WASHINGTON | January 6, 2014
With Congress working on a long-term Medicare “SGR fix” in the recent short-term budget deal, lawmakers laid down seeds for addressing issues such as value-based reimbursement and EHR interoperability.
The House and Senate bills also revisit the HITECH Act. Senators John Thune and Mike Enzi, Republicans from South Dakota and Wyoming, added an amendment requiring “interoperability to be achieved by 2017 to be meaningful user under the Electronic Health Record Meaningful Use program,” with rules established via federal committee under the direction of the HHS Office of the National Coordinator.
Senator John Cornyn, a Republican from Texas, added a more specific and different amendment, directing HHS to adopt a common interoperability standard by 2017, as part of the rules for Meaningful Use Stage 3.
See also: [Stage set for big interoperability push.]
Members of the House Energy and Commerce Committee added similar provisions to their version of the SGR bill and also issued a report outlining their visions for health information technology, pointing out the connections between interoperability and quality and cost improvements.
Senator Mike Enzi“While technology has begun to change the way doctors provide care and patients engage in their health, we must recognize that these technologies will be unable to truly transform our health system unless they can easily locate and exchange health information,” the members wrote. “For this effort to be successful, however, more must be done to bolster interoperability. The Administration, acting through the Office of the National Coordinator for Health IT, must provide appropriate guidance to providers and to industry on its vision for interoperability and work to engage all stakeholders in adoption of those systems.”
The committee suggested that HHS adopt interoperability standards that “allow every healthcare provider to access and use longitudinal data on the patients they treat to make evidence-based decisions, coordinate care, and improve health outcomes as quickly as possible.”
With many payment reforms riding on information exchange, interoperability by 2018 “is reasonable,” they said, and “should be the highest priority for ONC in order to enable healthcare providers to measure, report, track, and perform on the quality measures and payment updates required by this legislation.”
[See also: Chasing the tail of interoperability.]
The timelines proposed for meaningful use fit within similar requirements Congress set for VA and DoD military health interoperability in the Defense Authorization Act, which even withholds some project funds until the agencies offer a plan for intergrated or interoperable systems.
The House and Senate attached riders to the budget, offering a three-month delay of the dreaded Medicare sustainable growth rate payment adjustment widely expected to be signed by President Obama.
The measure is billed as a bridge to more permanent solutions, if Congress and the President can find a compromise on certain matters this spring. With a 0.5 percent payment update instead of a 24 percent cut scheduled under the SGR, it give physicians a reprieve and time to build support for new ideas.
Among the amendments tacked onto the Senate bill are provisions for new integrated mental and behavioral health demonstrations, an increase in medical residency slots, and a mechanism for HHS to set aside funds for a stop-loss program to support hospitals seeing declines from the disproportionate share hospital program.