HIMSS14 Speakers Address Health Costs, Federal Health IT Efforts

February 25, 2014 in News

Wasteful health care spending should be the focus of “our policy decisions, our solutions, our IT,” Aetna Chair, President and CEO Mark Bertolini told attendees during his keynote address on Monday at the Healthcare Information and Management Systems Society Convention and Exhibition, Healthcare IT News reports.

Bertolini estimated that the U.S. health system has about $800 billion in wasteful spending each year (Monegain, Healthcare IT News, 2/25).

Bertolini noted that health insurance premiums in the U.S. have grown at nearly four times the rate of inflation. He said, “Consumers are paying 50% of the increases in costs in premium increases and benefit changes” (Conn [1], Modern Healthcare, 2/24).

He argued that health care spending “can’t keep increasing. We can’t afford it.” Health care costs will soon “consume all of our personal disposable income,” Bertolini predicted (Slabodkin, Health Data Management, 2/24).

According to Bertolini, there are three ways to improve health care:

  • Reform payment systems;
  • Improve care for chronically ill patients; and
  • Invest in overall wellness.

“We need to empower our customers to take control of their health care through digitally empowered tools,” Bertolini said (Conn [1], Modern Healthcare, 2/24).

He added, “The system needs to change its focus on individuals so the hospitals and health systems can make them better. They need to be connected to technology” (Pedulli, Clinical Innovation and Technology, 2/24).

CMS Officials Respond To Calls for Greater ‘Flexibility’

Meanwhile, Robert Tagalicod, director of the Office of E-Health Standards and Services at CMS, on Sunday suggested that CMS Administrator Marilyn Tavenner might address concerns over ICD-10 implementation and Stage 2 meaningful use rules later this week, Modern Healthcare reports (Conn [2], Modern Healthcare, 2/24).

U.S. health care organizations are working to transition from ICD-9 to ICD-10 code sets to accommodate codes for new diseases and procedures. The switch from ICD-9 to ICD-10 code sets means that health care providers and insurers will have to change out about 14,000 codes for about 69,000 codes.

In August 2012, HHS released a final rule that officially delayed the ICD-10 compliance date from Oct. 1, 2013, to Oct. 1, 2014, partially to look at the incremental changes needed in reforming health care (iHealthBeat, 2/20).

Speaking at a preliminary event Sunday before the start of HIMSS14, Tagalicod said, “We’ve heard the word ‘flexible,’” adding, “We understand … the burden that is out there. We hear about meaningful use.”

Under the 2009 federal economic stimulus package, health care providers that demonstrate meaningful use of certified electronic health record systems can qualify for Medicaid and Medicare incentive payments.

Tagalicod indicated that concerns from CIOs might be addressed in Tavenner’s upcoming speech, which is scheduled for Thursday. He said, “Hopefully, between now and then, some of the discussion we are having now and some on the subjects that fall under the rubric of relief may be a little clearer” (Conn [2], Modern Healthcare, 2/24).

ICD-10 Delay Not ‘Being Considered’

In related news, Matthew Albright, director of CMS’ Office of E-Health Standards and Services Administration Simplification Group, said the agency is not considering a further delay to ICD-10 implementation, Clinical Innovation and Technology reports.

In an interview with Clinical Innovation and Technology, Albright said that cost estimates for ICD-10 mostly represent funds that have already been spent, meaning that further delays to the program will not alleviate much of the burdens providers are feeling (Walsh, Clinical Innovation and Technology, 2/24).

OCR Warns Industry To ‘Pay Attention’ to HIPAA Details

Those in the health IT industry should “pay attention” to the details of changes to HIPAA that took effect this year, Susan McAndrew, deputy director for health information privacy at HHS’ Office of Civil Rights, said Monday, Healthcare IT News reports.

Speaking at a HIMSS14 session on HIPPA, McAndrew reviewed changes and enforcement actions taken in 2013 and forecasted OCR’s plans for 2014. She noted that the agency would heavily focus on HIPAA enforcement and compliance (Miliard, Healthcare IT News, 2/24).

Fridsma Says ‘Jury Still Out’ on MU Stage 2 Progress

Health care providers have made “good progress” on adopting Stage 1 of meaningful use standards, but the “jury is still out” on the Stage 2 progress, according to Doug Fridsma, chief science officer at the Office of the National Coordinator for Health IT and director of its Office of Science and Technology, Health Data Management reports.

Fridsma also focused on the importance of interoperability. He noted that “the standards and interoperability framework” is “a way for us to invest in where the bottlenecks are to achieving consensus and getting people together to solve some of these really hard challenges that we’ve got” (Slabodkin [1], Health Data Management, 2/23).

FDA’s Patel Responds to Criticism Over Mobile App Regs

FDA senior policy adviser Bakul Patel, speaking at a HIMMS14 pre-conference symposium, defended the agency’s final guidance on mobile medical applications that was released last September, Health Data Management reports.

Patel said that FDA’s oversight of the apps is “risk based” and focuses on a narrow subset of applications that could present the largest health risks to consumers. He said the final guidance “limits” FDA’s “focus and oversight on things that really matter,” leaving the vast majority of apps free of active FDA oversight (Slabodkin [2], Health Data Management, 2/23).

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