Tuesday, April 13, 2010

Healthcare Reform and HIT

I recently planned a speaking engagement and was warned to avoid healthcare reform commentary - too controversial and too emotionally charged.

Regardless of your politics, some aspects of healthcare reform are not controversial. Here's a list of health information technology tactics included in healthcare reform.

Accountable Care Organizations (ACO)- No later than January 1, 2012, the Secretary is required to establish a shared savings program that would reward ACOs that take reasonability for the costs and quality of care received by their patient panel over time. The bill requires ACOs to “define processes to promote evidence-based medicine and patient engagement, report on quality and cost measures, and coordinate care, such as through the use of telehealth, remote patient monitoring, and other such enabling technologies.” (Sec. 3022)

Independence at Home Demonstration Project- The bill creates a new demonstration program to begin not later than January 1, 2012, for chronically ill Medicare beneficiaries to test a payment incentive and service delivery system that utilizes physician and nurse practitioner directed home-based primary care teams aimed at reducing expenditures and improving health outcomes. It also defines an “independence at home medical practice” as one that “uses electronic health information systems, remote monitoring, and mobile diagnostic technology.” (Sec. 3024)

Community Health Teams to Support the Medical Home- The bill directs the Secretary to establish a program to provide grants to or enter into contracts with eligible entities that can establish community-based interdisciplinary, inter-professional teams to support primary care practices, including obstetrics and gynecology practices, within the hospital services areas served by the entities. It also requires the health teams to “support patient-centered medical homes” defined as a “mode of care that includes. . .safe and high-quality care through evidence-informed medicine, appropriate use of health information technology, and continuous quality improvements.” (Sec. 3502)

State Option to Provide Health Homes for Individuals with Chronic Conditions in Medicaid- The bill creates a new Medicaid state plan option under which enrollees with at least two chronic conditions, or with one chronic condition and at risk of developing another, or with at least one serious and persistent mental health condition, could designate a provider, a team of health care professionals, or a health team as their health home. States will also include in their state plan amendments “a proposal for use of health information technology in providing health home services under this section and improving service delivery and coordination across the care continuum (including the use of wireless patient technology to improve coordination and management of care and patient adherence to recommendations made by their provider).” (Sec. 2703)

Here's a great summary of healthcare reform and its IT implications by Bill Bernstein at Manatt, Phelps & Phillips, LLP.

It's time to put aside the emotion and begin the work of planning IT as funded and supported by healthcare reform. Reform is built on a foundation of meaningful use, so I see this effort as part of single plan incorporating Healthcare Reform and Healthcare IT Reform!


Anonymous said...

Was this planned speaking event at Babson? I hope you will still speak as I am attending this event and looking forward to hearing you.

I would like to hear what you have to say about healthcare reform and any other areas that you believe are important to share with others. Free speech.

John Halamka said...

Unrelated to Babson!