HIMSS: Road to healthcare reform paved by health IT
Lately, healthcare reform and health IT has been a “high-priority legislative issue,” and the Healthcare Information and Management Systems Society (HIMSS) believes that healthcare reform can be enabled by leveraging health IT, explained David W. Roberts, MPA, vice president of HIMSS Government Relations, during a legislative update session of the HIMSS virtual conference on June 9.
Roberts opened the session by offering background on recent healthcare reform efforts, noting the call for action released by HIMSS in December 2008, which proposed the arrangement of a permanent legal Office of the National Coordinator (ONC), the authorization of a federal advisory and coordinating body for health IT and the investment of a minimum of $25 billion in health IT.
“We didn’t just pull this number out of the air,” noted Roberts. “We worked with other organizations to decide what the right investment was regarding health IT for reform…Our call to action to the Obama Administration was that the federal government had to make an investment, or this initiative was not going to succeed."
The first step
The American Recovery and Reinvestment Act of 2009 (ARRA) was the first step in healthcare reform, noted Roberts, explaining that ARRA proposed $2 billion for ONC to begin work on its initiatives. “This office now has the ability to really transform healthcare,” he said.
“Once ARRA passed, people believed the baseline was put in place with incentives to begin working on healthcare reform,” said Roberts. On March 23, Obama signed the Patient Protection and Affordable Health Care Act (HR 3590) into law, which Roberts noted has a “large impact on providers, health plans and employers,” as it restructures Medicare payments and Medicaid disproportionate share hospital allotments, creates state-based health insurance exchanges, prohibits insurance companies from denying coverage to individuals with pre-existing conditions and provides tax credits to small employers to purchase health insurance.
Roberts noted that while it has been estimated that this new legislation will cost $940 billion in first decade, “when you consider the overall size of the U.S. healthcare system, which is almost 20 percent of our gross domestic product, it’s not that large in the grand scheme of things.”
Health IT specifications
Roberts spoke to three particular health IT provisions he selected from within the healthcare reform legislation regarding operating rules and standards, quality healthcare and healthcare IT workforce.
Under the operating rules and standards section of the legislation, one component of the section is administrative simplification, which proposes specific rules for eligibility verification and claims status, as well as how funds can be transferred. “People believed that these operating rules had to be set up in order to make healthcare reform work,” noted Roberts, explaining that this section was included in every piece in the different versions of healthcare reform. Other included requirements in this section of the legislation were enhancement of long term care and health IT enrollment standards and protocols.
The quality healthcare section calls for: the development of new quality measures; requirements to submit quality data; a national strategy to improve healthcare quality; health benefits exchanges; a consumer operated and oriented plan program; the development of accountable care organizations; the expansion of the physician quality reporting initiative through 2014 and a Center for Medicare and Medicaid Innovation. “[The Center for Medicare and Medicaid Innovation] adds an opportunity for CMS to really be involved in how to innovate payment and service delivery models,” he offered.
“One of the big items we’ve heard on Capitol Hill is that there is going to be a health IT workforce shortage,” said Roberts. The healthcare reform legislation addresses health IT workforce provisions, including the need for a national healthcare workforce commission or a federal advisory commission that can coordinate on ideas to bring people into the health IT workforce, as well as address the demands of workers in IT.
Roberts pointed out that from now until 2015, there will be “a lot of opportunities and under the ARRA EHR incentives, there are a number of activities to start beginning to provide incentives for eligible professionals and hospitals to install EHRs.” To help facilities meet these timelines, Roberts encouraged health professionals to attend the 2010 National Health IT Week beginning next week in Washington, D.C.
“Not all the answers are known yet. We are trying to do our best to keep up with all the changes going on and sharing them with everybody,” concluded Roberts. “We encourage you to stay involved.”
Roberts opened the session by offering background on recent healthcare reform efforts, noting the call for action released by HIMSS in December 2008, which proposed the arrangement of a permanent legal Office of the National Coordinator (ONC), the authorization of a federal advisory and coordinating body for health IT and the investment of a minimum of $25 billion in health IT.
“We didn’t just pull this number out of the air,” noted Roberts. “We worked with other organizations to decide what the right investment was regarding health IT for reform…Our call to action to the Obama Administration was that the federal government had to make an investment, or this initiative was not going to succeed."
The first step
The American Recovery and Reinvestment Act of 2009 (ARRA) was the first step in healthcare reform, noted Roberts, explaining that ARRA proposed $2 billion for ONC to begin work on its initiatives. “This office now has the ability to really transform healthcare,” he said.
“Once ARRA passed, people believed the baseline was put in place with incentives to begin working on healthcare reform,” said Roberts. On March 23, Obama signed the Patient Protection and Affordable Health Care Act (HR 3590) into law, which Roberts noted has a “large impact on providers, health plans and employers,” as it restructures Medicare payments and Medicaid disproportionate share hospital allotments, creates state-based health insurance exchanges, prohibits insurance companies from denying coverage to individuals with pre-existing conditions and provides tax credits to small employers to purchase health insurance.
Roberts noted that while it has been estimated that this new legislation will cost $940 billion in first decade, “when you consider the overall size of the U.S. healthcare system, which is almost 20 percent of our gross domestic product, it’s not that large in the grand scheme of things.”
Health IT specifications
Roberts spoke to three particular health IT provisions he selected from within the healthcare reform legislation regarding operating rules and standards, quality healthcare and healthcare IT workforce.
Under the operating rules and standards section of the legislation, one component of the section is administrative simplification, which proposes specific rules for eligibility verification and claims status, as well as how funds can be transferred. “People believed that these operating rules had to be set up in order to make healthcare reform work,” noted Roberts, explaining that this section was included in every piece in the different versions of healthcare reform. Other included requirements in this section of the legislation were enhancement of long term care and health IT enrollment standards and protocols.
The quality healthcare section calls for: the development of new quality measures; requirements to submit quality data; a national strategy to improve healthcare quality; health benefits exchanges; a consumer operated and oriented plan program; the development of accountable care organizations; the expansion of the physician quality reporting initiative through 2014 and a Center for Medicare and Medicaid Innovation. “[The Center for Medicare and Medicaid Innovation] adds an opportunity for CMS to really be involved in how to innovate payment and service delivery models,” he offered.
“One of the big items we’ve heard on Capitol Hill is that there is going to be a health IT workforce shortage,” said Roberts. The healthcare reform legislation addresses health IT workforce provisions, including the need for a national healthcare workforce commission or a federal advisory commission that can coordinate on ideas to bring people into the health IT workforce, as well as address the demands of workers in IT.
Roberts pointed out that from now until 2015, there will be “a lot of opportunities and under the ARRA EHR incentives, there are a number of activities to start beginning to provide incentives for eligible professionals and hospitals to install EHRs.” To help facilities meet these timelines, Roberts encouraged health professionals to attend the 2010 National Health IT Week beginning next week in Washington, D.C.
“Not all the answers are known yet. We are trying to do our best to keep up with all the changes going on and sharing them with everybody,” concluded Roberts. “We encourage you to stay involved.”