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E Health Update CMS Perspective. Betsy L. Thompson, MD, DrPH Chief Medical Officer CMS, Region IX November 10, 2010. An Unsustainable Status Quo. 46 51 million uninsured Americans Health insurance premiums for family coverage at a small business increased 85% since 2000

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e health update cms perspective

E Health UpdateCMS Perspective

Betsy L. Thompson, MD, DrPH

Chief Medical Officer

CMS, Region IX

November 10, 2010

an unsustainable status quo
An Unsustainable Status Quo
  • 4651 million uninsured Americans
  • Health insurance premiums for family coverage at a small business increased 85% since 2000
  • 16%17.3%of our economic output tied up in the health care system
  • Without reform, by 2040, 1/3 of economic output tied up in health care--15% of GDP devoted to Medicare and Medicaid
  • Without reform, the number of uninsured would grow to 58 million in 2020*

*Source: Urban Institute: “The Cost of Failure to Enact Health Reform: 2010-2020” March 15, 2010

practice variation
Practice Variation

Source: http://www.dartmouthatlas.org/atlases

the triple aim goals of cms
The Triple Aim Goals of CMS
  • Better Care
    • Patient Safety
    • Quality
    • Patient Experience
  • Reduce Per Capita Cost
    • Reduce unnecessary and unjustified medical cost
    • Reduce administrative cost thru process simplification
  • Improve Population Health
    • Decrease health disparities
    • Improve chronic care management and outcome
    • Improve community health status
cms quality improvement roadmap
CMS’ Quality Improvement Roadmap

Vision: The right care for every person every time through care that is:

  • Safe
  • Effective
  • Efficient
  • Patient-centered
  • Timely
  • Equitable
value driven care
Value Driven Care
  • Goal: Transformation from passive payer to active purchaser of higher quality, more efficient health care
  • Tools: measurement, payment incentives, public reporting, conditions of participation, coverage policy, Quality Improvement Organizations

Source: Jha A, DesRoches C, Campbell E, Donelan K, Rao S, Ferris T, Shields A, Rosenbaum S, Blumenthal D. “Use of Electronic Health Records in U.S. Hospitals”. New England Journal of Medicine: 360;16. April 16, 2009.

federal government responds hitech act
Federal Government Responds: HITECH Act
  • Part of American Recovery and Reinvestment Act of 2009 (ARRA)
  • Goal: Every American to have an EHR by 2014
  • Systematically addresses major barriers to adoption and Meaningful Use:
    • Money/market reform
    • Technical assistance, support, and better information
    • Health information exchange
    • Privacy and security
slide10

HITECH: How the Pieces Fit Together

Regional Extension Centers

Workforce Training

ADOPTION

Improved Individual &

Population Health

Outcomes

Increased

Transparency &

Efficiency

Improved

Ability to Study &

Improve Care Delivery

Medicare and Medicaid

Incentives and Penalties

MEANINGFUL USE

State Grants forHealth Information Exchange

Standards & Certification Framework

Privacy & Security Framework

EXCHANGE

Health IT Practice Research

10

health care delivery system transformation

Clinical Care

Knowledge

Barrier

Health Care Delivery System Transformation

Enhancing

Health System Performance

Competencies

Adoption of Health Information

Technology

Transformation Barrier

Integrated

Care

Infrastructure

Barrier

Accountable

Care

Episodic/

Uncoordinated

Personalized

Health Care

Management

summary
Summary
  • We live in exciting times
  • Transformation is built on quality and value
    • Meaningful use of EMRs
    • All of us working together
  • Many opportunities and challenges ahead

12

ehr resources
EHR Resources
  • Get information, tip sheets and more at CMS’ official website for the EHR incentive programs:

www.cms.gov/EHRIncentivePrograms

  • For more about MU measures:

http://www.cms.gov/QualityMeasures/03_ElectronicSpecifications.asp#TopOfPage

  • Learn about certification and certified EHRs, as well as other ONC programs designed to support providers as they make the transition:

http://healthit.hhs.gov

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