CMS and HIT Adoption (Text Version)

Slide Presentation from the AHRQ 2009 Annual Conferenc

On September 15, 2009, Tony Trenkle made this presentation at the 2009 Annual Conference. Select to access the PowerPoint® presentation (748 KB). Plugin Software Help.

Slide 1

CMS and HIT Adoption

Tony Trenkle
Director
Office of E-Health Standards and Services
Centers for Medicare & Medicaid Services

Slide 2

CMS-The Numbers

• Medicare provides health insurance to approximately 45 million beneficiaries
• CMS also has federal oversight of the state-administered Medicaid program and Children's Health Insurance Program (CHIP), covering about 50 million and 11 million enrollees respectively
• 33.7% of national health expenditures are paid by Medicare or Medicaid
• Medicare processes over a billion claims/yr.
• There are approximately one million Medicare providers

Slide 3

HIT Adoption

• CMS' large percentage of overall healthcare purchasing as well as its regulatory role makes it the key driver for successful HIT adoption
• CMS support of standards drives industry adoption and builds a foundation to support interoperable HIT.
• CMS incentives programs promote adoption but also effective use of HIT.
• CMS demos and pilots provide a way to measure the impact of HIT on the Medicare and Medicaid populations.

Slide 4

Demos and Pilots

• DOQ-IT
  • QIO 8 th Scope of Work
  • Focus on small-medium sized primary care practices

• Medicare Care Management Performance
  • Authorized under MMA
  • 3 year pay for performance to promote HIT adoption and use
  • Also focuses on small-medium sized primary care practices (up to 10 physicians)

Slide 5

Demos and Pilots

• EHR Demonstration Project ¤ Expands the MCMP demonstration
  • Over 800 practices in 4 demo sites
  • Began June 2009, will end May 2014
  • Also focuses on small-medium sized primary care practices (up to 20 physicians)
    
• Medicaid Transformation Grants
  • 22 states grants focused on HIT
  • EHRs, E-RX, HIEs

Slide 6

Other Drivers

• Stark/Anti-Kickback
  • Allows donation of EHR software under certain conditions
• CHIPRA
  • Promotes development of a pediatric EHR and quality measures
    
• PQRI/RHQDAPU
  • Promoting the reporting of quality measures through EHRs for 2010
    
• MIPPA
  • E- rx incentive-2009-2013

Slide 7

HITECH

• HITECH Act-effective 2011
  • Section 4101-Medicare eligible professionals
  • Section 4102-Medicare incentives for hospitals
  • Section 4201-Medicaid

• Game changer
  • Scale-up to $40 billion
  • Brings together the CMS programs (Medicare FFS, Medicare Advantage, Medicaid)
  • Meaningful Use-potential to bring about vast changes

Slide 8

Challenges

• Numerous CMS programs to promote adoption have begun or will start shortly.
• All contribute to increased use of interoperable HIT to improve the quality and efficiency of healthcare.
• Challenges in the near term
  • Synchronize these efforts to optimize effects and not create unintended outcomes.
  • Create a platform that builds in continued improvements over time.
  • Implement HITECH the right way
    • Depth vs. width