CMS State Innovation Models Grants Awarded

The HHS announced Tuesday that a significant portion of the $665 million in available grants was awarded to health IT programs.The District of Columbia, 28 states, and three territories received grant money to fund local experiments in improving health care. The money is the second round of grants coming from CMS's State Innovation Models initiative. A breakdown of the awarded grants can be found at the initiative website. 

Politico reports that the selected health IT projects largely focus on improving data in electronic health records and systems. Part of the $100 million New York will receive will go toward better health IT, "including greatly enhanced capacities to exchange clinical data and an all-payer database." Overall, the state is looking to create a stronger, more integrated primary care workforce and delivery system. Colorado will receive up to $65 million over four years to integrate physical and behavioral health care in primary care and community mental health center. Part of the money will expand IT efforts including telehealth. The money will also assist in integrating public health, behavioral health and primary care sectors. Data analytics is a factor in the plans for Michigan and Iowa.

CMS Names Niall Brennan First Chief Data Officer

The Centers for Medicare & Medicaid Services (CMS) today announced the formation of the Office of Enterprise Data and Analytics (OEDA) which will be led by Niall Brennan, the agency’s first Chief Data Officer (CDO), and tasked with overseeing improvements in data collection and dissemination as the agency strives to be more transparent. OEDA will help CMS better harness its vast data resources to guide decision-making and develop frameworks promoting appropriate external access to and use of data to drive higher quality, patient-centered care at a lower cost.

CMS collects a wealth of data that is critical to decision making for the agency and other stakeholders in the nation’s health care system. CMS generates data administering the Medicare, Medicaid and CHIP programs. In addition, new responsibilities, including stewardship of the EHR Incentive Programs, more expansive quality measurement programs, and the establishment of the Health Insurance Marketplaces, have expanded the scope of data that CMS collects. As CMS works to shift the focus from volume of services to better health outcomes for patients, coordinating care, and spending dollars more wisely, the need for CMS to analyze data across its multiple programs and provide greater access to this data, whether in granular or aggregate form, will only intensify.

“It’s clear how much data transparency will help the country improve outcomes, control costs and aid consumer decision making,” said CMS Principal Deputy Administrator Andy Slavitt. “This appointment signals to the industry that there is no turning back from the health care data agenda. Niall Brennan will help make sure CMS leads the way.”

The creation of this new post and the data and analytics office  builds on the steps CMS has taken in recent years to better harness its data resources both internally and externally. CMS is now routinely analyzing claims data in real time and applying predictive analytics to proactively identify fraud and abuse and track key metrics such as hospital readmissions. Accountable Care Organizations and State Medicaid agencies receive monthly near real-time feeds of Medicare data to support care coordination. CMS has launched the Virtual Research Data Center to facilitate lower cost access to CMS data for researchers and federal grantees. CMS has also released numerous public use datasets; the most notable releases to date include the release of data on hospital charges and physician utilization in 2013 and 2014.

“Our commitment to transparency is matched by our commitment to keeping personal information safeguarded. We can't expect to advance health outcomes unless we also ensure that our policies and practices around data privacy are leading the way,” said Slavitt. “We look forward to building on the success of recent releases, providing a clearer picture of the health care delivery system.”

IATRIC SYSTEMS ANNOUNCES "EHR-NEUTRAL" SOLUTION FOR APPLE HEALTH

Politico reports that health IT company Iatric Systems, Inc. has announced its integration with Apple Health to pull patient data into HealthKit and present it from inpatient, ambulatory and patient-generated sources. The "EHR-neutral" approach will link data from records, physician practices and other health IT software, according to an announcement from Iatric. Iatric envisions that patients will help hospitals with meaningful use requirements--especially view, download and transmit.

Two hospitals are currently using Iatric for integration with Apple Health - Michigan's Memorial Healthcare and King's Daughters Medical Center in Mississippi. "We envision our patients using Apple Health easily because for many, the iPhone is already a main part of their lives, said Frank Fear, CIO at Memorial Healthcare, in the announcement. "We could have integrated Apple Health within a portal from our EHR vendor or ambulatory system vendor, but data from disparate systems sits in silos. Iatric Systems was a natural fit because their portal integrates across all of our systems, giving us one tool for capturing and sending data to patients, and eventually, receiving data back from them."

For more information visit Politico here. 

Join NAHAM Webinar: Developing Patient Access Leaders for Tomorrow

Developing Patient Access Leaders for Tomorrow 

November 11, 2014

Join NAHAM for our monthly webinar and hear a detailed account of how WellSpan Health’s Patient Access Department instituted an internal leadership development program to prepare for growth and succession in their rapidly growing Access departments. From conception and development to the inaugural program and its evolution over time, experience a detailed dissection of the various elements of the program, aimed at cultivating our leaders for tomorrow.

The webinar will: 

• Describe how WellSpan Health's rapid growth drove the need for an internal leadership development program, and how that program was implemented and molded.

• Detail the various elements of the leadership development program, including what worked, what didn't and what has changed over time.

• Discuss the challenges and successes of the leadership development program, including lessons learned, success stories, facilitation, participation, and relevance.


Register now and learn how to reduce registration times, increase point-of-service collections, and increase patient satisfaction! NAHAM members will enjoy free access to this live webinar, just one of the perks of NAHAM membership. For all non-members, the cost to attend this webinar is $35.

Date: November 11, 2014
Time: 2:00 pm – 3:00 pm EST
Presented by: Lisa Woods, Manager of Access Operations, WellSpan Health
NAHAM Contact Hours: 1
Register Here 

More than 10,000 Electronic Health Records at Risk in Data Breach

Service Coordination notified nearly 14,000 Maryland residents this month that their personal medical information may have been compromised. Service Coordination is a state-licensed nonprofit organization based in Frederick, Maryland, that works with Maryland residents with intellectual and developmental disabilities. Service Coordination is one of five organizations licensed to provide services by Maryland's Developmental Disabilities Administration. To date there have been no reports of breaches from the other four licensed organizations. 

The organization learned of the security breach in October of 2013, but delayed notifying affected individuals at the request of the U.S. Justice Department. The Justice Department requested the delay to allow time for an unhindered federal investigation. The investigation resulted in the identification of the alleged hacker and the seizure of the hacker's equipment and accounts. 

To date there is no evidence that the data has been released or used for nefarious purposes. Service Coordination spokesman, Michael Baisey, explained that the breach involved a single document that contained personal information for nearly 70% of the group's 13,900 clients. Service Coordination will assist clients and families with credit report checks and identity theft protection. 

CMS Issues Guidance on Stage 2 Meaningful Use Hardship Exceptions

The Centers for Medicare and Medicaid Services (CMS) issued guidance on qualifying for the hardship exception from Stage 2 meaningful use requirements under the federal electronic health record incentive payment program. CMS has been under pressure by stakeholders and lawmakers alike to provide clarification about how to apply and what conditions qualified hospitals and eligible professionals for a hardship exemption

The guidance explains that CMS may grant hospitals and eligible professionals the hardship exception and grant an extension for meeting the Stage 2 meaningful use requirements if their electronic health record (EHR) vendor is at fault for their failure to meet the deadline. This expands on previous statements by CMS Administrator Marilyn Tavenner that the applications for exceptions would be evaluated on a case-by-case basis. 

The guidance specifically states that providers may apply for hardship exceptions if the "EHR vendor was unable to obtain 2014 certification" or the hospital or eligible professional "was unable to implement meaningful use due to 2014 EHR certification delays." If approved, the hardship exception is valid for a single payment year. In the event the application for exception is denied hospitals and eligible professionals may not appeal the decision and any denial is considered final.

The hardship exception application for hospitals is available here.

The hardship exception application for eligible professionals is available here. 

Patient Identification and Matching Report Released by ONC

The Office of the National Coordinator for Health Information Technology (ONC) released the final version of the Patient Identification and Matching Report. The report evaluated best practices and current trends in using electronic health record systems to accurately identify patients and exchange information between providers, patients, and caregivers. Mistakes in properly identifying patient health records put patient safety at risk and has resulted in too many patient deaths. 

The drafting process for the report included an industry environmental scan with input from stakeholders at meetings, on calls, and requests for submitted comments and recommendations. NAHAM was an active participant throughout the drafting process and provided recommendations focused on improving patient safety that are featured in the report. NAHAM's recommendations can be found on page 76 of the report. 

The report resulted in 10 findings that ONC will use as they move forward with the process of improving electronic health record systems and patient matching to improve patient safety.The findings are below.

Findings

1. Standardized patient identifying attributes should be required in the relevant exchange transactions. 

2. Any changes to patient data attributes in exchange transactions should be coordinated with organizations working on parallel efforts to standardize healthcare transactions. 

3. Certification criteria should be introduced that require certified EHR technology (CEHRT) to capture the data attributes that would be required in the standardized patient identifying attributes.

4. The ability of additional, non-traditional data attributes to improve patient matching should be studied. 

5. Certification criteria should not be created for patient matching algorithms or require organizations to utilize a specific type of algorithm. 

6. Certification criteria that requires CEHRT that performs patient matching to demonstrate the ability to generate and provide to end users reports that detail potential duplicate patient records should be considered. 

7. Build on the initial best practices that emerged during the environmental scan by convening industry stakeholders to consider a more formal structure for establishing best practices for the matching process and data governance. 

8. Work with the industry to develop best practices and policies to encourage consumers to keep their information current and accurate. 

9. Work with healthcare professional associations and the Safety Assurance Factors for EHR Resilience (SAFER) Guide initiative to develop and disseminate education and training materials detail best practices for accurately capturing and consistently verifying patient data attributes. 

10. Continue collaborating with federal agencies and the industry on improving patient identification and matching processes. 

No Extension for ICD-10 Implementation

Marilyn Tavenner, Administrator for the Centers of Medicare & Medicaid Services, announced today that there will be no extension of the October 1, compliance deadline for the nationwide conversion to the ICD-10 diagnostic and procedural codes. Speaking at the Healthcare Information and Management Systems Society convention in Orlando, Florida, Tavenner also explained that CMS was not changing compliance requirements for Stage 2 despite extensive pressure on the agency. 

Stage 2 of the electronic health record incentive payment program requires providers to electronically exchange healthcare records with each other to improve the interoperability of CMS' value-based payment programs. Eligible hospitals must commence 90 consecutive days of meeting the meaningful-use criteria on schedule. The starting date for most hospitals was October 1, 2013. However eligible professionals and physicians which operate on a fiscal year must begin compliance on April 1 or July 1, 2014. 

CMS will consider extensions on a case-by-case basis for providers and health IT vendors to obtain a "hardship exemption" that will extend the deadline for that facility. Tavenner does not expect the exemptions to delay full Stage 2 implementation by 2015. 

Timing is Crucial for Effective ICD-10 Education

The ICD-10 billing code system will expand the number of billing codes in the ICD-9 from 18,004 to 155,000 codes. This change will take place by October 1, 2014. The expanded codes create a need for the biller to have a more in-depth understanding of the medical conditions and diseases to accurately bill the patient. If billers are untrained or improperly trained it will create havoc for practices. Practices across the country are wrestling with the questions of 'when' and 'how' to train employees.

Several training methods are available. The depth of the training ranges from self-paced online modules to certification courses that require dozens of hours of in-person instruction. With the huge increase in individual codes and variety of training programs many administrators are left scratching their heads at the decision of how to train their staff. There seems to be a consensus that an online training module provides the flexibility and informational value that best suits the educational needs of many practices. 

Experts recommend that the training material used is centered around billing codes most commonly used in the practice. For example, the employees of a cardiologist practice should focus their training on the medical billing codes for heart-related disease and conditions. 

The experts also suggested that practices begin training now by assessing how well the staff works with ICD-9. The practice should address any bad practices and frequent problems before moving to the more complex ICD-10 system. 

Many experts suggest waiting to train employees until about three months before the transition to ICD-10 to avoid workers forgetting how to use the new coding system since they will be still be interacting with the older system daily.