In my last post, I discussed the benefits of migrating to an Electronic Health Records (EHR) model in the US health care system. EHR is a popular topic in 2010, because President Obama has made advancing the US health care system a top policy item for his administration. In fact, the American Recovery and Reinvestment Act (ARRA) passed in 2009 allocated federal funds to accelerate the adoption of EHR. Most people associate the ARRA with the road signs you see on secondary highways and bridges. After sitting in a 45-minute traffic jam I always pleased to see a sign that states “This Project Funded by the American Recovery and Reinvestment Act” followed by “Your Tax Dollars at Work.” Or maybe it is “Putting America to Work,” but you get the idea. But ARRA is about more than just road signs. The legislation includes a significant allocation of federal funds to build a series of regional Health Information Exchanges (HIE) which will ultimately be linked together in the National Health Information Network (NHIN). Below is some background information on the initiatives currently underway.
In addition to the $100B of funding for science and infrastructure projects, the ARRA also includes $59B for health care reform. Specifically, included with the ARRA economic stimulus package was the Health Information Technology for Economic and Clinical Health Act (HITECH Act). According to the US Health and Human Resources web site:
“The provisions of the HITECH Act are specifically designed to work together to provide the necessary assistance and technical support to providers, enable coordination and alignment within and among states, establish connectivity to the public health community in case of emergencies, and assure the workforce is properly trained and equipped to be meaningful users of EHRs.”
Incentives and Penalties
HITECH provides funding for a number of grant programs for higher education programs in Health Information Technology as well as R&D funds to invest in fortifying security and network architectures for EHR. HITECH also includes grant programs to enable states to rapidly develop HIEs within their jurisdictions. As a result, in March 2010 over $500B in State Grants were awarded to 56 different US states and territories. The leading beneficiaries were the most populated states with California ($38B); Texas ($28B); New York ($22B), Florida ($20B) and Illinois ($18B). There are also a set of financial motivators for providers in the form of incentives and penalties. Physicians can receive up to $44K of incentive payments if they achieve “meaningful use” of a certified E.H.R. Hospitals and larger provider groups are eligible for millions of dollars in incentives. After 201 5, penalties will begin to be assessed in the form of reduced Medicare payments for physicians or hospitals that have not met the requirements.
Driving EHR Adoption – The Carrot and Stick Approach
Community of Participants
A diverse and broad range of constituents in the health care community will benefit from sharing or viewing electronic health records. The largest benefits in both patient care and administrative efficiencies can be gained by providers, which might include hospitals, physician offices, specialists, public health clinics, long term care providers, behavioral/mental health, military or VA medical facilities. Additionally, tremendous efficiency gains can be obtained by connecting independent laboratories, radiology centers, retail pharmacies, pharmacy benefit managers. Although entities such as Medicare, Medicaid and commercial health plans do not provide patient care, connections to these payers is critical to the success of EHR. Payers must have accurate details on prescriptions requested, lab tests ordered, physician visits completed in order to remit payment. Consequently, payers are frequently the best source of data for historical information that can be compiled from claims history.
More than Just Road Signs
A wide variety of transaction types are being exchanged amongst the community of HIE participants. The most popular documents currently being shared include lab results, medication data, radiology results, emergency care discharge summaries and inpatient diagnoses, procedures and discharge summaries.
In a future post I will provide an update on the growth of HIEs since the passing of the ARRA legislation.
One Response to “ARRA – More than Just Road Signs, Electronic Health Records Too”
[...] the US constitution. So they are proud of being first. DHIN offers an example of the types of benefits that can be achieved through a successful Health Information Exchange. Below are some details that I captured about DHIN during the [...]