.

Physician practices and pharmacies used e-prescribing features for electronic renewals much less often than for new prescriptions. More than a quarter of the community pharmacies reported that they did not send electronic renewal requests to physicians. Similarly, one-third of physician practices had e-prescribing systems that were not set up to receive electronic renewals or only received them infrequently.

Physician practices reported that some pharmacies that sent renewal requests electronically also sent requests via fax or phone, even after the physician had responded electronically. At the same time, pharmacies reported that physicians often approved electronic requests by phone or fax or mistakenly denied the request and sent a new prescription.

The study noted that resolving e-prescribing challenges will become more pressing as increasing numbers of physicians adopt the technology in response to federal incentives. Physicians can qualify for Medicare and Medicaid electronic health record incentive payments by generating and transmitting more than 40 percent of all prescriptions to pharmacies electronically, excluding prescriptions for controlled substances, as part of the HITECH Act of 2009.

The study, "Transmitting and processing electronic prescriptions: Experiences of physician practices and pharmacies," concludes that a broad group of public and private stakeholders will need to work together to address these issues. Stakeholders include the federal government, e-prescribing standard-setting organizations, vendors and others. It is available at http://jamia.bmj.com/content/early/2011/11/17/amiajnl-2011-000515.full.

Source: AHRQ News Release

Smart Card Alliance Releases White Paper on Health ID

2011-11-30T12:04:00.002-05:00

The Smart Card Alliance Healthcare Council released a white paper providing smart card guidance for the Workgroup for Electronic Data Interchange (WEDI) Health Identification Card Implementation Guide. The white paper provides WEDI-compliant smart card designs and includes a discussion of the features and benefits of smart ID cards for healthcare providers and payers.

“The Smart Card Alliance supports WEDI’s goal to enable automated and interoperable identification using standardized machine-readable health identification cards,” said Randy Vanderhoof, executive director of the Smart Card Alliance. “This white paper complements the WEDI guide by outlining how smart card technology provides a strong foundation for health ID cards. They enable improvement in healthcare processes and in patient identity verification, while securing patient information and protecting patient privacy.”

“The intent of the WEDI Guide and its underlying ANSI standard is to standardize present practice and bring uniformity of information, appearance, and machine-readable technology. It offers great benefit; yet it is a simple identification card. Smart card technology, with its far greater capacity and ability to be updated, brings opportunity for heightened security and new health applications,” said Peter Barry, co-chair, WEDI Health ID Card workgroup.

The white paper provides a thorough explanation of smart card technology, as well as the benefits of smart cards for healthcare applications for payers, healthcare delivery organizations, patients, healthcare providers, and healthcare employers. Some of these benefits include:
- Accurate identification of the patient
- Accurate information on patient health plan
- Reduction in medical fraud
- Reduction of duplicate tests and payments
- Streamlined patient registration
- HIPAA compliance
- Improved patient privacy and information security
- Support for meaningful use requirements
- Reduced costs

“The WEDI Health ID Implementation Guide specifically mentions smart cards as an appropriate card type, and this white paper expands on the idea. Smart cards are the only technology that can provide the security and privacy features that are fundamental to any patient identity management system,” said Michael Magrath, chairman of the Smart Card Alliance Healthcare Council and business development director for Gemalto.

Please click here for more information.

Source: Smart Card Alliance News Release

HHS Awards Affordable Insurance Exchange Funds to States

2011-11-30T11:55:00.001-05:00

The Department of Health and Human Services (HHS) awarded nearly $220 million in Affordable Insurance Exchange grants to 13 states to help them create Exchanges, giving these states more flexibility and resources to implement the Affordable Care Act. The health care reform law gives states the freedom to design Affordable Insurance Exchanges – one-stop marketplaces where consumers can choose a private health insurance plan that fits their health needs and have the same kinds of insurance choices as members of Congress.

The Department also released several Frequently Asked Questions providing answers to key questions states need to know as they work to set up these new marketplaces. Critical among these are that states that run Exchanges have more options than originally proposed when it comes to determining eligibility for tax credits and Medicaid. And states have more time to apply for “Level One” Exchange grants.

The awards bring to 29 the number of states that are making significant progress in creating Affordable Insurance Exchanges. States receiving funding today include: Alabama, Arizona, Delaware, Hawaii, Idaho, Iowa, Maine, Michigan, Nebraska, New Mexico, Rhode Island, Tennessee, and Vermont.

“We are committed to giving states the flexibility to implement the Affordable Care Act in the way that works for them,” HHS Secretary Kathleen Sebelius said. “Exchanges will give consumers more choices and make it easy to compare and shop for insurance plans.”
In the new Exchanges, insurers will provide new information such as an easy-to-understand summary of benefits and costs to consumers. The level of detail will sharpen competition between carriers which will drive costs down.

HHS also released a set of Frequently Asked Questions (FAQs) in anticipation of state legislative sessions beginning in January. Answers will help advance state policy development for Exchanges. For example, they clarify that Exchange grants can be used to build a state Exchange that is operational after 2014; that state-based Exchanges will not be charged for accessing Federal data needed to run Exchanges in 2014; and that state insurance rules and operations will continue even if the Federal government is facilitating an Exchange in the state. HHS will also allow greater flexibility in eligibility determinations, allowing, for example, a state-based Exchange to permit the Federal government to determine eligibility for premium tax credits.

Of the 13 states awarded grants today, 12 are receiving Level One grants, which provide one year of funding to states that have already made progress using their Exchange planning grant. The 13th state, Rhode Island, is receiving the first Level Two grant, which provides multi-year funding to states further along in the planning process.

Forty-nine states and the District of Columbia have already received planning grants, and 45 states have consulted with consumer advocates and insurance companies. Thirteen states have passed legislation to create an Exchange.

States have many opportunities to apply for funding. To accommodate state legislative sessions and to give states more time to apply, HHS also announced a six-month extension for Level One establishment grant applications. Applications now will be accepted until June 29, 2012 (the original deadline was December 30, 2011).

For the FAQs, visit http://cciio.cms.gov/resources/regulations/index.html#hie.

For more information on Affordable Insurance Exchanges, visit http://www.HealthCare.gov/law/features/choices/exchanges/index.html

For more information on the states receiving grants, visit http://www.healthcare.gov/news/factsheets/2011/05/exchanges05232011a.html

Source: HHS News Release

HHS Releases Tool to Help Small Businesses Compare Insurance Plans

2011-11-30T11:43:00.001-05:00

A greatly expanded website to give small business owners an unprecedented detailed review of their health insurance plan choices was announced by the U.S. Department of Health and Human Services (HHS).

Just in time for 2012, this powerful new tool allows small business owners to compare the benefits and costs of health plans and choose those that are best for their employees. For the first time ever, it will allow small businesses to research locally available products in an unbiased manner and foster a more transparent and competitive marketplace.

“This new information will help business owners navigate what has traditionally been a complicated and confusing decision,” said HHS Secretary Kathleen Sebelius. “Both owners and their employees can feel more confident that the plans offered will be the best to suit everyone’s needs.”

In addition to the market being difficult to analyze, small businesses do not fare as well large employers when negotiating health care prices, on average small businesses spend 18 percent more for the same health insurance coverage. This new tool brings needed transparency to the marketplace, which will help ensure insurance companies will compete for business on the basis of price and quality.

The tool is located on www.HealthCare.gov, which was created under requirements contained in the Affordable Care Act, the new health care law of 2010. The website is the first of its kind to bring information and links to health insurance plans to one place, and to make it easy for consumers to learn about and compare their insurance options. The Centers for Medicare & Medicaid Services worked to define and collect detailed benefits and premium rating information from insurers across the country to develop the site.

The new information added gives small business owners access to the following:
Insurance product choices for a given ZIP code, sorted by out-of-pocket limits, average cost per enrollee, or other factors.

A summary of cost and coverage for small group products that shows the available deductibles, range of co-pay options, included and excluded benefits, and benefits available for purchase at additional cost.

The ability to filter product selection based on whether the plans are Health Savings Account eligible, have prescription drug, mental health, or maternity coverage, or allow for domestic partner or same sex coverage.

More than 530 insurers have provided information for more than 2,700 coverage plans across all states and the District of Columbia.

“Tens of thousands of small businesses from across America have already logged-on to www.HealthCare.gov to see what health coverage options are available to them,” said Steve Larsen, director of the Center for Consumer Information and Insurance Oversight. “The new, unprecedented ability to search at this level of detail will bring the marketplace into better balance by giving insurance purchasers the power of information.”

In addition, the website provides extensive information about consumer rights, tips for how to navigate the market’s complexities, and details on how the Affordable Care Act provides new protections for beneficiaries.

To access the small business Insurance Finder, go to the home page of www.HealthCare.gov and click on the blue tab at the top of the page.

For more information, visit www.HealthCare.gov, or access the HHS Facebook page or Twitter account. To download a www.HealthCare.gov Insurance Finder widget visit www.HealthCare.gov/stay_connected.html.

Source: HHS News Release

TJC To Launch Enhanced e-App

2011-11-30T11:38:00.002-05:00

The Joint Commission announced that on December 28, 2011, it will launch an enhanced electronic application for accreditation (E-App) for all accreditation programs, except for the laboratory accreditation program and certification programs.

Source: TJC Release

NIH Undergraduate Design Challenge Focuses on Healthcare Tech Solutions

2011-11-30T11:33:00.002-05:00

A competition for undergraduate students to foster the design and development of innovative diagnostic and therapeutic devices, and technologies to aid underserved populations and the disabled is being sponsored by the National Institute of Biomedical Imaging and Bioengineering (NIBIB), part of the National Institutes of Health. The Design by Biomedical Undergraduate Teams (DEBUT) Challenge is part of NIBIB's efforts to build, strengthen, and prepare the future workforce of biomedical engineers.

One winning student team will be selected for each of three challenge categories: diagnostic devices/methods; therapeutic devices/methods; and technology to aid underserved populations and individuals with disabilities. Eligible team candidates must be full time undergraduate students and U.S. citizens or permanent residents. Each winning team will receive a $10,000 prize, to be distributed among the team members. Winners will be honored at an award ceremony during the 2012 Annual Meeting of the Biomedical Engineering Society (BMES) in Atlanta, Ga. Each winning team will also receive up to $2,000 towards travel and registration costs to attend the awards ceremony.

Dr. Zeynep Erim, the architect of the NIBIB challenge, said "At NIBIB, we aim to prepare the next generation of engineers working at the intersection of the biological and physical sciences to improve human health. This program challenges up-and-coming biomedical engineers to force the boundaries of their design skills and knowledge to develop innovative biomedical technology for health care."

"As a nation, we have reached a crossroads where there is a tremendous opportunity to harness the science, engineering, and mathematics talent within our universities to address challenges in health care," stated Dr. Roderic Pettigrew, NIBIB director. "NIBIB's DEBUT Challenge, authorized under the America Competes Act, seeks to promote competitiveness in these disciplines and to put American ingenuity to work to address some of the unmet medical needs that are most prevalent in our country. I look forward to seeing what technological innovations our best and brightest students can offer to improve health care in our nation."

Details on how to enter, requirements and general information about the challenge can be found at http://debut.challenge.gov/.

For updates and additional information, visit http://www.nibib.nih.gov/Training/UndergradGrad/DEBUT

Source: NIH News Release

CMS Announces New Demonstrations to Help Curb Improper Medicare, Medicaid Payments

2011-11-30T11:21:00.001-05:00

The Office of Management and Budget (OMB) announced that the Administration cut wasteful improper payments by $17.6 billion dollars in 2011 as part of the Obama Administration’s Campaign to Cut Waste, fueled by decreases in payment errors in Medicare, Medicaid, Pell Grants, and Food Stamps. Combined with the avoided improper payments in 2010, agencies have avoided making over $20 billion in improper payments in the two years since President Obama issued an Executive Order initiating an aggressive campaign against the wasteful payment errors.

To help cut improper payments, the Centers for Medicare & Medicaid Services (CMS) has announced it will launch demonstration programs beginning in January 2012 targeting some of the most common factors that lead to improper payments. The demonstration programs will help strengthen Medicare by aiming at eliminating fraud, waste, and abuse.

To see the OMB press release, please visit: http://www.whitehouse.gov/the-press-office/2011/11/15/we-can-t-wait-agencies-cut-nearly-18-billion-improper-payments-announce-

To learn more about CMS efforts to cut improper payments, please visit: https://www.cms.gov/apps/media/press/factsheet.asp?Counter=4176

Source: HHS News Release

Patient Engagement Important to Success of Health Care Reform

2011-11-28T13:26:00.003-05:00

Kenneth Bertka, MD, recently authored an article about the importance of patient engagement in the success of health care reform. In his article Patient Engagement's Critical Role in Post-Reform Success: 6 Steps to Improve Patient Centeredness, Dr. Bertka says that "[p]atient engagement...is more than a nice thing to do. Engaged patients are more likely to comply with their treatment and prevention plans, which results in higher quality care, fewer medical errors and lower cost."

Read Dr. Bertka's article here.

Source: Becker's Hospital Review

OCR Launches Privacy and Security Audits

2011-11-09T09:41:00.001-05:00

The American Recovery and Reinvestment Act of 2009, in Section 13411 of the HITECH Act, requires the U.S. Department of Health and Human Services (HHS) to provide for periodic audits to ensure covered entities and business associates are complying with the HIPAA Privacy and Security Rules and Breach Notification standards. To implement this mandate, the HHS Office for Civil Rights (OCR) is piloting a program to perform up to 150 audits of covered entities to assess privacy and security compliance. Audits conducted during the pilot phase will begin in November 2011 and conclude by December 2012.

More information regarding OCR’s Pilot Audit Program is available on the OCR website at http://www.hhs.gov/ocr/privacy/hipaa/enforcement/audit/index.html

Source: OCR News Release

PCPAN Coalition Urges Opposition to Merger of Two Large Pharmacy Benefit Chains

2011-11-07T15:01:00.002-05:00

More than 50 consumers, small business owners and community pharmacists with Preserve Community Pharmacy Access NOW! (PCPAN) Coalition gathered in Washington, D.C. on November 4 to urge Congress and the Federal Trade Commission (FTC) to support patient care and oppose the planned merger between Express Scripts Inc. and Medco Health Solutions Inc, two of the nation’s largest pharmacy benefit management (PBM) companies.

Several Members of Congress attended the press conference to express their opposition to the merger.

“If allowed to go forward, this merger would have devastating effects on consumers and small businesses, alike,” said Congressman Joe Courtney (D-CT). “In an industry that already offers few choices, further market concentration would squeeze out the community pharmacies many of us have come to trust the most.”

“Right now, there is not a level playing field which is why I feel we need to act now,” said Congressman Thomas Marino (R-PA). “I supported community pharmacies when I sponsored a bill that sets out to level that playing field – and that would not cost the federal government or anyone else a penny. As a matter of fact, it would actually lower the prices for independent pharmacies and they, in turn, would pass it on to the consumer. I continue to support community pharmacies now.”

Pharmacy benefit managers (PBMs) manage prescription drug benefit programs for employers, unions, health plans and others. PBMs control the drug benefits of more than 200 million patients nationwide. This number includes a diverse group of Americans such as Medicare Part D beneficiaries, servicemen and veterans that are TRICARE beneficiaries, and more.

"[Dr]ugstores are lobbying against the merger, arguing that the deal, in which Express Scripts would acquire Medco for $29 billion, would put drugstores out of business and lead to higher consumer prices," reports Cq.com.

The House Judiciary Subcommittee on Intellectual Property, Competition and the Internet held a hearing on the merger on September 20. The Senate Judiciary Subcommittee on Antitrust, Competition Policy and Consumer Rights plans to hold a hearing on the merger in December.

TJC, SGS Form Alliance to Offer Coordinated Accreditation and ISO Certification Option

2011-11-03T09:46:00.002-04:00

The Joint Commission (TJC) and SGS Group are joining forces to offer hospitals and critical access hospitals in the United States the option of pursuing both accreditation and certification to various ISO and industry best practice standards beginning in early 2012.

This program combines The Joint Commission’s modern health care quality and safety standards, survey process, and accountability performance measures with SGS management system audits including certification to the ISO 9001 quality management system standards. The combination of accreditation and ISO offers hospitals the tools to maintain best practices and lower costs across their entire operation while remaining focused on their core service – delivering quality health care to patients.

ISO standards articulate management systems to consistently meet established requirements. Joint Commission standards supply the valuable quality and safety enhancing requirements which can be integrated into an organization’s quality management system. By encouraging leadership commitment to maintaining focused, organized and dynamic processes, the coordinated option has the potential to deliver extra value by improving the operating performance of the organization.

SGS, a public company, is the world’s leading verification, inspection, certification, and testing company focused on providing independent certification and quality assurance services through its worldwide network of subsidiaries, branches and agencies. SGS operates a network of 1,250 offices around the world.

The Joint Commission, and its affiliate Joint Commission International, are the leading health care accrediting bodies, both in the United States and internationally, utilizing up-to-date standards they have developed working with the health care community to help improve the quality and safety of care.

“We are providing this option for hospitals and critical access hospitals in the United States that are interested in exploring the combination of ISO education and certification with Joint Commission accreditation as a mechanism to more precisely identify system vulnerabilities and inefficiencies. Future plans are to expand the option to organizations accredited under other Joint Commission accreditation programs,” says Ann Scott Blouin, RN, Ph.D., FACHE, executive vice president, Accreditation and Certification Operations, The Joint Commission.

“Providing this enhanced service to health care organizations through the alliance of SGS and The Joint Commission is a natural progression for health care performance improvement,” says Tony Perkins, senior vice president, SGS. “We are offering health care organizations an opportunity to take advantage of a number of ISO standards which complement Joint Commission accreditation requirements. This provides a method for hospitals to focus on improvements in quality and customer service in all departments, as well as their facility’s impact on the environment.”

Click here for more information.

Source: TJC News Release

EHNAC Requests Public Review of Program Accreditation Criteria

2011-11-03T09:34:00.005-04:00

The Electronic Healthcare Network Accreditation Commission (EHNAC), a non-profit standards development organization and accrediting body, announced that it has posted new versions of program criteria for general public review. EHNAC seeks interested parties to provide opinions, comments and suggestions for the upgraded criteria versions that have been developed for each of EHNAC’s accreditation programs with regard to the necessity, appropriateness and workability of the criteria versions proposed for adoption.

Comments are due on Nov. 26, 2011.

Below is a listing of the eleven affected programs:
ePAP – e-Prescribing Accreditation Program
FSAP EHN – Financial Services Accreditation Program for Electronic Health Networks
FSAP Lockbox – Financial Services Accreditation Program for Lockbox Services
HIEAP – Health Information Exchange Accreditation Program
HNAP-70 – Healthcare Network Accreditation Plus Select SAS 70©1 Criteria Program
HNAP EHN – Healthcare Network Accreditation Program for Electronic Health Networks [Includes Payer]
HNAP Medical Biller – Healthcare Network Accreditation Program for Medical Billers
HNAP TPA – Healthcare Network Accreditation Program for Third Party Administrators
MSOAP – Management Service Organization Accreditation Program
OSAP – Outsourced Services Accreditation Program
OSAP HIE – Outsourced Services Accreditation Program for Health Information Exchange Services

Please click here for more information and to review the criteria.

Source: EHNAC News Release

ONC Seeks Opinions on Mobile Devices as Health Information Tools

2011-11-02T09:51:00.003-04:00

The Office of the National Coordinator for Health Information Technology’s (ONC) Office of the Chief Privacy Officer plans to perform a project using a qualitative data collection approach to obtain in-depth information from mHealth users regarding privacy and security concerns with this technology and perspectives on potential safeguards.

mHealth refers to the use of mobile devices to communicate health information, and includes text messaging, email accessibility on the device, Skype, or the use of applications downloaded to the device.

ONC is conducting focus group research to identify and explore the attitudes and preferences of a diverse sample of consumers with respect to the communication of health related information on mobile phones and devices, including text messaging. Results from this focus group research are expected to be available in 2012. For more information on this and other mHealth initiatives at HHS, please visit http://www.hhs.gov/open/initiatives/mhealth/projects.html.

Source: ONC News Release

HHS Announces Refined Survey Standards to More Constitently Measure Care Disparities

2011-10-31T15:41:00.005-04:00

The U.S. Department of Health and Human Services (HHS) released final standards to more consistently measure race, ethnicity, sex, primary language, and disability status, thereby improving the ability to highlight disparities in health status and target interventions to reduce these disparities.

“It is our job to get a better understanding of why disparities occur and how to eliminate them. Improving the breadth and quality of our data collection and analysis on key areas, like race, ethnicity, sex, primary language and disability status, is critical to better understanding who we are serving,” said HHS Secretary Sebelius. "Today, through these new standards, we are providing a new set of powerful tools to help us achieve our vision of a nation free of disparities in health and health care.”

The Affordable Care Act requires new standards for the collection and reporting of health care information based on race, ethnicity, sex, and primary language. Making data standards consistent will help identify the significant health differences that often exist between and within ethnic groups, particularly among Asian, Hispanic/Latino and Pacific Islander populations.

For example, a study showed that the diabetes-related mortality rate for Mexican Americans (251 per 100, 000) and Puerto Ricans (204 deaths per 100, 000) was twice as high as the diabetes-related mortality rate for Cuban Americans (101 deaths per 100, 000). However, this information would have remained unknown if only the umbrella terms of “Hispanic” or “Latino” had been used.

By adding Mexican American and Chicano/a, Puerto Rican, Cuban, and other Hispanic Latino/a or Spanish origin as explicit categories required on all HHS-sponsored health surveys, we can better capture the individual ethnic group challenges that are often found within minority populations. This specificity allows for better measurement and tracking of health differences in these populations and target interventions appropriately.

The new data collection requirements also will improve researchers' ability to consistently monitor more dimensions of health disparities among people with disabilities. Collection of all data will take place under HHS’ longstanding, strict commitment to protecting privacy.

“Many racial and ethnic minorities, people with limited English proficiency, people with disabilities, and other populations face unique health challenges, often have reduced access to health care and often pay the price with poorer health,” said Garth Graham, M.D., MPH, HHS deputy assistant secretary for minority health. “Today we are implementing an important provision of the Affordable Care Act that reinforces our commitment to reducing these health disparities. These new standards will help us carry forward the HHS Action Plan to Reduce Racial and Ethnic Health Disparities and our work to address disparities in people with disabilities as well.”

The standards, effective upon publication today, apply to health surveys sponsored by HHS where respondents either self-report information or a knowledgeable person responds for all members of a household. The standards will be used in all new surveys and at the time of revision to current surveys.

For more information on the final data standards, visit www.minorityhealth.hhs.gov/section4302.

Source: HHS News Release

NLM Honors Winners of Software Development Challenge

2011-10-31T15:26:00.004-04:00

Five innovative software applications that help researchers, health professionals, and the general public in their quest for medical and scientific information are the winners of the National Library of Medicine's first software development challenge.

The winning applications can help people learn about anatomy, help researchers find gene information in research literature, and help people sift through large amounts of scientific and medical information.

The library's software development challenge, Show off Your Apps: Innovative Uses of NLM Information, solicited applications that used the library’s data to develop innovative ways for people to obtain and share scientific and medical information. Entrants could create a new app, or submit an existing one. An independent panel of judges chose five winners and five honorable mentions.

The National Library of Medicine (NLM), part of the National Institutes of Health, is the world’s largest medical library and itself a pioneer and innovator in the use of technology to improve access to biomedical and health information. NLM provides a wide variety of information online by developing groundbreaking databases and software tools that enable people to explore medical literature, clinical trials, historical images, DNA sequences and much more.

"NLM was a leader in open data long before that term was coined," says U.S. Department of Health and Human Services (HHS) Chief Technology Officer Todd Park. "Challenges like this one bring the library’s rich data sources to the attention of new groups of innovators."
"By making our data available for others to use, we spark more innovation and give taxpayers a bigger dividend on their investment," says Donald A.B. Lindberg, M.D., director of the NLM, which is celebrating its 175th anniversary this year.

Click here to view the winners of the Challenge.

Click here for more information about the Software Development Challenge.

Source: NIH News Release

CMS Proposes Regulatory Reduction Rules

2011-10-24T13:34:00.001-04:00

On October 18, the Centers for Medicare & Medicaid Services (CMS) took steps to reduce unnecessary, obsolete, or burdensome regulations on American hospitals and healthcare providers. These steps would help achieve the key goal of President Obama’s regulatory reform initiative to reduce unnecessary burdens on business and would save nearly $1.1 billion across the health care system in the first year for a total of over $5 billion over 5 years.

CMS proposed two sets of regulatory reforms and finalized a third. All are designed to improve transparency and help providers operate more efficiently by reducing their regulatory burden. One set proposes updates to the Medicare Conditions of Participation (CoPs) for hospitals and critical access hospitals (CAHs). The second set addresses regulatory requirements for a broader range of health care providers and suppliers who are regulated under Medicare and Medicaid. CMS also finalized a third rule reducing regulatory burden for ambulatory surgical centers (ASCs).

CMS estimates that annual savings to hospitals from the proposed revisions to the Conditions of Participation could exceed $900 million in its first year as hospitals increasingly use this new flexibility. The Medicare Regulatory Reform rule could save up to $200 million in the first year. The final rule for ASCs could generate an extra $50 million in savings per year.

Taken together, these three rules would reduce hospital and other healthcare provider costs by nearly $1.1 billion the first year. These cost savings would come directly from reduced regulatory burdens, and are not accompanied by reimbursement reductions. As such, all of these savings would be available to help providers improve the quality of care they provide to Medicare beneficiaries and all Americans.

Click here to view the news release.

Source: CMS News Release

CMS Launches Innovation Advisors Program

2011-10-24T13:31:00.002-04:00

The Centers for Medicare & Medicaid Services (CMS) announced that it was accepting applications for a new Innovation Advisors program to help health professionals deepen skills that will drive improvements to patient care and reduce costs. These health care improvements will benefit people enrolled in Medicare, Medicaid, and the Children’s Health Insurance Program (CHIP). Made possible by the Affordable Care Act, this initiative will be managed by the Center for Medicare and Medicaid Innovation (Innovation Center).

“We seek to support and expand the number of health care leaders with the knowledge and the vision to find innovative ways to improve care for patients and use our healthcare dollars more wisely,” said CMS Administrator Don Berwick, M.D. “The CMS Innovation Center is an ideal host for this network of experts. It will support their work on efforts that can strengthen public-private partnerships and ensure patients can spend more time with their doctor and get higher-quality care and lower costs.”

Under the new program, there will be up to 200 Innovation Advisors, including clinicians, allied health professionals, health administrators and others. They will attend in-person meetings as well as remote sessions to expand their skills and knowledge, and apply what they learn in their organizations and areas.

After an initial, intensive orientation phase, Innovation Advisors will work with the Innovation Center to test new models of care delivery in their own organizations and communities. They will also create partnerships to find new ideas that work and share them regionally and across the United States.

Innovation Advisors will be expected to commit up to 10 hours per week to the Innovation Advisor Program during the initial six months of the program, with part of that time devoted to seminars and instruction. The rest of that time will be devoted to implementing the improvement project they propose in their initial application. The Innovation Advisors who are selected will meet regularly to exchange insights, report on successes and discuss common challenges.

This initiative is just one of a number of efforts made possible by the Affordable Care Act to help bring better health and better health care not just to Medicare beneficiaries, but also to all Americans, while helping use healthcare dollars more wisely. Already, more than 5,000 organizations have joined the Partnership for Patients and pledged to reduce hospital-acquired conditions and improve transitions in care. The Bundled Payments for Care Improvement initiative will give providers flexibility to work together to coordinate care for patients over the course of a single episode of an illness. The Comprehensive Primary Care Initiative will allow CMS and other payers, such as employer-based health plans, to align strategies designed to strengthen primary care services delivered to Medicare beneficiaries.

Applications for the Innovation Advisors program are due on November 15, 2011. Applications will be reviewed and Innovation Advisors will be notified of their selection by mid-December 2011.

More information, including a fact sheet, frequently asked questions, application and terms and conditions can be found at: http://innovations.cms.gov/innovation-advisors-program.

Source: CMS News Release

HHS Releases New Program to Help Providers Give Better Care to Medicare Patients

2011-10-24T13:24:00.004-04:00

People with Medicare will be able to benefit from a new program designed to encourage primary care doctors, specialists, hospitals, and other health care providers to coordinate their care under a final regulation issued today by the Department of Health and Human Services (HHS).

Created by the Affordable Care Act, these final rules on Accountable Care Organizations add to the menu of options for providers looking to better coordinate care for patients and will make it easier for providers to deliver high quality care and use health care dollars more wisely.
The initiatives announced are just two of several efforts made possible by the Affordable Care Act to help bring better health, better care and lower costs not just to Medicare beneficiaries, but to all Americans. For example, the Bundled Payments for Care Improvement Initiative and Comprehensive Primary Care Initiative offer alternatives to coordinate and improve health care.

“Today we have taken another step to improve health care for people with Medicare,” said HHS Secretary Kathleen Sebelius. “We are excited to give doctors, hospitals and other providers the flexibility and support they need to work together and focus on making sure patients get the care they need.”

“This model of delivering care may not be right for everyone, but it provides new incentives for doctors, hospitals, and other health care providers to work together in new ways,” said Secretary Sebelius.

The two initiatives launched – the Medicare Shared Savings Program and the Advance Payment model – will help providers form Accountable Care Organizations and reflect the significant input provided by stakeholders as well as lessons learned by innovators in care coordination in the private sector.

The Medicare Shared Savings Program will provide incentives for participating health care providers who agree to work together and become accountable for coordinating care for patients. Providers who band together through this model and who meet certain quality standards based upon, among other measures, patient outcomes and care coordination among the provider team, may share in savings they achieve for the Medicare program. The higher the quality of care providers deliver, the more shared savings the providers may keep.

The Advance Payment model will provide additional support to physician-owned and rural providers participating in the Medicare Shared Savings Program who also would benefit from additional start-up resources to build the necessary infrastructure, such as new staff or information technology systems. The advanced payments would be recovered from any future shared savings achieved by the Accountable Care Organization.

“As a physician I understand the complexities of caring for a patient who may have multiple providers,” said Donald M. Berwick, M.D., administrator of the Centers for Medicare & Medicaid Services (CMS). “This opportunity to coordinate care among providers could greatly improve the quality of care Medicare beneficiaries receive.”

Both the Medicare Shared Savings Program and Advance Payment model create incentives for health care providers to work together to treat an individual patient across care settings – including doctors’ offices, hospitals, and long-term care facilities.

Unlike a managed care plan, Medicare beneficiaries will not be locked into a restricted panel of providers. Rather, a determination of whether an Accountable Care Organization was responsible for coordinating care for a beneficiary will be based on whether that person received most of their primary care services from the organization.

“We listened very carefully to the more than 1,300 comments we received on the proposed rule released this spring, and this final rule includes a number of improvements suggested by those comments that will strengthen the program,” Dr. Berwick said. “For example, the final rule will increase the incentives and streamline the Shared Savings Program, extending the benefits of the new program to a broader range of beneficiaries.”

Other changes from the proposed rule include making the one-sided model truly one-sided, expanding participation to Rural Health Clinics and Federally Qualified Health Centers and organizations where specialists provide primary care, and providing a flexible starting date in 2012. Federal savings from this initiative could be up to $940 million over four years.

To aid organizations interested in becoming Accountable Care Organizations, CMS offers a number of learning opportunities for providers, including the third Accelerated Development Learning Session on November 17-18 in Baltimore. This free session will offer providers the opportunity to learn more about this option for providing care. For more information, visit https://acoregister.rti.org/.

People with Medicare have received information about what an Accountable Care Organization could mean for them in the annual issue of “Medicare & You” and if their current health care provider is participating in an Accountable Care Organization, they will receive additional information from their provider.

The Shared Savings Program final rule can be found at: http://www.HealthCare.gov/law/resources/regulations/index.html. (See Final Rule on Shared Savings Program: Accountable Care Organizations)

The Advanced Payment solicitation is posted at: http://innovations.cms.gov/areas-of-focus/seamless-and-coordinated-care-models/advance-payment/.

For more information, fact sheets are posted at: http://www.HealthCare.gov/news/factsheets/2011/10/accountable-care10202011a.html and http://www.cms.gov/ACO/.

The joint CMS and Department of Health and Human Services Office of Inspector General (OIG) Interim Final Rule with Comment Period addressing waivers of certain fraud and abuse laws in connection with the Shared Savings Program can be found at: http://www.HealthCare.gov/law/resources/regulations/index.html. (See Request for Public Comment on Final Waivers in Connection with the Shared Savings Program).

The Antitrust Policy Statement is posted at: www.ftc.gov/opp/aco/ andhttp://www.justice.gov/atr/public/health_care/aco.html.

The Internal Revenue Service (IRS) Fact Sheet, Tax-Exempt Organizations Participating in the Medicare Shared Savings Program through Accountable Care (FS-2001-11), is posted at: http://www.irs.gov/newsroom/article/0,,id=248490,00.html.

Source: HHS News Release

Medical Office Survey on Patient Safety Culture Comparative Database & Toolkit Available

2011-10-24T13:17:00.002-04:00

AHRQ’s Medical Office Survey on Patient Safety Culture is a tool for medical offices to use to assess clinician and staff opinions about the culture of patient safety in their medical offices.
The database is a central repository for survey data from medical offices, health care systems, or survey vendors that have administered the AHRQ medical office survey instrument. It will produce comparative results among users to help medical offices identify strengths and opportunities for improvement in their patient safety culture.

Select for more information.

Source: AHRQ News Release

EHR Decision Support Tool Saved Physicians Time, Errors in Retrieving Clinical Information

2011-10-24T13:16:00.000-04:00

A decision support tool generated by an electronic health record (EHR) that collects clinical information on ambulatory diabetes care saved primary care physicians more than 4 minutes compared to the conventional method of searching on multiple EHR screens, an AHRQ-funded study has found. Writing in the September/October 2011 issue of the Annals of Family Medicine, researchers at the University of Missouri family medicine department created an EHR-generated diabetes “dashboard” with the technology company Cerner. The dashboard collects important diabetes clinical data on one page and mirrors the information sought by national organizations to benchmark high-quality diabetes care. Physicians using the dashboard located the 10 data elements within 1.3 minutes, compared to 5.5 minutes among physicians searching multiple EHR screens. Physicians who used the dashboard correctly identified the data requested 100 percent of the time, compared to 94 percent for physicians using the conventional method.

Select for the article.

Source: AHRQ News Release

EHR Use Results in Higher Quality Care, AHRQ-Funded Study Finds

2011-10-24T13:14:00.001-04:00

Patients who are treated by physicians using electronic health records (EHRs) were significantly more likely to receive care that corresponds to accepted treatment standards and get better care than patients treated by physicians who rely on paper records, a new AHRQ-funded study concludes. The study, published in the September 1 issue of the New England Journal of Medicine, examined physician practices in the Cleveland, OH, area that treated more than 27,000 adults with diabetes. Regardless of insurance mix, practices using EHRs showed higher achievement of care and outcome standards and greater improvement in diabetes care. Nearly half (43.7 percent) of the patients at EHR practice sites had diabetes outcomes that met at least four of the five standards, compared to 15.7 percent of patients at paper-based practice sites. Annual improvements in meeting care standards and quality outcomes were faster in practices with EHRs than paper-based practices. Select to access the article.

Source: AHRQ News Release

AHRQ Launches Initiative to Encourage Better Communication Between Clinicians and Patients

2011-10-24T13:09:00.002-04:00

The U.S. Department of Health and Human Services (HHS) Agency for Healthcare Research and Quality (AHRQ) announced a new initiative with the Ad Council to encourage clinicians and patients to engage in open communication to ensure safer care and better outcomes.

AHRQ has long supported patients getting more involved in their health care, and this effort builds on previous public education campaigns with the Ad Council that encouraged patients to ask questions. In the new campaign, clinicians are reminded that a “simple question can reveal as much medical information as a medical test.”

The campaign also includes a series of videos featuring actual patients and clinicians who discuss why asking questions and sharing information is so important. Other elements of the campaign include an interactive tool that lets patients create a personalized list of questions based on their health condition; a new brochure that helps patients be more prepared before, during and after their appointment; and upcoming ads about the campaign for clinicians that will appear in a variety of print and online journals, including the New England Journal of Medicine, the Journal of the American Medical Association, and others.

Select for more information on the new initiative.

Source: AHRQ News Release

New CMS Proposed Rules Designed to Cut Red Tape

2011-10-18T14:10:00.002-04:00

New proposed rules released by the Centers for Medicare & Medicaid Services (CMS) would reduce unnecessary, obsolete, or burdensome regulations and save hospitals and healthcare providers nearly $1.1 billion each year and over $5 billion over 5 years. The new proposals regarding the rules for hospitals that treat Medicare and Medicaid patients were developed in response to President Obama’s call on all Federal agencies to eliminate burdensome and unnecessary regulations.

“The President and I have challenged agencies to hunt down burdensome regulations,” said Vice President Joe Biden. “Today’s steps will remove outdated, duplicative, unnecessary burdens on hospitals - saving money and improving care.”

“President Obama has been clear: it’s time to cut the red tape,” said HHS Secretary Kathleen Sebelius. “Our new proposals eliminate unnecessary and obsolete standards and free up resources so hospitals and doctors can focus on treating patients.”

CMS proposed two sets of regulatory reforms and finalized a third. All are designed to improve transparency and help providers operate more efficiently by reducing their regulatory burden.

One set proposes to update the rules for hospitals that treat Medicare and Medicaid patients -- the Medicare Conditions of Participation. As an example, the proposed reforms would consolidate patient care plans and eliminate outdated requirements for hospital management. This could save hospitals over $900 million per year and perhaps grow to much more over time as hospitals increasingly use this new flexibility.

The second set of reforms address regulatory requirements for providers other than hospitals and could save up to $200 million in the first year. The rule would identify and begin to eliminate duplicative, overlapping, outdated, and conflicting regulatory requirements for healthcare providers and suppliers such as end-stage renal disease facilities and durable medical equipment suppliers. Examples of these reforms include updating obsolete e-prescribing technical requirements to meet current standards and eliminating other out-of-date and overly prescriptive requirements for healthcare providers.

CMS is also finalizing a third rule that reduces regulatory burden for ambulatory surgical centers (ASCs), which is expected to save ASCs $50 million per year. This rule makes common-sense changes to the requirements ASCs must follow in order to meet Medicare and Medicaid health and safety standards.

These regulatory reforms are just one part of a wide-ranging effort by the Obama Administration to improve the quality of health care and lower costs for all Americans, using important new tools provided by the Affordable Care Act. These efforts include the National Quality Strategy and the Partnership for Patients. These initiatives aim to reform the health care delivery system and bring together both private and public sector partners to keep patients from getting injured or sicker in the health care system and to improve transitions between care settings. CMS intends to invest up to $1 billion to help drive these changes through the Partnership for Patients initiative. And beginning in FY 2013, for the first time, the Hospital Value-Based Purchasing program authorized by the Affordable Care Act will pay hospitals’ inpatient acute care services based partially on care quality, not just the quantity of the services they provide.

To view the proposed and final rules, please visit: www.ofr.gov/inspection.aspx.

Both proposals invite the public, including doctors, hospitals, patient advocates, and other stakeholders, to comment. To submit a comment, visit www.regulations.gov, enter the ID number CMS-9070-P or CMS-3244-P, and click on “Submit a Comment.”

For additional information on these and other Conditions of Participation, visit http://www.cms.gov/CFCsAndCoPs/01_Overview.asp

For additional information on the Department of Health and Human Services overall Plan for Retrospective Review of Existing Rules, visit http://www.hhs.gov/open/execorders/13563/hhs_final_retrospective_review_plan_8-19-11_4.pdf.

Source: HHS News Release

Health Care Reform Presents Opportunities for Performance Improvement

2011-10-17T11:09:00.002-04:00

A recent article Becker's Hospital Review says that providers will need to find ways to reduce costs - particularly in Medicare and Medicaid - while maintaining or improving quality.

William C. Mohlenbrock, MD, FACS, discusses "three specific initiatives to improve quality and control costs [in the healthcare reform law]: the Medicare Shared Savings Program, which establishes Medicare accountable care organizations; the Bundled Payments for Care Initiative, which expands CMS' Acute Care Episodes; and Consumer Operated and Oriented Plans."

Source: Becker's Hospital Review

Journal of Hospital Medicine Shows Link Between Accreditation, Quality

2011-10-14T11:28:00.001-04:00

New research published in the October issue of the “Journal of Hospital Medicine” shows that hospitals accredited by The Joint Commission outperformed non-accredited hospitals on nationally standardized quality measures of acute myocardial infarction (AMI), heart failure, and pneumonia and that the performance gap between Joint Commission accredited and non-accredited hospitals increased over the years of the study.

The study, “Hospital Performance Trends on National Quality Measures" is the first to show the association between Joint Commission accreditation status and performance improvement over a five-year reporting period.

Source: TJC News Release

HHS announces record number of National Health Service Corps members

2011-10-14T11:24:00.001-04:00

U.S. Department of Health and Human Services (HHS) Secretary Kathleen Sebelius announced that the number of participants in the National Health Service Corps (NHSC) has nearly tripled because of investments in the National Health Service Corps through the Affordable Care Act, the American Recovery and Reinvestment Act and annual appropriations. The NHSC has awarded nearly $900 million in scholarships and loan repayment to health care professionals to help expand the country’s primary care workforce and meet the health care needs of communities across the country.

“Thanks to the National Health Service Corps, more Americans can see a doctor and get the health care they need,” said HHS Secretary Sebelius. “The investments we made are improving health and creating access to care, fueling economic activity nationwide.”

Analysts: Debt Reduction Talks Stalling Hospital Expansion

2011-10-14T10:54:00.003-04:00

Wall Street panelists at the Center for Studying Health System Change's (HSC) recent "Wall Street Comes to Washington" Conference say that expansions and construction of new hospitals aren't happening because of investor fears and over potential cuts that may be made by Congress to reduce the national debt.

"I think right now the biggest hurdle is planning," said Fitch Ratings analyst Jeff Schaub. "There are so many things that are unknown. And the planning cycle at acute care providers is five years, 10 years they’re looking out and there’s a big black hole starting 2013, 2014 and extending through 2017. So capital decisions that need to be made now, organizational decisions, affiliation decisions that really need to be made now are being made with a certain amount of contingency. Very often when I meet with hospitals they’re talking about...five, six, maybe even 20 different alternative views of the future and trying to quantify and make decisions among that entire array of possible outcomes."

Citigroup analyst Gary Taylor said that facilities that should be being built right now are probably not because investors do not know if how or if Congress will cost shift Medicare and Medicaid cuts to publicly-traded hospitals. “Since this debt ceiling debate took over and we’ve made commitments to reduce entitlement spending etcetera, publicly traded hospital stocks are down probably 40 percent on average, [and] nursing home stocks are down 70 and 80 percent on average,” Taylor said according to a report in CQHealthbeat (subscription required). “The collective wisdom of the market right now is that investing in . . . certain types of health care providers is extraordinarily risky because of the policy changes, primary reimbursement cuts, that are going to potentially come out of Congress.”

Source: CQ Healthbeat (subscription required); HSC Conference Transcript

ONC/FHA Call For Participants in HIMSS 2012 Interoperability Showcase

2011-10-14T10:45:00.002-04:00

Is your organization successfully using nationally recognized standards to securely share patient data with other organizations? Demonstrate your successes within the Office of the National Coordinator for Health IT (ONC) and Federal Health Architecture (FHA) area in the HIMSS 2012 Interoperability Showcase!

ONC and FHA are looking to highlight cutting-edge interoperable health information exchange at HIMSS 2012, with a focus on ONC-related initiatives, including:

Nationwide Health Information Network
CONNECT
Direct Project
State HIE Programs
S&I Framework
SHARP Program
Regional Extension Centers
Beacon Communities

All nominated demonstrations must include interoperable health information exchange among at least three end user organizations. End users include healthcare organizations (hospitals, clinics, state or federal agencies, etc.) and health information exchanges, not health IT vendors or IT service providers. All demonstrations must be live. No canned demonstrations or static presentations will be considered.

A panel of ONC staff will evaluate all nominations and determine which nominated demonstrations will be included within the ONC/FHA area of the Interoperability Showcase. Only nominations directly related to ONC programs will be considered. Nominations are due October 26th at 5:00 p.m. ET, and the determination of who will be included will be made by November 2nd.

Complete information is here:
http://www.connectopensource.org/forms/himss12-call-for-participants
Source: ONC/FHA News Release

HSPH Study: Lower Quality, High Cost Hospitals Treat More Poor, Minorities

2011-10-07T08:07:00.002-04:00

Hospitals with the lowest scores on certain quality and cost measures treat more than twice as many minority and poor patients as hospitals with the highest scores, according to a Harvard School of Public Health study published in Health Affairs.

The study compared quality and cost measures at roughly 3,200 hospitals with the proportion of minority and Medicaid patients the hospitals served. "As the United States embarks on efforts to improve hospital care using value-based purchasing principles, we will need to help hospitals improve quality and efficiency simultaneously and to monitor the results of their efforts, so that we do not inadvertently worsen disparities in care," the study concludes.

Maulik Joshi, president of the Health Research & Educational Trust and senior vice president of research for the AHA, said the AHA "is committed to sharing with hospitals tools and strategies that can help eliminate disparities in care. As noted by today's study and others in Health Affairs, there are many community-based influences on health and health care. We need to address the many factors that impact community health, such as access to preventive and follow-up care, and work with all stakeholders to ensure improved care for patients and communities."

Source: AHA News Release

Blue Cross Blue Shield Association Unveils Action Plan To Improve Healthcare Quality; Rein In Costs

2011-10-05T10:56:00.003-04:00

The Blue Cross and Blue Shield Association (BCBSA) released a comprehensive, interconnected action plan that fundamentally transforms the healthcare system, moving it away from a fee-for-service model to a patient-centered model. The action plan, Building Tomorrow's Healthcare System: The Pathway to High-Quality, Affordable Care in America, provides specific recommendations to improve healthcare quality and tackle rising costs and is based on the experience of BCBSA's 39 Plans in all 50 states and federal territories, in every market and every zip code. An independent economic analysis of the recommendations shows that, if adopted, this action plan will achieve more than $300 billion in federal savings over the next 10 years.

"We believe that the healthcare system needs to fundamentally change so that people get the best, most affordable care possible. We need to put the patient back in the center of healthcare and this is going to take a significant collaborative effort between both public and private sectors," said Scott P. Serota, president and CEO of BCBSA. "It's time to stop the finger pointing and start working together to make our system the best for patients. In Building Tomorrow's Healthcare System, we make specific recommendations for what the government should do and show how Blue companies nationwide have been working with doctors, hospitals, consumers and policymakers to transform the healthcare system."

The proposal lays out specific, actionable steps the government should take in four key areas:
1.Reward Safety: National and local leadership along with new provider incentives are needed to eliminate preventable medical errors, infections and complications that harm hundreds of thousands of people each year and cost billions of dollars.
2.Do What Works: The incentives in our system must be changed to advance the best possible care and reward quality outcomes, instead of paying for more services that are ineffective or redundant and add unnecessary costs to the system.
3.Reinforce Front-Line Care: A higher value must be placed on primary care and on ensuring there is an adequate workforce of professionals to deliver necessary, timely and coordinated care that results in better outcomes and lower costs.
4.Inspire Healthy Living: With 75 percent of today's healthcare dollar spent on the treatment of chronic illnesses — many of which are preventable — consumers must be empowered and encouraged to make better choices, live healthier lives and better manage their health.

If adopted, the recommendations would save $319 billion over the next decade according to an economic analysis by Ken Thorpe, Ph.D., Robert W. Woodruff Professor and Chair Department of Health Policy & Management Rollins School of Public Health, Emory University.

"The BCBSA proposal reflects a clear understanding of the transformational approach needed to reform our prevention and healthcare delivery system," said Thorpe. "Building evidence-based approaches to coordinate care for Medicare and Medicaid patients that will improve the quality and reduce healthcare spending is a discussion we need to have. Rather than simply shifting federal costs to seniors, the states, or elsewhere, these proposals have the potential to reduce total healthcare spending."

The proposal contains several examples of Blue Cross and Blue Shield initiatives underway across the country that can work as models for improving care and reducing costs. One example is the Michigan Health and Hospital Association's Keystone: ICU Program, which has dramatically reduced central line-associated bloodstream infection rates and ventilator-assisted pneumonia rates in ICU patients. More than 70 Michigan hospitals participate in this program and over a six-year period the initiative has saved 1,830 lives, eliminated an estimated 140,700 avoidable hospital days for patients, and saved more than $300 million.

"This action plan recommends changes that will bring about real improvement for our fragmented healthcare system," said Daniel Loepp, president and CEO, Blue Cross Blue Shield of Michigan. "In Michigan, and in local communities across the country, the Blues are seeing first hand the difference that these types of programs can make for patients. That is why we're encouraging the government to work with the private sector to expand on efforts that improve the quality and affordability of care."

To read Building Tomorrow's Healthcare System: The Pathway to High-Quality, Affordable Care in America, please visit www.bcbs.com/pathway.

Source: BCBSA Press Release

Medicare "Plan Finder" Available

2011-10-03T10:44:00.003-04:00

In advance of the new, earlier annual enrollment period, people with Medicare can begin reviewing plan benefit and cost information on Saturday, October 1st, 2011. The Centers for Medicare & Medicaid Services (CMS) will launch access to its popular web-based Medicare Plan Finder that allows beneficiaries, their families, trusted representatives, and senior program advocates to look at all local drug and health plan options that are available for the 2012 benefit year.

“With Open Enrollment coming early this year, it is important that people with Medicare take advantage of the next couple weeks to review their current coverage and compare it with the options that are available for next year,” said CMS Administrator Donald M. Berwick, M.D. “The information that’s available now on the Plan Finder will also help caregivers, health providers, and partners that support and counsel seniors and people with disabilities in selecting the best plan for their needs.”

The annual enrollment period begins earlier this year, on October 15th, and runs through December 7th. People with Medicare will have seven weeks to review Medicare Advantage and Part D prescription drug coverage benefits and plan options, and choose the option that best meets their unique needs. The earlier open enrollment period also ensures that Medicare has enough time to process plan choices so that coverage begins without interruption on January 1, 2012.

This year, as beneficiaries look over their available plan options, they will see better value in the Medicare Advantage (Part C) and Prescription Drug (Part D) plan benefits. All beneficiaries will have access to Medicare-covered preventive services at zero cost-sharing, including an Annual Wellness Visit. Those in the Part D coverage gap, or donut hole, will continue to receive 50 percent discounts on covered brand name drugs thanks to the Affordable Care Act. On average, Medicare Advantage premiums will be four percent lower in 2012 than in 2011, and plans expect enrollment to increase by 10 percent. Average premiums for Part D prescription drug plans will also decrease to $30 in 2012, about 76 cents less compared to the average 2011 premium. The premium amount is based on bids submitted by Part D plans for the 2012 plan year. Benefits in 2012 remain consistent with those offered in 2011.

People can use the Plan Finder – available at www.Medicare.gov –by inserting their home zip code to find out which Medicare Advantage (Part C) and Prescription Drug (Part D) plans are available in their areas. If the zip code search shows multiple counties it will prompt users to select one county to continue the search. For 2010, the Plan Finder was the most popular tool on www.Medicare.gov, with more than 280 million page views. Also available online is Medicare’s Formulary Finder, which allows beneficiaries to insert their prescribed medications and zip code to see a display of plans offered locally that cover their drugs.

Due to provisions in the Affordable Care Act, Medicare will begin to financially reward Medicare Advantage plans which achieve high quality ratings. Part D plans will also continue to receive quality ratings. Beginning October 12, the Medicare Plan Finder will include each plan’s quality star rating for 2012. For the first time this year, people who use the Plan Finder will also see a gold star icon designating the top rated 5-star plans, and will continue to see warnings for those plans who consistently are poor performers. “We encourage all Medicare beneficiaries enrolled in private plans to know their plan’s overall star rating and to consider enrolling in plans with high ratings,” said Jonathan Blum, CMS Deputy Administrator and Director, Center for Medicare. When comparing plans, beneficiaries should consider the plan’s quality in addition to its costs, coverage, and other conveniences. On October 15, people with Medicare will be able to make informed decisions when they select their plan for the coming year.

More information is available at http://www.healthcare.gov/, a new web-based portal brought to you by the U.S. Department of Health & Human Services.

Source: CMS News Release

Children's Hospitals Growing; Raises Questions About Spending

2011-09-29T11:04:00.002-04:00

A news report by Kaiser Health News says that children's hospitals are growing and this growth spurt has led to questions about spending. The report says that the hospitals have hired lobbyists to obtain ensure special treatment by Congress and ensure that the highest insurance rates are paid to their facilities.

Source: Kaiser Health News Article

Survey: Physicians Say They Over-Treat Patients

2011-09-29T10:51:00.002-04:00

A recent survey of physicians conducted by the VA Outcomes Group and the Dartmouth Institute for Health Policy and Clinical Practice reveals that they feel that they are over-treating their patients. Many physicians indicate that this is caused by pressures caused by the fear of malpractice suits, the realignment of financial incentives towards more aggressive treatment, and shortened time to spend with patients.

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

DOJ Requests Supreme Court Review of Health Care Reform Law

2011-09-29T10:33:00.004-04:00

The U.S. Department of Justice (DOJ) requested that the United States Supreme Court review the constitutionality of President Obama's signature health care reform law after a 3 judge panel of the U.S. Court of Appeals for the 11th Circuit struck it down. The timing of the request virtually assures that a decision on the Affordable Care Act will come in the thick of next year's presidential campaign.

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

HHS launches new Affordable Care Act initiative to strengthen primary care

2011-09-29T10:26:00.000-04:00

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

Study: Health Insurers Pushing Premiums Higher; Outpaces Worker Pay

2011-09-29T10:05:00.003-04:00

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.

A New York Times article on the study may be viewed here.

Source: Kaiser Family Foundation News Release

Report on Health Care Reform 1st Anniversary Issued

2011-09-26T12:53:00.002-04:00

One year after the Affordable Care Act’s Patient’s Bill of Rights took effect, the U.S. Department of Health and Human Services (HHS) released a report summarizing some of the achievements of the health reform law. In the eighteen months since the president signed the Affordable Care Act into law, health reform has had a tangible effect in the lives of millions of Americans. The report discusses how the law is helping to give hardworking families the security they deserve and the reforms in the Affordable Care Act that have helped hold down insurance premiums, hold insurance companies more accountable and strengthen Medicare.

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

Task Force Recommendations on Health Text Messaging, Mobile Health Tech Released

2011-09-21T09:42:00.002-04:00

The U.S. Department of Health and Human Services (HHS) announced new recommendations to support health text messaging and mobile health (mHealth) programs. The department has been actively exploring means to capitalize on the rapid proliferation of mobile phone technology and platforms, such as text messaging, to develop programs and/or partnerships with the overall aim of improving public health outcomes. The potential to provide citizens with an expansive level of access to health resources can help HHS achieve its goal of a healthier nation and help individuals and families get critical information that can improve -- and even save -- their lives.

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

ONC Seeks Public Input on Query Health Initiative

2011-09-19T16:26:00.003-04:00

ONC launched its Query Health initiative officially on September 5, 2011. Query Health is a public-private collaboration chartered to establish standards and services for distributed population queries of electronic health records. ONC is seeking active participation from interested and engaged parties who have an interest in helping create these standards and services.

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

Data Segmentation Initiative Announced

2011-09-19T11:56:00.002-04:00

The ONC Office of the Chief Privacy Officer and Office of Standards and Interoperability are launching an initiative to address standards for the ability to exchange parts of a medical record (often called data segmentation). The initiative is under the auspices of the ONC Standards & Interoperability Framework.

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

Democrats Signal Discomfort with Obama's Openness to Health Care Cuts

2011-09-14T16:12:00.003-04:00

According to a report in the New York Times, Democrats in Washington are concerned about President Obama's willingness to cut up to $300 billion over 10 years from popular programs such as Medicare.

To view the article, please click here.

Source: NYT Article

White House Proclaims National Health Information Technology Week

2011-09-13T11:10:00.002-04:00

President Barack Obama has declared the week of September 11-16, 2011, National Health Information Technology Week.

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

HHS Proposes to Increase Security of Patient Lab Info; Releases Model Privacy Notice

2011-09-12T16:19:00.005-04:00

U.S. Department of Health and Human Services (HHS) Secretary Kathleen Sebelius proposed new rules designed to expand the rights of patients to access their health information through the use of health information technology (IT). Specifically, the new rules would empower patients and allow them to gain access to test results reports directly from labs. They would ensure that labs covered by the Health Insurance Portability and Accountability Act of 1996 (HIPAA) provide such information, upon request, directly to patients or their personal representatives.

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

HHS Awards Affordable Care Act Funds to Improve e-Reporting

2011-09-12T16:15:00.002-04:00

Health Resources and Services Administration (HRSA) Administrator, Dr. Mary Wakefield, and Department of Health and Human Services (HHS) National Coordinator for Health Information Technology, Dr. Farzad Mostashari, announced awards of $8.5 million to 85 community health center programs located in 15 of the 17 Beacon Communities throughout the United States. The funds, made available through HRSA under the Affordable Care Act, help support health centers with the adoption of health information technology (HIT) to support long-term improvements in quality of care, health outcomes and cost efficiencies.

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

ONC Announces Launch of HealthIT.gov

2011-09-09T14:20:00.001-04:00

The Office of the National Coordinator for Health Information Technology (ONC) announced the launch of its new website, HealthIT.gov. This website is designed to become the leading national resource on health information technology (health IT) for both consumers and health care professionals.

Source: ONC Release

CMS Announces 2011 eRx Incentive Program Final Rule

2011-09-09T14:15:00.002-04:00

The Centers for Medicare & Medicaid Services (CMS) announced Changes to the Medicare Electronic Prescribing (eRx) Incentive Program for Calendar Year 2011.

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

HHS Submits Report on HITECH Act to Congress

2011-09-09T13:51:00.002-04:00

The U.S. Department of Health and Human Services (HHS) Office of Civil Rights (OCR) posted reports to Congress on the Health Information Technology for Economic and Clinical Health (HITECH) Act. The HITECH Act requires the Secretary of the Department of Health and Human Services to prepare and submit annual reports on breach notifications and compliance with the Privacy and Security Rules promulgated under the Health Insurance Portability and Accountability Act of 1996 (HIPAA).

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

New AHRQ Report Highlights Impact of Human Resources on Safety and Quality

2011-09-09T12:58:00.002-04:00

A new report funded by the U.S. Department of Health and Human Services (HHS) Agency for Healthcare Research and Quality (AHRQ) examines the growing support for a link between innovative human resources staffing patterns, also known as high-performance work practices, and improvements in safety and quality in health care settings.

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

Study: EHRs Improve Quality of Diabetes Care

2011-09-09T12:55:00.002-04:00

The New England Journal of Medicine (NEJM) published a study examining care delivered to diabetic patients in physician practices that use electronic health records compared to physician practices that do not. The results indicate that practices that use EHRs deliver measurably better care than practices which rely on paper records.

Source: ONCIT Buzz Blog

HHS Announces $11.9 million to Implement HIT in Rural Areas

2011-09-09T12:49:00.002-04:00

Rural health networks across the nation will receive more than $11.9 million to support their adoption of Health Information Technology (HIT) and certified Electronic Health Records (EHR). The funding announced by HHS Secretary Kathleen Sebelius will also help these rural health networks’ participating eligible providers qualify for Medicare and Medicaid EHR incentive payments, administered by the Centers for Medicare &Medicaid Services.

“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

TJC to Launch e-App in October

2011-09-09T12:41:00.002-04:00

The Joint Commission (TJC) announced that it will launch its enhanced electronic application for accreditation (E-App) for all accreditation programs, except for the laboratory and certification programs, in October 2011.

Source: TJC News Release

HHS Awards $40 million to Boost Public Health Infrastructure, Prepare Tomorrow’s Public Health Workforce

2011-09-09T12:35:00.002-04:00

The U.S. Department of Health and Human Services (HHS) Secretary Kathleen Sebelius announced over $40 million in grant funding, partly supported by the Affordable Care Act, to state, tribal, local and territorial health departments and several schools of public health to enhance the nation’s public health infrastructure and strengthen the public health workforce. Awarded in nearly every state, this funding will improve the delivery of necessary public health services in communities, cities and states across the country.

“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

Bundled Payments Initiative Launched

2011-08-29T11:38:00.003-04:00

The U.S. Department of Health and Human Services (HHS) announced a new initiative to help improve care for patients while they are in the hospital and after they are discharged. Doctors, hospitals, and other health care providers can now apply to participate in a new program known as the Bundled Payments for Care Improvement initiative (Bundled Payments initiative). Made possible by the Affordable Care Act, it will align payments for services delivered across an episode of care, such as heart bypass or hip replacement, rather than paying for services separately. Bundled payments will give doctors and hospitals new incentives to coordinate care, improve the quality of care and save money for Medicare.

“Patients don’t get care from just one person – it takes a team, and this initiative will help ensure the team is working together,” said HHS Secretary Kathleen Sebelius. “The Bundled Payments initiative will encourage doctors, nurses and specialists to coordinate care. It is a key part of our efforts to give patients better health, better care, and lower costs.”

In Medicare currently, hospitals, physicians and other clinicians who provide care for beneficiaries bill and are paid separately for their services. This Centers for Medicare & Medicaid Services (CMS) initiative will bundle care for a package of services patients receive to treat a specific medical condition during a single hospital stay and/or recovery from that stay – this is known as an episode of care. By bundling payment across providers for multiple services, providers will have a greater incentive to coordinate and ensure continuity of care across settings, resulting in better care for patients. Better coordinated care can reduce unnecessary duplication of services, reduce preventable medical errors, help patients heal without harm, and lower costs.

The Bundled Payments initiative is being launched by the new Center for Medicare and Medicaid Innovation (Innovation Center), which was created by the Affordable Care Act to carry out the critical task of finding new and better ways to provide and pay for health care to a growing population of Medicare and Medicaid beneficiaries.

The Innovation Center’s Request for Applications (RFA) outlines four broad approaches to bundled payments. Providers will have flexibility to determine which episodes of care and which services will be bundled together. By giving providers the flexibility to determine which model of bundled payments works best for them, it will be easier for providers of different sizes and readiness to participate in this initiative.

“This Bundled Payment initiative responds to the overwhelming calls from the hospital and physician communities for a flexible approach to patient care improvement,” said CMS Administrator Donald Berwick, M.D. “All around the country, many of the leading health care institutions have already implemented these kinds of projects and seen positive results.”

The Bundled Payments initiative is based on research and previous demonstration projects that suggest this approach has tremendous potential. For example, a Medicare heart bypass surgery bundled payment demonstration saved the program $42.3 million, or roughly 10 percent of expected costs, and saved patients $7.9 million in coinsurance while improving care and lowering hospital mortality.

“From a patient perspective, bundled payments make sense. You want your doctors to collaborate more closely with your physical therapist, your pharmacist and your family caregivers. But that sort of common sense practice is hard to achieve without a payment system that supports coordination over fragmentation and fosters the kinds of relationships we expect our health care providers to have,” said Dr. Berwick.

Organizations interested in applying to the Bundled Payments for Care Improvement initiative must submit a Letter of Intent (LOI) no later than September 22, 2011 for Model 1 and November 4, 2011 for Models 2, 3, and 4. For more information about the various models and the initiative itself, please see the Bundled Payments for Care Improvement initiative web site at:
http://www.innovations.cms.gov/areas-of-focus/patient-care-models/bundled-payments-for-care-improvement.html.

To view a factsheet on the Bundled Payments for Care Improvement initiative visit http://www.healthcare.gov/news/factsheets/bundling08232011a.html.

Interested parties may obtain answers to specific questions by e-mailing CMS at: BundledPayments@cms.hhs.gov.

This initiative is part of a broader effort by the Obama Administration to improve health, improve care, and lower costs. A brief summary of other efforts, including those authorized by the Affordable Care Act, can be found at: www.HealthCare.gov/news/factsheets/deliverysystem07272011a.html.

For more information about the CMS Innovation Center, please visit: http://www.innovations.cms.gov.

Source: HHS News Release

HHS Awards $137 million to States to Boost Prevention, Public Health

2011-08-29T11:30:00.003-04:00

U.S. Department of Health and Human Services (HHS) Secretary Kathleen Sebelius awarded up to $137 million, partly supported by the Affordable Care Act, to states to strengthen the public health infrastructure and provide jobs in core areas of public health. Awarded in nearly every state, the grants enhance state, tribal, local and territorial efforts to provide tobacco cessation services, strengthen public health laboratory and immunization services, prevent healthcare-associated infections, and provide comprehensive substance abuse prevention and treatment.

“More than ever, it is important to help states fight disease and protect public health,” said Secretary Sebelius. “These awards are an important investment and will enable states and communities to help Americans quit smoking, get immunized and prevent disease and illness before they start.”

The grants will fund key state and local public health programs supported through the Centers for Disease Control and Prevention (CDC) and the Substance Abuse and Mental Health Services Administration (SAMHSA). Most of these grant dollars come from the Prevention and Public Health Fund created by the Affordable Care Act. Additional SAMHSA dollars supplement this investment.

“CDC supports state and local public health departments which are key to keeping America safe from threats to health, safety, and security from this country or anywhere in the world,” said Centers for Disease Control and Prevention Director Dr. Thomas Frieden. “With these funds, CDC is strengthening our ability to prevent and combat diseases and keep Americans safe against expensive and dangerous health threats.”

“These funds will allow us to bolster public health services to communities and build on successful programs that have helped people lead healthier lives. Today’s investments will help us prevent future health care costs from problems such as tobacco-related illness and substance abuse,” said Pamela Hyde, administrator of SAMHSA.

The awards include:

- $1 million to further enhance the nations’ public health laboratories by hiring and preparing scientists for careers in public health laboratories, providing training for scientists, and supporting public health initiatives related to infectious disease research.

- Nearly $5 million to help states and territories enhance and expand the national network of tobacco cessation quitlines to increase the number of tobacco users who quit. Quitlines are the toll-free numbers people can call to obtain smoking cessation treatments and services.

- More than $42 million to support: improvements to the Immunization Information Systems (registries) and other immunization information technologies; development of systems to improve billing for immunization services; planning and implementation of adult immunization programs; enhancement of vaccination capacity located in schools; and evaluations of the impact on disease of recent vaccine recommendations for children and adolescents.

- $2.6 million to the Emerging Infections Programs around the country to continue improvement in disease monitoring, professional development and training, information technology development, and laboratory capacity.

- $9.2 million to eight national non-profit professional public health organizations to assist state, tribal, local, and territorial health departments in adopting effective practices that strengthen their core public health systems and service delivery. They will also enhance the workforce by providing jobs in critical disciplines of epidemiology and informatics, thus attracting new talent to public health.

- $1.5 million to evaluate and prevent ventilator-associated pneumonia to reduce cases of Methicillin-resistant Staphylococcus aureus (MRSA) infections and protect Americans from healthcare-associated infectious diseases.

- Up to $75 million to fund nine Screening, Brief Intervention, Referral and Treatment programs over the next five years. These programs will allow communities throughout the nation to provide more comprehensive substance abuse screening, secondary prevention, early intervention and referrals to treatment for people at higher risk for substance abuse. The actual award amounts may vary, depending on the availability of funds and the performance of the grantees.

A full list of grantees is available at: http://www.hhs.gov/news/press/2011pres/08/state_prevention_grants.html.

Source: HHS News Release

HHS Sponsors Contest for Facebook Personal Preparedness Applications

2011-08-22T14:49:00.003-04:00

Federal officials are challenging software application developers to design new Facebook applications to help people prepare for emergencies and get support from friends and family after an emergency strikes – from personal medical emergencies to natural or man-made disasters.

The U.S. Department of Health and Human Services’ Office of the Assistant Secretary for Preparedness and Response (ASPR) issued the ASPR Lifeline Facebook Application Developer Challenge in collaboration with the Federal Emergency Management Agency (FEMA), a health-focused online community of developers, designers, patients, providers, health care organizations that promotes health technology innovation.

The online challenge runs throughout National Preparedness Month in September and the remainder of the 2011 hurricane season, closing Nov. 4.

“After disasters, a tremendous number of people use Facebook to post and share information,” said Assistant Secretary Nicole Lurie, M.D., a rear admiral in the U.S. Public Health Service. “We’re challenging our country’s most innovative developers to create apps that help people use Facebook not only to reach out to friends and family for any kind of help they may need after emergency but also to become better prepared in the first place.”

The person or team developing the best application will receive $10,000 from HHS and free admission from Health 2.0 to the 2012 Health 2.0 conference, and will be invited to an HHS event with Dr. Lurie. Second place will be awarded $5,000, and third place will receive $1,000.

While most tools take months or years to roll out, the first place challenge winner will work with the U.S. government and Facebook immediately to get the application into use just weeks after selection.

Submissions will be judged on the application’s ability to enhance community connections and improve individual preparedness. The goal is an app that enables a Facebook user to invite three Facebook friends to become lifelines, points of contact who agree to act as a source of support during disasters such as providing transportation, a place to stay or anything else the Facebook friend may need.

The ideal application includes a way for users to identify lifelines, to create and share a personal preparedness plan including health considerations with these lifelines, and to encourage others to use the application. Additional considerations include being easy to use on basic mobile devices, incorporating Geographic Information System (GIS) locating or tagging, and connecting with other social media and emergency relief technologies.

All submissions will be reviewed by judges from Facebook, ASPR, FEMA, and the New Orleans Health Commissioner.

To register as a participant in the ASPR Lifeline Facebook Application Developer Challenge, visit http://challenge.gov/challenges/220, or http://www.health2challenge.org/2011/07/12/the-aspr-lifeline-facebook-application-challenge/.

Federal employees, federal contractors, and recipients of federal grants may not participate in the challenge using time paid by federal funds. Winners must be U.S. citizens, permanent U.S. residents or businesses incorporated in and maintaining their primary place of business in the United States.

The HHS Office of the Assistant Secretary for Preparedness and Response coordinates the federal public health and medical response to disasters, leading the nation in preventing, preparing for, and responding to the adverse health effects of public health emergencies and disasters. ASPR focuses on preparedness planning as well as response; building federal emergency medical operational capabilities; countermeasures research, advance development, and procurement; and grants to strengthen the capabilities of hospitals and health care systems in public health emergencies and medical disasters.

To learn more about ASPR, visit www.phe.gov.

Source: HHS News Release

NIH Seeks Improvements in Data Gathering for Children's Study

2011-08-15T11:56:00.002-04:00

The National Children’s Study is changing its approach to informatics—the science of classifying, cataloging, storing, analyzing, and retrieving information, study officials recently announced.

The new approach, termed facilitated decentralization, seeks to test a variety of different yet compatible information systems to identify those that will best meet the needs of the study. Study officials invite interested researchers in the federal government and in research institutions to collaborate on new informatics components to be integrated into the study’s main informatics system.

The National Children’s Study is a multi-site research study examining the effects of environment and genetics on the growth, development and health of children across the United States, from pre-conception to age 21. Because of its size, length, and complexity, the study will be conducted as two separate but related studies: a vanguard, or pilot study and a main study. The vanguard study seeks to evaluate the ease, acceptability, and costs involved in the methods needed to conduct the main study.

Results from the vanguard study will be used to inform the design of the main study, which is planned to begin in mid-2012. The new components for the National Children’s Study informatics systems will be tested in the vanguard study.

To learn more about opportunities to collaborate on informatics as well as other aspects of the study, researchers are invited to attend National Children’s Study Research Day on Aug. 24, 2011 on the NIH campus in Bethesda, Md. Additional information is available at http://www.nationalchildrensstudy.gov/newsandevents/events/Pages/ncsresearchday.aspx

The National Children’s Study is led by the Eunice Kennedy Shriver National Institute of Child Health and Human Development of the National Institutes of Health, in collaboration with a consortium that includes the NIH’s National Institute of Environmental Health Sciences, the Centers for Disease Control and Prevention, and the Environmental Protection Agency.

“The idea is to identify and develop systems that not only meet the study’s current needs, but can also be adapted and upgraded easily to meet the changing needs of the study as it proceeds through its 21 year span,” said Capt. Steven Hirschfeld, M.D., United States Public Health Service, the acting director of the National Children’s Study and director of clinical research.

Dr. Hirschfeld explained that the facilitated decentralization approach for the study seeks to move away from proprietary informational systems to publicly available, non-proprietary systems. The National Children’s Study will establish uniform standards for the new informational systems components to be studied. In addition to being non proprietary, prospective components must open architecture based—meaning that it can be easily upgraded by researchers wishing to collaborate to expand the system’s capacity.

Dr. Hirschfeld added that the new approach is the first time that different systems can be evaluated concurrently. In addition, the approach is intended to facilitate efforts to classify the concepts and terminology needed to carry out the study. Many conditions and disorders that National Children’s Study scientists will study are unique to childhood and are not uniformly found in the current classification systems that researchers use for their analysis of adult studies. For example, different terminology systems vary on how they have classified a structural birth defect affecting the roof of the mouth. The condition is generally referred to as cleft palate, but different terminologies in use may or may not include a cleft lip within the term or the concept. The NCS is working to coordinate the various terminology systems that apply to early childhood, relate them to terms and concepts across the life course, and ensure that a robust informatics infrastructure supports a uniform terminology.

Information for researchers interested in collaborating in the study’s new facilitated decentralization approach is available at http://www.nationalchildrensstudy.gov/about/overview/Pages/NCS_concept_of_operations_04_28_11.pdf.

Source: NIH Press Release

ONC Issues Metadata Standards Proposal

2011-08-08T11:31:00.003-04:00

The Office of the National Coordinator for Health Information Technology (ONC) issued an advance notice of proposed rulemaking, which solicits public comments on the metadata standards recommended to it by the HIT Standards Committee.

The metadata standards under consideration relate to:
• Patient Identity Metadata – These metadata relate to patient identity and include: a patient’s name; date of birth; address; zip code; and relevant patient identifier(s).
• Provenance Metadata – These metadata would be used to provide information on the “who, what, where, and when.” Provenance metadata would include: a tagged data element (TDE) identifier; a time stamp; the actor; and the actor’s affiliation.
• Privacy Metadata – Privacy metadata would include a policy pointer and content elements descriptions such as data type (e.g., consultation note) and sensitivity.

ONC will accept public comments up to September 23, 2011.

For more information, please visit ONC's website at http://healthit.hhs.gov/. The proposed rule may be viewed here: http://www.ofr.gov/OFRUpload/OFRData/2011-20219_PI.pdf.

Source: ONC Release

CMS Launches New Consumer Data Tool

2011-08-08T11:18:00.005-04:00

The Centers for Medicare & Medicaid Services (CMS) announced a new tool for patients and caregivers and other enhanced initiatives today to empower consumers to make informed choices about their health care, and to help improve the quality of care in America’s hospitals, nursing homes, physician offices, and other health care settings.

“These tools are new ways CMS is making sure consumers have information about health care quality and important information they need to make the best decisions about where to receive high-quality care,” said Dr. Don Berwick, the CMS Administrator. “These efforts are designed to also encourage providers to deliver safe, patient-centered care that consumers can rely on and will motivate improvement across our health care system.”

The steps include:

• A Quality Care Finder to provide consumers with one online destination to access all of Medicare’s Compare tools -- comparison information on hospitals, nursing homes and plans: www.Medicare.gov/QualityCareFinder.

• An updated Hospital Compare website, which now includes data about how well hospitals protect outpatients from surgical infections and whether hospitals care for outpatients who are treated for suspected heart attacks with proven therapies that reduce death: www.hospitalcompare.hhs.gov

• An enhanced Quality Improvement Organization (QIO) program under which QIOs provide technical assistance and resources to health care providers across the country to assist them in changing how care is delivered in hospitals, nursing homes, physician offices, and across care settings.

CMS has also updated data for outcomes of inpatient hospital care on Hospital Compare. Today’s update includes new 30-day mortality rates and 30-day readmissions rates for inpatients admitted with heart attack, heart failure, and pneumonia. These rates encompass three full years of claims data (from July 1, 2007 to June 30, 2010).

This year, the national 30-day mortality rates for heart attack have continued to decline, falling by 0.3 percent from the 2006 through 2009 rate of 16.2 percent to the more recent 2007 through 2010 rate of 15.9 percent. Mortality rates for heart failure and pneumonia increased slightly over the same period, showing an increase from 11.2 to 11.3 percent for heart failure and 11.6 to 11.9 percent for pneumonia, respectively.

Also this year, national 30-day readmissions rates for heart attack, heart failure, and pneumonia showed small changes in their updated rates. The new 2007 through 2010 rates for these three conditions are 19.8 percent, 24.8 percent, and 18.4 percent, respectively. These rates were slightly higher for heart attack in 2006 through 2009, at 19.9 percent, and slightly lower for pneumonia, at 18.2 percent, and heart failure, at 24.5 percent.

“Both sets of inpatient measures are risk-adjusted, taking health conditions into account to ‘level the playing field’ among hospitals and to help ensure accuracy in performance reporting,” Dr. Berwick said.

Hospital Compare also includes 10 measures that capture patient experience with hospital care. After two years of reporting these patient experience measures, hospitals have shown modest but meaningful improvement on most experience measures. The degree of this improvement has been relatively uniform across most measures and hospitals.

The website also contains 25 process-of-care measures and three children’s asthma care measures. The site also features information about the volume of certain hospital procedures performed and conditions treated for Medicare patients and what Medicare pays for those services.

Consumers have relied on Hospital Compare since 2005 to provide information about the quality of care provided in over 4,700 of America’s acute-care, critical access and children’s hospitals. So far this year, Hospital Compare has received about 1 million page views each month. More information about Hospital Compare is online at www.hospitalcompare.hhs.govse

The QIOs will integrate and coordinate care across settings within communities, improve community health by promoting preventive services, and make health care costs sustainable in the long term by supporting care that keeps patients safe from costly and dangerous complications and harm. The works supports the administration’s National Quality Strategy and its Partnership for Patients, designed to build collaborative models to improve health care quality, reduce hospital-acquired conditions and lower hospital readmissions.

“Patient-centeredness means that every decision that’s made and every program that’s established is focused on patients and their families,” said Patrick Conway, M.D., M.Sc., CMS chief medical officer and director of the agency’s Office of Clinical Standards and Quality. “QIOs will promote this concept by including beneficiaries and front line clinicians in quality improvement initiatives, learning and action networks and communications. Listening to the voices of patients and staying focused on their outcomes and experiences are essential to achieve care centered on the patient.”

More information about the QIO Program is on the CMS website at www.cms.gov/qualityimprovementorgs.

Source: CMS News Release

AHRQ Releases Updated Software for Public Reporting, Research Use

2011-08-08T11:14:00.001-04:00

The Agency for Healthcare Research & Quality (AHRQ) has released Version 2.0 of MONAHRQ, its unique, desktop, Windows®-based software application for developing Web sites for hospital quality public reporting or research use. MONAHRQ 2.0 allows users to report Medicare Hospital Compare results along with, or instead of, their own inpatient discharge data. Web sites created with MONAHRQ 2.0 provide information for: quality of care at the hospital level; utilization at the hospital level; potentially avoidable hospitalizations at the area level; and rates of health conditions and procedures at the area level.

Source: AHRQ Release

AHRQ Releases Tool to Help Consumers Reduce Medication Errors

2011-08-08T11:09:00.002-04:00

To address the high levels of prescription medicine non-compliance, AHRQ and the National Council on Patient Information and Education have released a newly revised guide to help patients learn more about how to take medicines safely. The booklet, Your Medicine: Be Smart. Be Safe., includes a detachable, wallet-sized card that can help patientskeep track of all medicines they are taking, including vitamins and herbal and other dietary supplements.

Available in English and Spanish, the guide includes questions that patients can ask their doctors about their medications.

Source: AHRQ release

AHRQ Focuses on Patient Safety Organizations

2011-08-08T11:04:00.002-04:00

The July issue of the U.S. Department of Health and Human Services (HHS) Agency for Healthcare Research & Quality (AHRQ) Web M&M examines the role of patient safety organizations. The issue on features an interview with William Munier, MD, MBA, who directs AHRQ’s Center for Quality Improvement and Patient Safety and heads the Agency’s oversight of the Patient Safety Organization (PSO) program. The interview describes the support that AHRQ provides to PSOs, the variations in state-level protection, and how the agenda for PSOs has evolved in recent years. The July issue also features a spotlight case on the challenges of managing blood thinner medications. Physicians and nurses can receive free CME, CEU or training certification by taking the Spotlight Quiz.

TJC Posts National Safety Goals Presentation

2011-08-08T10:53:00.002-04:00

The Joint Commission has posted a presentation outlining 2011-2012 National Patient Safety Goals. The goals were established in 2002; development and oversight of the safety goals is done by the Patient Safety Advisory Group.

Source: The Joint Commission

ISMP Medication Safety Self-Assessments Due August 31

2011-08-04T15:58:00.002-04:00

The Institute for Safe Medicine Practices (ISMP) is requesting data submissions until August 31, 2011 for their self-assessment for hospitals to use to evaluate their medication safety practices.

Additional information about the assessments is here.

Source: The Joint Commission

AHRQ Releases Report on Improving Consumer HIT Application Development

2011-08-03T14:54:00.003-04:00

A new report funded by the U.S. Department of Health and Human Services (HHS) Agency for Healthcare Research and Quality (AHRQ) offers a range of design methods that may be applicable for use in developing consumer health information technology (IT) applications. Improving Consumer Health IT Application Development: Lessons from Other Industries: Background Report offers an environmental scan of design practices found in successful consumer products and identifies those that could support improved development of consumer health IT applications. The full report provides recommendations of methods that can be incorporated into consumer health IT application design processes.

Source: AHRQ News Release

CMS Releases IRF Quality Reporting Program Rule

2011-08-01T10:55:00.002-04:00

The Centers for Medicare & Medicaid Services (CMS) issued a final rule that updates Medicare payment policies and rates for more than 1,200 freestanding and hospital-based inpatient rehabilitation facilities (IRFs) in Fiscal Year (FY) 2012. The final rule increases IRF payment rates under the IRF Prospective Payment System (PPS) by 2.2 percent and establishes a new quality reporting system authorized by the Affordable Care Act. CMS projects that total payments under the IRF PPS will increase by $150 million in FY 2012.

“The final rule extends to the Inpatient Rehabilitation Facility payment system a quality reporting program designed to encourage these facilities to adopt practices that will better protect patient safety and prevent hospital-acquired conditions, which is an essential part of providing well-coordinated patient-and-family-centered care,” said CMS Administrator Dr. Donald Berwick.”

Initially, IRFs will submit data on two quality measures, a urinary catheter-associated urinary tract infection measure and a measure for new or worsening pressure ulcers, with a third measure—“30-day Comprehensive All Cause Risk Standardized Readmission”--under development. IRFs that do not submit performance data will see their payments reduced by two percentage points beginning in FY 2014. CMS anticipates adding measures for reporting in the future through rulemaking and establishing a process for making the data available to the public. As with other data on the CMS website, the IRFs would have an opportunity to review the data for accuracy before it becomes public.

The final rule will affect payments to more than 200 freestanding rehabilitation hospitals and more than 1,000 IRF units in acute care hospitals and critical access hospitals, beginning with discharges on or after Oct. 1, 2011. Under the IRF PPS, the Medicare payment to an IRF increases after the IRF’s costs for treating a beneficiary exceed an outlier threshold amount. The threshold is set for FY 2012 at an amount that is projected to maintain outlier payments at three percent of total payments under the IRF PPS.

The final rule also:

• Updates the case-mix group (CMG) relative weights using FY 2010 IRF claims and FY 2009 IRF cost report data;

• Uses the final FY 2011 pre-reclassified and pre-floor hospital wage data to determine the FY 2012 rates;

• Freezes the facility-level adjustment factors for FY 2012 at FY 2011 levels for one additional year while the agency explores ways to improve upon the accuracy and consistency of the current methodology used to calculate the facility-level adjustment factors;

• Allows IRFs to receive temporary adjustments to their FTE intern and resident caps if they take on interns and residents who are unable to complete their training because the IRF that had originally been their assigned training site either closed or ended its resident training program; and

• Allows IRF and inpatient psychiatric facility units to expand in the middle of a cost reporting period, rather than restricting such expansions to the start of a cost reporting period.

“The final rule we are announcing today will help ensure that Medicare beneficiaries who require rehabilitation in an inpatient setting, continue to have access to high quality care that will help them meet their rehabilitation goals during the difficult work of recovery,” said Dr. Berwick.

The final rule went on display on July 29, 2011 at the Office of the Federal Register’s Public Inspection Desk and will be available under “Special Filings” at: http://www.ofr.gov/OFRUpload/OFRData/2011-19516_PI.pdf and http://www.ofr.gov/inspection.aspx?AspxAutoDetectCookieSupport=1

It will appear in the Aug. 5, 2011 Federal Register.

For more information, please see: www.cms.hhs.gov/InpatientRehabFacPPS/.

And the CMS Fact Sheet: https://www.cms.gov/apps/media/press/factsheet.asp?Counter=4033.

Source: CMS News Release

CMS Releases Final Wage Index Changes for Medicare Hospices

2011-08-01T10:44:00.003-04:00

Hospices serving people with Medicare will see a 2.5 percent increase in their Medicare payments for fiscal year (FY) 2012, according to a final regulation released by the Centers for Medicare & Medicaid Services (CMS). Hospices are also called upon to begin reporting on the quality of care received by Medicare patients, as a result of this final regulation.

The estimated hospice payments are the net result of a 3.0 percent increase in the “hospital market basket,” an indicator of industry-related price increases, offset by an estimated 0.5 percent decrease in payments to hospices due to updated wage index data and the third year of CMS’ seven-year phase-out of a wage index budget neutrality adjustment factor (BNAF).

The final rule also implements Affordable Care Act requirements, including a hospice quality reporting program, and clarifies previously adopted policies on hospice face-to-face certifications, said Jonathan Blum, deputy administrator and director of CMS’ Center for Medicare.“These payment and policy changes and additional attention to quality will work to encourage better coordination of hospice benefits and fair payments to Medicare hospice providers.”

The final rule continues the BNAF phase-out, now in its third year. The BNAF was implemented in 1997, when the former Health Care Financing Administration (HCFA), now CMS, moved from an outdated wage index to a more current and accurate method for determining hospice payments. To minimize disruption to services during the transition, a special budget neutrality adjustment was applied. In FY 2010 rulemaking, CMS adopted a schedule to phase out the BNAF over seven years, reducing it by 10 percent in FY 2010, 15 percent in FY 2011, and successive 15 percent reductions from FY 2012 through FY 2016.

The final rule revises how CMS calculates each hospice’s yearly aggregate cap. Federal law requires that CMS impose a limit on the aggregate Medicare payments a hospice provider receives annually. CMS calculates each hospice’s aggregate cap by multiplying the number of patients served by the hospice in a cap year by a cap amount. Medicare payments made to a hospice during the cap year that exceed the hospice’s aggregate cap must be refunded to Medicare.

In this final rule, CMS will:

- Change the way it counts hospice patients for the 2012 cap accounting year and beyond. The final policy for counting the number of Medicare hospice beneficiaries in care for a given cap year calculates the cap based on the number of days of care the patient received in that cap year for each hospice. This rule also finalized that the new counting method be applied to past cap years in certain instances.

- Allow hospice providers who do not want a change in their patient counting method to elect to continue using the current method.

- Allow any hospice physician to perform the face-to-face encounter regardless of whether that same physician recertifies the patient’s terminal illness and composes the recertification narrative.

- Implement a hospice quality reporting program, which includes a timeframe for reporting, as required by section 3004 of the Affordable Care Act. The measures that are being adopted in this final rule for the FY 2014 program are one measure endorsed by the National Quality Forum related to pain management and one structural measure that assesses whether a hospice administers a Quality Assessment and Performance Improvement (QAPI) program that contains at least three indicators related to patient care.

As finalized, hospices will be required to begin collecting quality data in October 2012, and will submit the data in 2013; hospices may also voluntarily begin collecting data on the QAPI measure in October 2011 for submission in 2012. Hospices failing to report quality data in 2013 will have their market basket update reduced by two (2) percentage points in FY 2014.

Information on the final hospice wage index payment and policy changes and other healthcare news can also be found on a new web portal, www.healthcare.gov, made available by the U.S. Department of Health and Human Services. A link to the final rule, which will be published in the Federal Register on August 4, 2011, along with accompanying documents will be available at: http://www.ofr.gov/OFRUpload/OFRData/2011-19488_PI.pdf or http://www.federalregister.gov/inspection.aspx.

Source: CMS News Release