ONC: no caps on per-provider EHR incentive payments

National Coordinator for Health IT Farzad Mostashari has announced there is no cap on how much individual providers may receive in meaningful use incentive payouts, as long as they meet the requirements for the EHR incentive payments program.  According to the ONC, almost seven billion of the approximately twenty billion dollars in incentives allocated under the HITECH Act has already been distributed.

Via Healthcare IT News:

WASHINGTON – There are no set appropriations for how much the federal government can spend on rewarding providers who adopt and use electronic health records under the Medicare and Medicaid meaningful use EHR incentive program, according to National Coordinator for Health IT Farzad Mostashari, MD.

"Whoever qualifies, gets paid; there's no hard cap," said Mostashari, who gave a keynote at the Annual Policy Summit for the Health Information Management and Systems Society (HIMSS) on Wednesday.

Mostashari said the federal government estimates it will pay out around $20 billion in incentives before the program shifts to a penalty in 2015, but there is no fixed budget set in the HITECH Act that mandated the program. The government recently announced it has paid out nearly $7 billion since the program began in 2011.

[See also: "Government EHR incentives near $7B."]
 

The federal health IT czar said he couldn't imagine health IT advancement – which enjoys widespread bipartisan support – losing the backing of Congress after the election, no matter the party in control.

It would be hard to picture Congress cutting or capping the program after doctors and hospitals have made major investments in health IT "on the good word of Congress," he said.

An attendee of the HIMSS Policy Summit – a sort of pep rally for HIMSS members to promote HIT on the Hill – recommended that Congress all be encouraged to use Blue Button to access their personal health data. This would "crystallize quite clearly" where things stand with regard to health IT today. We need more time and support, the attendee said, and Mostashari and other attendees agreed.

Mostashari praised the meaningful use incentive program, noting that "we've made great steps." He predicted that Stage 2, set to begin in 2014, will bring about even more "incredible progress."

The use of electronic health records is "ultimately about population health," Mostashari said. "You have to care more about the people who didn't walk into your door, than those who did." The meaningful use program is intended to go from measuring quality at the start, to accounting for population health. "That's why doctors are doing what they're doing, [and] that's why we're doing what we're doing," he said of federal regulators.

At a visit to the Cleveland Clinic recently, Mostashari said he observed health data exchanged between the clinic and other local facilities, using compatible coding that transferred the data easily. "They do it all day, every day," he said. "So don't tell us that exchange isn't happening."

[See also: "Stage 2 MU released at last."]

Two years ago, the industry wasn't there, he said of health information exchange. The patient information wasn't packaged and ready to code medications and lab reports in the same record. But things have changed, Mostashari added. He praised the industry and the  marketplace for pushing it forward.

The industry came together with a consensus and pilots and working groups, which resulted in the meaningful use Stage 2 rule, Mostashari said. "We're light years ahead of where we could possibly have been in Stage 1," he added, noting that he believes meaningful use Stage 2 will necessitate a push from the industry for health information exchange standards.

It will be important in the near future to tap into "the biggest underused resource – the patient," Mostashari said. Providers will have to "be sticky," and attract patients to their services because patients will no longer be limited to the provider that holds their health information.

Said Mostashari, speaking to doctors as a doctor: "We have to make them want to come to us."

By Diana Manos, Senior Editor

Mostashari: No cap on EHR incentive payouts,” Healthcare IT News (September 13, 2012)

Advisory panel submits recommendations to HIT Policy Committee regarding health data exchanges

On August 19, 2010, the "tiger team" advisory panel submitted a letter to the HIT Policy Committee, established pursuant to the HITECH Act, proposing new safeguards for personally identifiable information on health information exchanges.  Via Bloomberg Business Week:

The recommendations were developed in response to a specific set of privacy-related questions raised by the Office of the National Coordinator for Health Information Technology. They touch upon and clarify topics such as patient consent and the use of third-party service providers in the exchange of personally identifiable health information.

<...> One of the bigger recommendations relates to patient consent. The direct exchange of electronic patient data between health providers for treatment purposes does not require any additional patient consent, the panel noted. The same rules that apply to paper or faxed exchanges of health information should apply in the electronic realm as well.

HIT Policy Committee will have to review and approve the proposed safeguards.  You can read more about the proposed standards after the jump, and can read the letter in full by clicking here.

 

Bloomberg Business Week described some of the proposed safeguards:

However, any data exchange that involves a third-party does require specific and "meaningful" patient consent, the letter noted. Any such consent also needs to be transparently and easily revocable by the patient at any time, the panel said.

The letter also recommended further exploration of technologies that allow individuals to exercise more granular control over the data for instance permitting the exchange of certain kinds of health data, but not all.

Third-party service organizations should also not be allowed to collect, use or share personal health data for any purposes other what's specified in their service agreements, the panel recommended.

Third parties should also be required to retain personal health data only for as long as it is reasonably needed and should then be required to destroy the data, the panel said.

All third parties having access to patient health information also need to comply with the privacy and security requirements of HIPAA.

"Panel drafts privacy recommendations for health data exchanges," Bloomberg Business Week (August 19, 2010).