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By Robert Hudock, on April 20th, 2009
 Print This PostStimulus Update – HIPAA This alert provides a brief overview of privacy and security provisions included within “The American Recovery and Reinvestment Act of 2009” (H.R.1, S.1) (the “Stimulus”). The Stimulus also includes funding for health information technology (“HIT”) and funding for comparative effectiveness research. These provisions will be the subject of future alerts. Future [...] April 20th, 2009 | Tags: Attorney General, Business Associates, CMP, Culpability, HIPAA, HR 1, Security Breach Notification, SR 1, Stimulus, The American Recovery and Reinvestment Act of 2009 | Category: American Recovery and Reinvestment Act, HIPAA Privacy, HIPAA Security, HITECH Act, Health Information Technology, Health Reform, Privacy Law |
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Print This PostBy Robert Hudock, on April 17th, 2009
Print This PostThe “Health Information Technology for Economic and Clinical Health Act’’ or the ‘‘HITECH Act” (as contained within the American Recovery and Reinvestment Act of 2009 [the “Stimulus”]) will expand the use of health information technology (HIT) and appropriates $250 million for this Fiscal Year for implementing the new HITECH provisions.1 Politicians are now convinced that health care expenditures can be tamed using HIT: Health care expenditures currently make up 16% of the U.S. gross domestic product and are projected to become about 20% of the gross domestic product by 2015.2 The HITECH Act thus offers significant financial incentives to providers for implementing HIT, in particular, electronic health records [...] April 17th, 2009 | Tags: American Recovery and Reinvestment Act of 2009, EHR, EMR, HITECH Act, Incentives | Category: American Recovery and Reinvestment Act, HITECH Act, Health Information Technology, Health Reform |
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Print This PostBy Clayton Nix, on April 11th, 2009
Print This PostBarack Obama signed an executive order on April 8, 2009 to formally lay infrastructure in the executive branch to facilitate health care reform activities. The executive order officially creates the White House Office of Reform (the “Health Reform Office”) and lays out its principle functions, including coordination across executive departments and agencies, outreach activities with state and local policymakers, and working with Congress for the purpose of enacting and implementing health care reform. As we reported on March 6, 2009, Nancy Ann DeParle was selected to be the Director of the Health Reform Office. The order grants DeParle the discretion to work with “established or ad hoc” committees, task forces, or interagency groups. It remains to be seen how DeParle will use this authority to promote the goal of the Obama Administration to have an open, inclusive and transparent process for health care reform. The order also creates the HHS Office of Reform “to coordinate closely” with the White House office. InsideHealthPolicy reports that Jeanne Lambrew is the lead candidate to head the HHS office. Lambrew originally was tapped as the deputy director of the White House office when Tom Daschle was nominated for HHS Secretary and selected for the Health Reform Office in December 11, 2008. Prior to joining the Obama Administration, Lambrew was an associate professor of public affairs at the Lyndon B. Johnson School of Public Affairs at the University of Texas at Austin where she specialized in health care policy.
April 11th, 2009 | Tags: Economics, Health Care Economics, Obama Administration | Category: Uncategorized |
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Print This PostBy Mark Lutes, on April 4th, 2009
Print This PostThe need to change the rate at which health care costs increase (“Bending the Curve”) is axiomatic in the health reform debate. According to the President, Orszag at OMB, Hackbarth at MedPAC, and others, primary tools for this change are payment system changes. While the testimony that has been given in this regard is useful directionally, the organizations and systems thus far identified are largely at a gestational stage and we do not know whether they are far reaching enough to “move the needle” much less “bend the curve”. Seemingly the most fully developed of these notions is the proposal to bundle payment for the majority of facility services occurring within 30 days of a discharge into the DRG. The need for such a proposal was recently revalidated in a New Journal of Medicine article identifying the frequency and high cost of hospital readmissions. Moreover, the CBO and the President’s budget have at least put savings estimates around this program. These estimates are substantial but do not, by themselves, bend the curve materially. Other emerging notions of delivery system innovation to bend the curve include “bonus eligible organizations” and “accountable health organizations”. These innovations return us to familiar, but largely abandoned in practice, managed care territory – incentivization of physicians outside a group practice setting. Of course the success of such programs will depend on the strength of the incentive and that strength (as we learned in IPA model managed care) will be affected by the size of bonus or withhold, the timing of its payment, whether the data is believable and whether the opportunity to collect it is perceived by the physician to be real. Also, the real savings these organizations might achieve will be in lowering the “preference sensitive” care that is subject to wide geographic variations.
Full fledged capitation had potentially the strongest (most effective?) incentives. However, “capitation” carries a lot of media and political baggage so the term is being studiously avoided. That political reality is understandable. However, before we count our budgetary savings, we need to be sure that the alternative methods of payment sufficiently change physician incentives before we can realistically expect to “bend the curve” and can fairly claim the budgetary savings such a change would bring.
April 4th, 2009 | Tags: Cost of Health Care, Economics, Health Care Economics | Category: Uncategorized |
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Health Information Technology Public Utility Act of 2009 Would Facilitate the Adoption of Open Source EMR Solutions
On April 23rd Senator John Rockefeller IV introduced the Health Information Technology Public Utility Act of 2009 to to build upon open the source electronic health record (eleconic medical record) solution developed by the Department of Veterans Affairs (called VistA) and other open source software (e.g. OpenEMR). Unlike proprietary “closed source” software solutions, open source software allows unrestricted access to the source code and does not prohibit the use or re-distribution of [...]