Meaningful Use Education Module: Transitions of Care

What do you know about  Stage 2 Meaningful Use around Transitions of Care?

From the ONC:

Reflecting our continued commitment to expand the Stage 2 / 2014 Edition meaningful use education portfolio beyond webinars and speaking events, today ONC is launching a a brand new self-paced education module on the "transitions of care" interoperability criteria. ONC and CMS staff created the module in response to stakeholder questions about the objective’s measurement requirements and valid certification approaches. The new education module can be viewed on HealthIT.gov at the following link:

http://www.healthit.gov/policy-researchers-implementers/video/meaningful-use-education-module-transitions-care

CMS announces 106 new ACOs

The Centers for Medicare & Medicaid Services (CMS) just announced 106 new Accountable Care Organizations (ACOs) in this press release today.  Since passage of the Affordable Care Act, more than 250 Accountable Care Organizations have been established. Do you know if your state has an ACO?

CMS announces 500 practices for the Comprehensive Primary Care (CPC)

Today, CMS announced the 500 Participating Primary Care Practices for the Comprehensive Primary Care (CPC).

The Comprehensive Primary Care (CPC) initiative is a multi-payer initiative fostering collaboration between public and private health care payers to strengthen primary care. Medicare will work with commercial and State health insurance plans and offer bonus payments to primary care doctors who better coordinate care for their patients. Primary care practices that choose to participate in this initiative will be given resources to better coordinate primary care for their Medicare patients.

There are 500 primary care practices participating in the CPC initiative. This represents 2,144 providers serving an estimated 313,000 Medicare beneficiaries.

4 states are involved statewide: Arkansas, Colorado, New Jersey, & Oregon. The other participants are from specific regions around the country.

To view the list of those 500 practices, click here.

CMS Innovation Center Update: Comprehensive Primary Care Initiative

The following is an update from the CMS Innovation Center:

The CMS Innovation Center has selected seven geographic markets to carry out the Comprehensive Primary Care initiative, a new multi-payer approach that aims to strengthen the primary care system while achieving better health care and lower costs through improvement. These markets were selected based on a pool of applicants, which include private health plans, state Medicaid agencies, and employers, that proposed to pay for and support comprehensive primary care coordination in partnership with Medicare.

The markets represent a diverse range of regions spanning both coasts, the midwest and south, and rural and urban communities. The selected markets are:

• Arkansas: Statewide
• Colorado: Statewide
• New Jersey: Statewide
• New York: Capital District-Hudson Valley Region
• Ohio: Cincinnati-Dayton Region
• Oklahoma: Greater Tulsa Region
• Oregon: Statewide

Once the participating payers in each market have agreed to the terms and conditions to participate in the initiative by entering into a Memorandum of Understanding with CMS, the Innovation Center will release the application for primary care practices to participate in each market. Approximately 75 primary care practices will be selected to participate in the initiative in each designated market.

Community-based Care Transitions Program (CCTP)

Last week, the Center for Medicare & Medicaid Services (CMS) announced 23 additional participants for the Community-based Care Transitions Program (CCTP). These participants will join seven other community-based organizations already working with local hospitals and other health care and social service providers to support high-risk Medicare patients in maintaining the healing process as they transition from hospital stays to home, a nursing home, or other care setting.

The CCTP is an initiative of the Partnership for Patients, a nationwide public-private partnership that aims to cut preventable errors in hospitals by 40 percent and reduce preventable hospital readmissions by 20 percent over a three-year period. CCTP’s goals are to reduce hospital readmissions, test sustainable funding streams for care transition services, maintain or improve quality of care and document measureable savings to the Medicare program.

The Community-based Care Transitions Program will be hosting a webinar on Tuesday, March 27th, from 3:00pm-4:30pm EDT, to allow stakeholders to hear directly from some of the newly selected sites. CMS Innovation Center staff will provide additional information about the program and will be available to answer questions.

WHAT: Community-based Care Transitions Program Webinar
WHEN: Tuesday, March 27th 3:00pm-4:30pm EDT
WHERE: http://www.visualwebcaster.com/event.asp?id=85800

Participants are strongly encouraged to use the web link for full access to the presentation. If you are unable to hear audio via your computer speakers or would prefer to listen via the telephone, please dial 877-249-8016 and enter code 31613148#.

More information on the CCTP is available at: http://innovation.cms.gov/initiatives/Partnership-for-Patients/CCTP/index.html.

CMS Health Care Innovation Challenge Award Date Approaching

The CMS Health Care Innovation Challenge will be awarding $1 million to $30 million for a three-year period to organizations that propose innovative health care solutions aimed to:

1. Engage a broad set of innovation partners to identify and test new care delivery and payment models that originate in the field and that produce better care, better health, and reduced cost through improvement for identified target populations.
2. Identify new models of workforce development and deployment and related training and education that support new models either directly or through new infrastructure activities.
3. Support innovators who can rapidly deploy care improvement models (within six months of award) through new ventures or expansion of existing efforts to new populations of patients, in conjunction (where possible) with other public and private sector partners.

The anticipated award date is March 30, so stay tuned! For more information about the CMS Innovation Challenge, click here.

Submit a comment on the proposed "Physician Payment Sunshine Act"

The deadline to submit a comment on the proposed "Physician Payment Sunshine Act" is 5 pm ET on Feb 17.

You can view the latest draft of the proposed "Physician Payment Sunshine Act" here (technically, it's called the "Medicare, Medicaid, Children's Health Insurance Programs: Transparency Reports and Reporting of Physician Ownership or Investment Interests" and it was updated on Dec 19, 2011).

Here's a brief summary of the proposed act:

SUMMARY: This proposed rule would require applicable manufacturers of
drugs, devices, biologicals, or medical supplies covered by Medicare,
Medicaid or the Children's Health Insurance Program (CHIP) to report
annually to the Secretary certain payments or transfers of value
provided to physicians or teaching hospitals (``covered recipients'').
In addition, applicable manufacturers and applicable group purchasing
organizations (GPOs) are required to report annually certain physician
ownership or investment interests. The Secretary is required to publish
applicable manufacturers' and applicable GPOs' submitted payment and
ownership information on a public Web site.

You can submit your comment electronically here

Care Innovations Summit: Twitter Hashtag #cisummit

Leading voices in health care innovation will join CMS leadership at a unique event: The Care Innovations Summit in Washington D.C.

This event brings together representatives of health professions, the insurance industry, patient advocates, finance, and government to discuss ways they can collaborate to drive action towards better care and better health at lower cost through continuous improvement.

Registration to attend the event in person is now closed, but you don’t have to be there in person to engage the care innovations community.

The Official Web Site for the Medicare and Medicaid EHR Incentive Programs

In case you didn't know about it, the government has created an "Official Web Site for the Medicare and Medicaid EHR Incentive Programs."

It's on the CMS website here:
http://www.cms.gov/EHRIncentivePrograms/

Here's what you'll find if you visit that site:

•  Overview
•  Spotlight and Upcoming Events
•  Getting Started
•  Eligibility
•  Certification
•  Meaningful Use
•  Registration
•  Medicare Eligible Professional
•  Medicaid Eligible Professional
•  Hospitals
•  Medicare Advantage
•  Information for States
•  Frequently Asked Questions and Educational Materials

The nation’s healthcare system is undergoing a transformation in an effort to improve quality, safety and efficiency of care, from the upgrade to ICD-10 to information exchanges of EHR technology.   To help facilitate this vision, the Health Information Technology for Economic and Clinical Health Act, or the "HITECH Act" established programs under Medicare and Medicaid to provide incentive payments for the "meaningful use" of certified EHR technology.  The Medicare and Medicaid EHR incentive programs will provide incentive payments to eligible professionals and eligible hospitals as they  adopt, implement, upgrade or demonstrate meaningful use of certified EHR technology.  The programs begin in 2011. These incentive programs are designed to support providers in this period of Health IT transition and instill the use of EHRs in meaningful ways to help our nation to improve the quality, safety and efficiency of patient health care.

NOTE: This is a new program, and it is separate from other active CMS incentive programs, such as Physicians Quality Reporting Initiative (PQRI), Reporting Hospital Quality Data for Annual Payment Update (RHQDAPU) and e-Prescribing.

To learn more, visit: http://www.cms.gov/EHRIncentivePrograms/

Ingenious Med Receives Official Status as a 2010 PQRI Registry

ATLANTA, August 17, 2010 – Ingenious Med has completed an extensive vetting process by Centers for Medicare & Medicaid Services (CMS) to achieve official status as a 2010 Physician Quality Reporting Initiative (PQRI) Registry, the company announced Tuesday.

The process involved verification of Ingenious Med’s expertise in measure implementation, validation of processing of physician responses and confirmation in the ability to submit performance data in accordance with established CMS guidelines.

Thoughts about the final "meaningful use" rules

The final "meaningful use" rules came out yesterday. I'm still reading through the 800 page document and thinking about the amount of time it must have taken to come up with all these rules. The New England Journal of Medicine (NEJM) published a perspective article yesterday titled, "The “Meaningful Use” Regulation for Electronic Health Records." David Blumenthal, M.D., M.P.P., and Marilyn Tavenner, R.N., M.H.A. start the article with this paragraph:

The widespread use of electronic health records (EHRs) in the United States is inevitable. EHRs will improve caregivers’ decisions and patients’ outcomes. Once patients experience the benefits of this technology, they will demand nothing less from their providers. Hundreds of thousands of physicians have already seen these benefits in their clinical practice. 

They then remind the readers that:

Through HITECH, the federal government will commit unprecedented  resources to supporting the adoption and use of EHRs. It will  make available incentive payments totaling up to $27 billion  over 10 years, or as much as $44,000 (through Medicare) and $63,750 (through Medicaid) per clinician. This funding will provide important support to achieve liftoff for the creation of a nationwide system of EHRs.

That's a lot of money, but will it be adequate to ensure that hospitals and physicians are equipped with the support staff and the IT infrastructure to achieve "meaningful use" within their organizations?

Healthcare IT News is reporting that "Overall, AHA leaders said they remain concerned that the requirements may be out of reach for many hospitals. "Unfortunately, CMS continues to place some barriers in the way of achieving widespread IT adoption," AHA said in its statement."

America's Best Nursing Homes

The February edition of US News has a section titled, "America's Best Nursing Homes" and it lists some of the top nursing homes in various states. If you're thinking about long-term care for yourself or for a loved one, then you may want to look at this list.

In my region, some of the top nursing homes (according to US News) include:

• Crosslands in Kennett Square, PA
• Calvary Fellowship Homes in Lancaster, PA
• Holy Name Friary in Ringwood, NJ
  
• Cokesbury Village in Hockessin, DE
• Our Lady of Hope Residence in Latham, NY

There are 173 nursing homes listed and some scored a total of 15 stars while others scored a total of 14 stars in 3 different categories. All the homes listed scored 5 stars overall, the highest rating by the Centers for Medicare & Medicaid Services (CMS).

You can also view the Medicare.gov - Nursing Home Compare website to do some research about different nursing homes in your area (www.medicare.gov/nhcompare).

Leading Consumer, Business Experts Laud Two Key Federal Agencies for Hitting the Right Note on Meaningful Use of Health Information Technology (HIT)

Leading Consumer, Business Experts Laud Two Key Federal Agencies for Hitting the Right Note on Meaningful Use of Health Information Technology (HIT)

First Consumer, Business Reaction to Draft Regulations Applauds Agencies for Setting Achievable and Sensible Goals

Washington, DC – January 14, 2010 – Two leading experts are applauding the Centers for Medicare & Medicaid Services (CMS) and the Office of the National Coordinator for Health Information Technology (ONC) for setting the bar at the right level to effectively spur  the “meaningful use” of HIT in the recently published draft rule.  It defines “meaningful use” of HIT, and establishes an appropriate set of measures that are achievable by a broad array of health care practitioners.  It has the potential to greatly improve health care quality, according to Christine Bechtel, Vice President of the National Partnership for Women & Families and David Lansky, President and CEO of the Pacific Business Group on Health.  This is the right medicine for consumers, patients, providers and payers, they say.

“As a consumer representative on the HIT Policy Committee, I applaud CMS and ONC for putting us on the right track,” said Bechtel. “At the end of the day, we must make sure consumers and patients are seeing real benefits from these new technologies.  The draft rule is strategic, pragmatic and designed to make sure patients and families are engaged in making sure these investments benefit them.  We look forward to working with CMS and ONC to build on and improve this draft.”

Health IT "Meaningful Use" Defined?

The phrase "meaningful use" is a critical part of the health IT or HITECH provisions within ARRA (American Recovery and Reinvestment Act). The Office of the National Coordinator for Health Information Technology (ONC) health IT policy committee voted last week and approved the proposed meaning of "meaningful use." Based on the HITECH provisions, Medicare reimbursement incentives for physicians will begin as early as 2011 and penalties for those not engaging in the "meaningful use" of electronic health records or EHRs will start in 2017.

Now, the recommendations will need to be approved by David Blumenthal, MD, National Coordinator for Health IT before they go to CMS (Centers for Medicare and Medicaid Services).

So have we fully defined the phrase "meaningful use"? How many physicians will be using EHRs by 2017? If you think about it, 2011 really isn't that far away. I'd like to think that by 2017, most physician offices will be utilizing EHRs, but I also remember thinking that 10 years ago when I thought that health IT uptake was going to soar. Now that we have a major carrot and stick, we should see significant change over the next several years. Let's wait and see.

CMS rating hospitals based on readmission

The Centers for Medicare and Medicaid Services (CMS) is now rating hospitals based on readmission data and mortality. Should healthcare providers get rated based on readmission statistics? New ratings on 4,000 hospitals will show up on the CMS "Hospital Compare" Web site which can be found at: http://www.hospitalcompare.hhs.gov

CMS officials have suggested that readmission data - how frequently patients return to a hospital after being discharged - may be "a possible indicator of how well the facility did the first time around. Readmission rates will help consumers identify those providers in the community who are furnishing high-value healthcare with the best results."

As physicians, we are pushed to get patients out of the hospital quickly. Now, any patient who "bouces back" will harm our reputation. Is that fair? What about those non-compliant patients who refuse to adhere to their medication regimens? They are likely to "bounce back" if they get discharged on many critical meds and never fill their prescriptions. Maybe healthcare providers will be more motivated to fire these types patients. If that happens, then no one may want to care for them.

CMS has been tracking the outcomes of hospital care since 2007 when the "Hospital Compare" website provided 30-day mortality rates for heart attack and heart failure.

CMS proposes 21.5% reduction in Medicare payments

Are we going forwards or backwards? CMS is proposing reductions on physician reimbursement for Medicare patients. This may impact over 1 million physicians and nonphysician practitioners who are paid under the Medicare Physician Fee Schedule (MPFS). For 2010, CMS is proposing to include data about physicians’ practice costs from a new survey, the Physician Practice Information Survey (PPIS), designed and conducted by the American Medical Association (AMA). The Medicare law requires CMS to adjust the MPFS payment rates annually based on an update formula which includes application of the Sustainable Growth Rate or SGR that was adopted in the Balanced Budget Act of 1997. This formula has yielded negative updates every year beginning in CY 2002, although CMS was able to take administrative steps to avert a reduction in CY 2003, and Congress has taken a series of legislative actions to prevent reductions in CYs 2004-2009.

Here's the clencher: "Based on current data, CMS is projecting a rate reduction of -21.5 percent for CY 2010."

So, what do you think about that? Will this drive more physicians to move to a cash-only practice? Concierge medicine? Maybe they will stop accepting Medicare.

The 5010 Testing Project Collaboration

Have you heard of the 5010 Testing Project Collaboration? It's a major initiative that was conducted in collaboration with the Centers for Medicare and Medicaid Services (CMS), the CAQH (Council for Affordable Quality Healthcare) and other CAQH participant organizations, HIMSS (Healthcare Information and Management Systems Society), Integrating the Healthcare Enterprise (IHE) Initiative, and the Blue Cross Blue Shield Association (BCBSA).

The four goals for the 5010 Testing Project included:

• Initiating industry and market momentum for the adoption of the 5010 HIPAA transaction requirements and the complementary CORE rules certification process;
• Providing an avenue to demonstrate current industry capabilities for HIPAA-compliant administrative data exchange with multi-stakeholder participation through the 2009 North American Connect-a-thon and the 2009 HIMSS Interoperability Showcase;
• Highlighting the 5010 testing options in conjunction with the CORE Phase I and II rules testing scripts and testing tools already available to the market; and
• Displaying private-public collaboration, and the critical role that voluntary, private sector-led efforts like HITSP, IHE and CORE play in the national landscape.

I don't think I've ever used so many acronyms in a blog post before! Did you catch all those?

Everyone knows CMS (Centers for Medicare and Medicaid Services) and HIPPA (Health Insurance Portability and Accountability Act). You're probably even familiar with the BCBSA (Blue Cross Blue Shield Association).

How about there health IT acronmys?

• CAQH (Council for Affordable Quality Healthcare)
• CORE (CAQH's Committee on Operating Rules for Information Exchange)
• HIMSS (Healthcare Information and Management Systems Society)
• HITSP (Healthcare Information Technology Standards Panel)
  
• IHE (Integrating the Healthcare Enterprise)