CMS Nears $2 Billion in Meaningful Use Payments
Through November 2011, Medicare and Medicaid have each paid nearly $1 billion in electronic health records meaningful use incentive payments during the first year of the program.
Medicare has paid $920.3 million and Medicaid has chipped in an estimated $916 million, according to figures from the Centers for Medicare and Medicaid Services presented Dec. 7 to the HIT Policy Committee.
Medicare meaningful use payments have gone to 10,155 eligible professionals, 34 Medicare-only hospitals, and 377 Medicare and Medicaid hospitals. Medicaid meaningful use payments have gone to 11,270 eligible professionals and 800 hospitals.
After a start to the meaningful use programs that was slower than CMS anticipated, incentive payments took off in September for hospitals and in October for eligible providers, says Robert Anthony, a health insurance specialist in CMS' Office of E-Health Standards and Services. And with eligible providers having until Feb. 29, 2012, to attest to 2011 meaningful use, "we think we'll see a real influx of people coming in," he told the policy committee.
5 Steps To Electronic Health Record Meaningful UseJanuary 3, 2012
Several branches of the U.S. Department of Health and Human Services (HHS) have teamed up to produce an online guide for selecting and implementing electronic health records (EHRs). The goal is to help small physician practices earn Medicare and Medicaid bonus payments for Meaningful Use of EHRs, and ultimately deliver higher-quality care.
The "How To Get Started" guide, available at healthit.gov/providers-professionals/ehr-implementation-steps, walks providers through five steps of EHR implementation: assessing practice readiness; developing a strategy; choosing an appropriate system; training for, installing, and switching to the EHR; and achieving Meaningful Use.
It is not intended to be an EHR selection tool, which some medical specialty societies and health IT industry groups offer to their members, but rather more like a checklist. Accordingly, the site is not interactive, though it does link to outside resources that could help practices choose specific EHR products.
The information is geared toward helping practices employ EHRs and other IT to improve healthcare, population health, and the efficiency of providing care, according to a spokesman for the Office of the National Coordinator for Health Information Technology (ONC), which is spearheading the project. Some of it is rather basic. "The first step in EHR implementation is to conduct an assessment of your current practice and its goals, needs, and financial and technical readiness. With an accurate view of your level of preparedness, your practice can design an implementation plan that meets the specific needs of your practice," reads the introduction to step 1.
Much of the content is based on real-world experience reported by the nationwide network of Regional Extension Centers, the spokesman said. The 62 ONC-funded centers are tasked with helping small physician practices and critical access hospitals adopt EHRs and achieve Meaningful Use, and various HHS agencies consulted with the RECs when developing the site.
The RECs are part of ONC's National Learning Consortium, which also includes federally funded health IT Beacon Communities and state-level health information exchanges.
Other content comes from the Centers for Medicare and Medicaid Services (CMS), which administers the Meaningful Use program, and from the HHS Office for Civil Rights, which enforces Health Insurance Portability and Accountability Act (HIPAA) privacy and security standards.
The site actually went live last summer, though it might be hard to find. The tool has no catchy title, and it takes two clicks from the main HealthIT.gov page to get there. "We are promoting the site through various channels including active promotion through social media, such as regular blogging and Twitter," the ONC spokesman said via e-mail.
As healthcare providers of all shapes and sizes start implementing electronic medical records systems, security must be a top priority. Here's what you need to be thinking about to ensure your system is locked down. Download the report here (registration required).
HHS Says Looser Rules For Health Records Will Spur Job Creation
The Obama administration said Wednesday that it would relax certain healthcare regulations in its push to create jobs without waiting for Congress.
The Health and Human Services Department said looser standards for electronic health records are the latest piece of the administration's "we can't wait" campaign. The gradual conversion to electronic records has already created 50,000 jobs since 2009, according to HHS.
"We're making great progress, but we can't wait to do more," HHS Secretary Kathleen Sebelius said in a release. "Too many doctors and hospitals are still using the same record-keeping technology as Hippocrates."
Excerpted from: http://thehill.com/blogs/healthwatch
HHS extends Meaningful Use deadline by one yearDecember 1, 2011
To the relief of many providers, the Department of Health & Human Services (HHS) has announced its intent to delay the start of Stage 2 of the Meaningful Use requirements of electronic health records (EHR) from 2013 to 2014, reports FierceEMR.
Under current rules in the Medicare EHR Incentive Programs, providers that participate in the program this year would have to satisfy Stage 2 standards in 2013, whereas providers who waited until 2012 to participate wouldn't have to satisfy requirements until 2014--a prime reason for some providers to hold off attesting in Stage 1 until 2012. Therefore, with the HHS postponement, the regulatory agency encourages providers to adopt EHRs faster. Under the proposed delay, providers who attest to Stage 1 of Meaningful Use this year will not have to meet Stage 2 criteria until 2014, a welcome change to many healthcare organizations and professionals.
The move to delay the start of Meaningful Use isn't all that surprising. National Coordinator of Health IT Farzad Mostashari in July had endorsed the one-year postponement in the criteria for receiving government EHR incentives.
Hospitals should note, though, the postponement will come too late to attest this year. Eligible hospitals and physicians that begin participating this year still would have to meet new standards for the program in 2013; the last date on which they could do so was Nov. 30, FierceEMR reports.
But, according to the HHS statement, "doctors who act quickly can also qualify for incentive payments in 2011 as well as 2012."
Under the HITECH ACT, the Medicare EHR Incentive Programs incentivizes providers with payments to use health IT meaningfully, which offers the touted benefits of better patient care and savings, according to HHS Secretary Kathleen Sebelius.
What has the reaction been to the program thus far? Physicians' adoption of health IT has doubled in the past two years, according to a HHS report released yesterday, but Sebelius cautioned that even with great strides comes room for improvement.
"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," Sebelius said. "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."
To help move the EHR adoption along, HHS also is providing education and training to Medicare eligible professionals who have registered in the EHR incentive program but haven't met Meaningful Use requirements yet.
Health Information Exchanges: Get Everyone Onboard
The ultimate goal is a universally accepted national health information exchange. What's the holdup?November 29, 2011
Why have health information exchanges turned into such a debacle in the U.S.? At first blush, it's easy to jump to the conclusion that HIEs--organizations that let healthcare providers easily share information--are just a large sandbox with a lot of big egos not willing to play well together.
One player in the sandbox, of course, is the Centers for Medicare and Medicaid Services, which mandates that hospitals and medical practices participate in an HIE in order to obtain Meaningful Use incentive checks. Ignore the mandate and you'll eventually be penalized.
One of CMS' rules requires providers to "exchange clinical information electronically with other providers and patient authorized entities." In MU Stage one, that simply means clinicians have to show they're capable of sending this kind of information to someone outside their organization and testing that capacity. In Stages 2 and 3, they'll actually have to share that data.
Other players in the sandbox are the providers. Large hospitals and group practices sometimes object to sharing confidential data on patients because that will expose the demographics and disease characteristics of their respective patient populations, thus threatening their market share by making it easier for competitors to go after their patient population.
But a closer look at all the issues suggests HIE problems go much deeper. At its core, the model suffers not just from an unwillingness to cooperate on the part of major stakeholders, but also from a lack of technical standards, poor financial planning, and a crisis of confidence among patients.
Healthcare providers have no universally agreed-upon way to share patient data. A case in point is the way patient summaries are exchanged. Some providers prefer a Continuity of Care Document (CCD) while others use a Continuity of Care Record (CCR). CCD uses the XML markup standard and HL7 for encoding a patient summary. CCR, a related health record standard specification that's also XML-based, can likewise be used to exchange patient summaries but converting CCDs into CCRs can be problematic. Both are viable standards, but you probably don't want to use them both in the same HIE.
On a more positive note, seven states and 11 health IT vendors recently banded together to support a set of technical specifications to standardize health data sharing among healthcare providers and health information exchanges. The specs are the result of a workgroup originally launched by the New York eHealth Collaborative (NYeC). They facilitate two basic health-data-exchange capabilities: patient record look-up and point-to-point, or direct, data sharing.
The states and vendors supporting this initiative represent about a third of the U.S. population, so it should go a long way toward bringing some order to the situation.
As far as solving the financial issues that plague many HIEs, sustainable business models typically have providers pay subscription fees, rather than transactional fees, to help cover operational costs. Many HIEs also look to insurers for help in covering costs, especially since the payers are the stakeholders that will probably benefit most from avoiding the costs of unnecessary tests and medical errors that can be prevented when providers have access to more timely, complete patient data at the point of care.
Several insurers now realize the wisdom of such an investment. Capital District Physicians Health Plan , for instance, recently announced that it will offer $1 million to help 800 specialists within its network implement health IT. The money builds on more than $10 million that the company already has invested to help its providers digitize their medical records and support interoperability of clinical data. Officials at the Albany, N.Y., health plan said the latest awards will pay for consultation services to help specialists select electronic health records, attest to Meaningful Use, and connect to the Health Information Exchange of New York.
Similarly, Blue Shield of California recently announced awards totaling nearly $20 million to help 18 California hospitals, health systems, clinics, and physician groups adopt EHRs, establish HIE interoperability, and support clinical system integration among physicians.
Perhaps the most thorny problem to solve in trying to get an HIE up and running is the public's fear that their medical data won't be safe. Given the number of well-publicized data breaches in the news recently, you can certainly understand their concern. One way to approach this issue is a well-thought out public relations campaign. The Office of the National Coordinator for Health IT has spent a good deal on money convincing health professionals of the value of EHRs and health IT, with full-page ads in JAMA and the New England Journal of Medicine promoting them. Why not create a similar campaign to convince the public of health information exchanges' value--and their relative safety.
If the U.S. healthcare system's movers and shakers really want to put patients' welfare first, they'll find a way to build bigger and better HIEs, with the ultimate goal of creating a universally accepted national exchange. After all, if a patient lives in Miami but finds herself in a hospital while on vacation in California, her ER doctor should have full instant access to her records. How much longer does she have to wait?
Medical Records Sought by Defense in Murder Trial
Medical records are figuring prominently in the trial of yet another suspect in the news.
But it could be at least another week before a Virginia judge decides whether to release the medical records of Yeardley Love. Love, who played lacrosse at the University of Virginia, was killed last year in her apartment. George Huguely, 24, who had a relationship with Love, is accused in her death. Police say George Huguely killed Love by slamming her head against her apartment wall in May of 2010.
Huguely's attorneys want to see her medical records. They contend that Love may have died from an irregular heartbeat caused in part by the combination of prescription drugs and alcohol.
- excerpts taken from http://www.nbcwashington.com
Disability Scam Used False Medical Histories
A $1 billion disability scam pioneered by a one-time MTA board member helped hundreds of retired LIRR workers enjoy their golden years with an illegal gold mine.
The massive ripoff steered more than 1,000 Long Island Rail Road workers to corrupt doctors who created bogus medical histories, letting the railroad robbers double-dip on their pensions, a federal complaint charged.
Orthopedists Peter Ajemian and Peter Lesniewski were arrested Thursday for running "disability mills" that provided a monthly payoff to the healthy - and greedy - workers. The feds also busted Ajemian's office manager, Maria Rusin, who collapsed in Manhattan Federal Court at her bail hearing. In all, 11 were charged.
Their co-defendants, all arrested Thursday, include a former MTA board member/union president, a one-time official with the Railroad Retirement Board and a half-dozen ex-LIRR employees.
- excerpted from the NY Daily News