What did not happen in health care reform is happening in healthcare IT reform — Bi-Partisan Support. One letter contained Senatorial signatures ranging from Al Franken to John Thune (I never thought I would be using these two names in a healthcare IT blog post!). Although they are from neighboring states, they are on different ends of the political spectrum.
So, what is uniting this diverse group of 27 US Senators on Meaningful Use? In a letter to Charlene Frizzera, Acting Administrator at the Centers for Medicare and Medicaid Services (CMS), they offered comments and clarifying HITECH/ARRA points on the proposed rules driving Meaningful Use. The highlights from the esteemed colleagues from both sides of the aisle include:
- The definition of Meaningful Use is deemed too restrictive, resulting in many hospitals, especially rural and safety-net providers, not being able to participate in the incentives.
- Give hospitals more time to comply, extending the transition time so that the 23 separate EHR objectives and requirements can be met.
- Provide “flexibility” in the early years so that hospitals and physicians have time to gain access to the full incentive benefits.
- Critical Access Hospitals should not be excluded from the Medicaid incentive program.
- Delay electronic reporting of quality measures through EHRs – wait until EHRs can deliver on these requirements.
- Re-define a hospital-based physician (don’t exclude physicians practicing in outpatient centers and clinics which may be owned by the hospital system).
- Modify the scope of services it considers to be outpatient hospital services — don’t physicians practicing in hospital ambulatory sites.
- The Medicare provider number should not be used to determine hospitals for EHR incentives, especially since one number may include multiple hospitals. In other words, each hospital within a system should be eligible for EHR incentive payments.
- Provide direction to states on how to make the incentive payments — keep the funds focused on health IT implementation; don’t let the states stray from that goal.
If you parse through this letter, there are several intriguing elements to it.
First, the summary comments are remarkably similar to the many healthcare trade associations who have commented on both the healthcare standards IFR and the Meaningful Use NPRM. (Read an overview of their Meaningful Use NPRM and Healthcare Standards IFR comments.) The various trade associations are doing their job in leveraging their relationships with various congressional leaders. This is not a bad thing; it’s part of our political and legislative process.
Second, these Senators want to ensure the rural and safety-net providers are not overlooked in the incentive payments, and they want the opportunity for hospitals within a system to maximize their EHR adoption plans and, accordingly, their incentive participation. The same applies to the number of physicians who are eligible to partake. Again, this is not a bad thing. If we really want to drive a more electronic, interoperable, efficient, high quality, and meaningful health care system, then the more hospitals and physicians making the change, the more likely the opportunity for success.
OK, so we had bi-partisan support on the letter to CMS, but no bi-partisan support on the letter to Health & Human Services Secretary, Kathleen Sebelius. I am not sure why, since the content is similar. I guess we are no longer in Kansas. The letter to CMS was more detailed than the letter to the HHS, so maybe that was the deciding factor.
That wait is on for the next step to our new, new HITECH world of health care and healthcare IT!
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