Tag Archives: Paul Leonardo

Full steam ahead for Medicare/Medicaid EHR incentives

As reported in Modern Healthcare, the Centers for Medicare and Medicaid Services (CMS) has provided nearly $4.5 billion in electronic health records (EHR) incentive payments. About $2.4 billion of that is under Medicare, which started EHR incentives in May 2011. The rest is under Medicaid, which began EHR incentives in January 2011. Hospitals have received the bulk of the total in both programs, about $3.1 billion. The program has more than 225,000 active accounts. The EHR incentive program is part of the American Recovery and Reinvestment Act of 2009, which authorized $19 billion for the EHR incentive program.

For a couple of Milliman perspectives on the EHR program, check out this paper on state healthcare data exchanges which points out how:

Community-based data pooling initiatives in Minnesota, Massachusetts, Oregon, Washington, and Wisconsin (commonly known as Chartered Value Exchanges or CVEs) have already shown that, at least using administrative data, it is possible to bring stakeholders to the table, get appropriate infrastructure in place, and begin using community health data to improve quality and transparency. These organizations may serve as models or building blocks for more meaningful use of EHR data nationally.

It’s also worth taking a look at this 2009 research report, “The Convergence of Quality and Efficiency and the Role of Information Technology in Healthcare Reform,” which discusses how EHR can move beyond administrative efficiency to become a decision support tool for physicians.

You can download the latest EHR program data from CMS here.

The technology behind accountable care

We have blogged before about accountable care organizations and the need for an alternative to the fee-for-service payment model. Now a new paper looks at the kind of technology needed if provider organizations are going to start taking on the financial risk and reward that has typically been held by insurers.

What kind of technology are we talking about? The ideal platform can measure utilization and determine if care adheres to certain evidence-based measures. Many insurers already employ this kind of analysis, but it is likely to be new in most provider organizations.

Wisconsin health information exchange launches new database

Today’s Milwaukee Journal Sentinel reports that the community data pooling organization, Wisconsin Health Information Organization (WHIO), has launched a database that will now be available to large healthcare systems and, eventually, to consumers. The database will improve transparency and allow better understanding of healthcare quality and cost dynamics:

The database is drawn from the experiences of more than 1.6 million people and 72 million treatment services. In April, WHIO will add data from Dean HMO and Medicaid, which includes BadgerCare, the state health program for the working poor, adding the experiences of 1 million more insured people to the database.

“To us, the real opportunity is to look across all the claims aggregated here and get a picture of where we have cost-effective health care being delivered in Wisconsin, and where we have an opportunity to improve the cost-effectiveness of health care,” said Karen Timberlake, secretary of the state Department of Health Services and a WHIO board member.

“There isn’t a database like this that’s been available to providers to measure these sorts of things. And if you can’t measure it, you can’t improve it,” said Larry Rambo, chief executive of Humana’s Wisconsin, Michigan and Illinois markets.

Wisconsin is among a handful of states – including Minnesota, Massachusetts, Oregon and Washington – that have put infrastructures in place for pooling health data to improve quality and transparency, according to a briefing paper written this year by the consulting and actuarial company Milliman.

Click here for more information on these information exchanges.

More on interoperability and the push for EHR

Tech guru David Pogue recently interviewed national health IT director Dr. David Blumenthal. It’s an interesting read (or you can watch Pogue’s CBS program here).

Here’s an excerpt from the interview:

Pogue: What about the interoperability problem? Every software company selling these systems puts the data in a different format.

Blumenthal: We’re doing a lot in this office to try to minimize that problem. We’re gonna be helping states to create interoperability capability, capabilities to link records, to link institutions.

And we’re developing standards at the national level to make it possible for records to talk to each other. And then we’re also gonna be certifying records, to give physicians and hospitals some guidance about the capabilities of those records, so that they’ll know in advance whether or not the records are gonna be able to talk to each other.

These [standards discussions] are open processes. This will all be a very open and transparent process.

The interoperability problem is, of course, a big one—as explained here.

Are we building the foundation for a Health IT Tower of Babel?

We have seen much attention paid to the adoption of electronic health records (EHR). Paying for EHR is notable as one aspect of healthcare reform that already has won funding thanks to billions set aside in the American Recovery and Reinvestment Act. Some stimulus makes sense given the low adoption of EHRs by providers nationwide and the inefficiencies of a paper-based system.

But one aspect of EHR adoption has been largely overlooked. A new healthcare reform briefing paper by Rich Moyer and Paul Leonardo examines how population-level analysis is key to unlocking the potential of electronic health records. Community data pooling allows analysis that makes healthcare quality more apparent and can help measure and improve the system on a regional basis. These information exchanges are currently operational in at least five states and are already yielding results (while hopefully preventing the formation of new information silos in the move toward EHR).