HHS Will Bolster Data Sharing To Achieve Alternative Payment Goals

January 27, 2015 in News

On Monday, HHS announced an initiative to shift to alternative payment models for Medicare reimbursements, while leveraging IT to track efforts and achieve goals, Health Data Management reports (Goedert, Health Data Management, 1/26).

Initiative Details

Writing in the New England Journal of Medicine, HHS Secretary Sylvia Mathews Burwell outlined the major goals for the Medicare system in the coming years. She wrote that HHS will seek to have:

  • 30% of Medicare payments for hospitals and physicians through alternative payment models such as accountable care organizations and bundled payments by the end of 2016;
  • 50% of Medicare payments through alternate payment models by the end of 2018;
  • 85% of Medicare hospital fee-for-service payments tied to quality or value by the end of 2016; and
  • 90% of Medicare hospital fee-for-service payments tied to quality or value by the end of 2018 (Demko, Modern Healthcare, 1/26).

“This is the first time in the history of the Medicare program that HHS has set explicit goals for alternative payment models and value-based payments,” according to an HHS release (HHS release, 1/26).

To help achieve the above goals, Burwell wrote that the Obama administration aims to accelerate the availability of health data.

She wrote, “The Obama administration has led a major initiative in [health IT], focusing on the adoption of electronic health records and their meaningful use as a central avenue for transforming care,” adding, “Ongoing efforts will advance interoperability through the alignment of health IT standards and practices with payment policy so that patients’ records are available when needed at the point of care to permit informed clinical decisions to be made in a timely fashion” (Burwell, NEJM, 1/26).

During a call with reporters, National Coordinator for Health IT Karen DeSalvo said, “These are all interrelated parts.” She added, “We can’t just provide payment. We have to provide the right information support, and those payment supports in turn have to point back to advancing electronic health information adoption.”

Reaction

Despite the calls to accelerate health IT use, experts appear split on whether the industry is ready to leverage health IT in an effective way to spur payment reforms.

Marci Nielsen, CEO of the Patient Centered Primary Care Collaborative, said, “The payment reform piece can’t be dealt with until the interoperability piece is better managed.”

In regards to big data analysis, Devin Jopp, CEO of the Workgroup for Electronic Data Interchange, said, “While there are a lot of institutions that are moving on this, there’s certainly a lot more needs to happen.”

Doug Fridsma — president of the American Medical Informatics Association and a former Office of the National Coordinator for Health IT official — noted that payment policies and more advanced use of technology will need to develop together. He said, “Failure to look either at policy or IT in a strategic way could likely lead to the failure of both” (Pittman, Politico Pro, 1/26).

Meanwhile, Alice Borrelli, director of health care policy for Intel, praised the announcement, saying “As an employer, Intel is working with health care delivery systems to redesign payment models and leverage technology in ways that maintain our employees’ coverage while improving their health through a connected care experience.” Borrelli added, “We look forward to working with the department to share our experiences in building the foundation for integrated care” (Evans/Demko, Modern Healthcare, 1/26).

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