This week in health IT: MU, HIPAA

It doesn’t appear that anyone working in the federal government is slowing down this summer. The debate surrounding Meaningful Use rages on, including a new Senate hearing, and a new survey indicates a vastly different EHR market in just a few years. Meanwhile, we covered a huge breach and substantial fine for HIPAA violations.

In the first of a series of Senate Finance Committee hearings planned on health IT, witnesses Farzad Mostashari, MD, ScM, national coordinator for health IT and Patrick Conway, chief medical officer and director, Center for Clinical Standards and Quality and acting director, Center for Medicare and Medicaid Innovation, reported on progress of the Meaningful Use (MU) program and advised against temporarily halting it.

The hearing came three months after six Republican senators—Sens. Alexander Lamar (Tenn.), John Thune (S.D.), Pat Roberts (Kan.), Richard Burr (N.C.), Tom Coburn (Okla.) and Michael Enzi (Wyo.)—released a white paper calling to pause the program to address interoperability concerns and re-examine current procedures put in place to safeguard and ensure meaningful use of EHRs prior to forging ahead with Stages 2 and 3.

“I do not want progress stalled on implementing technology, but if we ignore problems along the way, we’ll end up further behind,” said Sen. Orrin Hatch (R-Utah).

“A pause in the program would stall the progress that has been hard fought,” said Mostashari, saying that there is sufficient movement for Stage 2 to move ahead. “We need to meet the urgency of the moment for the transformation of healthcare. A pause would take the momentum away from the progress.”

Also this week, the Centers for Medicare & Medicaid Services (CMS) released new data to demonstrate how EHRs are helping improve patient care through electronic prescribing, reminders and safety alerts.

CMS also announced positive and promising results from the first performance year of the Pioneer Accountable Care Organization (ACO) Model, including higher quality care and lower Medicare expenditures. But, seven of the ACOs will switch to a different ACO model and two will drop out entirely.

Costs for the more than 669,000 beneficiaries aligned to Pioneer ACOs grew by only 0.3 percent in 2012 while costs for similar beneficiaries grew by 0.8 percent in the same period. Thirteen out of 32 Pioneer ACOs produced shared savings with CMS, generating a gross savings of $87.6 million in 2012 and saving nearly $33 million to the Medicare Trust Funds. Pioneer ACOs earned more than $76 million by providing coordinated, quality care. Only two Pioneer ACOs had shared losses totaling approximately $4 million. Program savings were driven, in part, by reductions that Pioneer ACOs generated in hospital admissions and readmissions.   

All 32 Pioneer ACOs successfully reported quality measures and achieved the maximum reporting rate for the first performance year, with all earning incentive payments for their reporting accomplishments. Overall, Pioneer ACOs performed better than published rates in fee-for-service Medicare for all 15 clinical quality measures for which comparable data are available.

On the privacy and security front, the biggest data breach to date may have occurred in Texas. Texas Health Harris Methodist Fort Worth is notifying some 277,000 patients that their protected health information was compromised after hospital microfilms, which were supposed to be destroyed, were found in various public locations.

According to reports, Texas Health Fort Worth had contracted with Toronto-based Shred-it to destroy the confidential patient information, but the microfilms were not actually destroyed, as directed in the contract. Instead, a local resident found a portion of the microfiche in a nearby park in May. Additionally, three other sheets of microfiche were found in two other public areas.

And, HIPAA violations will cost insurer WellPoint $1.7 million in fines. The organization was charged with HIPAA violations after it left the names, Social Security numbers and personal health information of more than 600,000 individuals accessible over the internet.

HHS’ Office for Civil Rights said the potential HIPAA violations were due to WellPoint not establishing appropriate administrative and technical safeguards in its online application database.

Do any of these developments have any effect on your Meaningful Use and privacy and security efforts? Please share your thoughts.

Beth Walsh

Clinical Innovation + Technology editor