How do efforts to meet federally established requirements for Meaningful Use of electronic health records (EHRs) relate to the formation of accountable care organizations (ACOs)?
Both are the focus of major initiatives aimed at changing the way health care is delivered in our nation. And both are rooted in different mammoth pieces of legislation—the Health Information Technology for Economic and Clinical Health (HITECH) Act, enacted as part of the American Recovery and Reinvestment Act (ARRA) of 2009, and the Patient Protection and Affordable Care Act (ACA), respectively.
Some recent developments have made the connection between these two initiatives clearer.
On Feb. 11, the Meaningful Use Workgroup (MUWG) issued a presentation covering its Meaningful Use Stage 3 draft recommendations. The presentation includes over two dozen requirements. Of course, not all of them will find their way into the proposed rule, which the Health IT Policy Committee (HITPC) is expected to issue later this year, and even fewer will make it into the final rule, which is slated for release in the spring of 2015. What is clear is that the HITPC has asked the MUWG to focus on four areas—clinical decision support, patient engagement, care coordination, and population health management. This direction on focus areas provides, arguably for the first time, a clear and explicit link between the MU program and both ACOs and other healthcare delivery reforms that support fee-for-value.
The linkage between Meaningful Use and ACOs was also evident in the messaging and vision casting that National Coordinator for Health IT Karen DeSalvo and CMS Administrator Marilyn Tavenner shared in their keynote addresses on Feb. 27 at HIMSS14 in Orlando, Fla.
In addition, a piece of legislation currently being considered in Congress, H.R. 4015, the SGR (Sustainable Growth Rate) Repeal and Medicare Provider Payment Modernization Act of 2014, seeks to consolidate certain healthcare delivery reforms and programs. In addition to resolving the longstanding SGR conundrum by stabilizing the physician fee schedule’s annual updates for the next 10 years and beyond, H.R. 4015 also brings together three Medicare quality payment programs, including Meaningful Use of EHRs, and it provides strong financial incentives for ACOs and other Alternative Payment Models.
Simply put, Meaningful Use of EHRs provides one of the numerous infrastructural building blocks needed for ACOs to carry out effective population health management. Bringing together these two significant changes to the way health care is delivered brings to mind former National Coordinator for Health Information Technology David Blumenthal’s vision of “an electronic circulatory system for health information that nourishes the practice of medicine, research and public health, making healthcare professionals better at what they do and the American people healthier” (New England Journal of Medicine, Dec. 30, 2009).
Ken Perez is vice president of healthcare policy for Omnicell, Inc., in Mountain View, Calif.
Publication Date: Wednesday, March 12, 2014