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CMS and HIT Adoption. Tony Trenkle Director Office of E-Health Standards and Services Centers for Medicare & Medicaid Services. CMS-The Numbers. Medicare provides health insurance to approximately 45 million beneficiaries

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Cms and hit adoption

CMS and HIT Adoption

Tony Trenkle

Director

Office of E-Health Standards and Services

Centers for Medicare & Medicaid Services


Cms the numbers
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


Hit adoption
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.


Demos and pilots
Demos and Pilots

  • DOQ-IT

    • QIO 8th 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)


Demos and pilots1
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


Other drivers
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


Hitech
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


Challenges
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


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