CMS and HIT Adoption (Text Version)

---

On September 15, 2009, Tony Trenkle made this presentation at the 2009 Annual Conference. Select to access the PowerPoint® presentation (748 KB).

---

Slide 1

CMS and HIT Adoption

Tony Trenkle
Director
Office of E-Health Standards and Services
Centers for Medicare & Medicaid Services

Slide 2

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

 

Slide 3

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.

 

Slide 4

Demos and Pilots

• DOQ-IT
  • QIO 8 th 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)

 

Slide 5

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

 

Slide 6

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

 

Slide 7

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

 

Slide 8

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