February 3, 2012 - Advocacy Corner
CBO Foresees Rapid Increase in Deficits, Health Spending Over Next Decade
Washington was abuzz this week with the release of the Congressional Budget Office (CBO) 2012 outlook.
According to the annual report, CBO’s regular baseline (which is set based on current law) would result
in $3 trillion of accumulated deficits from 2013 through 2022. However, CBO also constructed an alternative
scenario, based largely on extending Bush-era tax cuts and repealing mandatory sequestration cuts. Observers
agree these options are more politically appealing, but extending tax breaks and sidestepping sequestration
would result in nearly $11 trillion in additional deficits over that period, CBO said. For those of us in the
healthcare world, the CBO revised cost estimates of the “doc fix,” estimating it would take $316 billion to
correct the sustainable growth rate formula for Medicare reimbursement. As for general spending on Medicare
and Medicaid, CBO foresees those programs climbing to $1.8 trillion – or about 7 percent of the entire
economy – by 2022. The budget office expects Medicare spending to rise 90 percent between now and 2022 — a
nd that’s assuming Congress signs off on Medicare cuts to physicians.
Talk of a permanent “doc fix,” was also buoyed by the CBO report, due to an accounting of how much the
drawdowns in Iraq and Afghanistan could save. Troop withdrawls would save $838 billion over 10 years,
CBO says, leading many Democrats (and a growing amount of Republicans) to argue for a partial SGR fix.
According to Senate Minority Whip Jon Kyl (R-Ariz.) he believes the pay-for is “quite likely to happen” –
though his plan would use $191 billion in war savings to pay off SGR debt, not the full $316 billion that
includes several years of physician payment increases. Negotiations between House and Senate leaders on how
to handle the doc fix continues next week, but they agree that a permanent solution must be found for the
flawed Medicare physician reimbursement system – or at a minimum the formula should be repealed while lawmakers
continue to search for a fix.
CMS Updates MU Payment & Reporting Period FAQs
The Centers for Medicare & Medicaid Services this week updated previously posted FAQs on topics
related to reporting periods, incentive payments and other topics. CMS highlighted five FAQs, to
provide clarity on issues including how long after attestation a hospital can expect payment and an
updated table explaining the reporting periods based off four scenarios. For updated answers to “How
and when will incentive payments be made,” click here. Or to learn more about the EHR reporting periods
for eligible hospitals participating in both the Medicare and Medicaid EHR Incentive Programs, click here.
For all 191 FAQs published by CMS on Meaningful Use, click here.
Legislation & Politics
AHIMA Enters ICD-10 Fray; AMA Lobbies Secretary Sebelius
The American Health Information Management Association (AHIMA) defended against calls to delay implementation
of ICD-10 this week. In response to increased pressure from the AMA to halt the required implementation of
ICD-10, AHIMA said providers who stop implementations to see what actions Congress takes may regret the decision.
AHIMA vice president for advocacy and policy Dan Rode urged the healthcare community to continue preparing for the
transition, calling it central to the US healthcare system moving forward. “The move to ICD-10-CM/PCS is at the
foundation of healthcare information changes underway in the United States,” Rode said. “Without ICD-10 data,
there will be serious gaps in our ability to extract important patient health information that will give physicians
and the healthcare industry measures for quality of care, provide important public health surveillance, support
modern-day research, and move to a payment system based on quality and outcomes.”
MGMA Renews Calls for 5010 Delay
In addition to sending a letter to House Speaker John Beohner, AMA executive vice president and CEO Dr. James Madara
sent a similar plea to HHS Secretary Sebelius. “On behalf of the physician and medical student members of the AMA,
I am writing to urge you to immediately halt the Health Insurance Portability and Accountability Act (HIPAA) required
implementation of ICD-10, and re-evaluate the penalty program timelines associated with the number of Medicare health
IT programs underway today,” Madara wrote.
The Medical Group Management Association wrote a letter to HHS Secretary Kathleen Sebelius contending
the HIPAA 5010 system is not working and is creating payment backlogs for many of its members. “Should
the government not take the necessary steps, many practices face significantly delayed revenue, operational
difficulties, a reduced ability to treat patients, staff layoffs, or even the prospect of closing their practice,”
wrote MGMA President and CEO Susan Turney, MD. The letter went on to reiterate MGMA's request for CMS to delay
enforcement of HIPAA 5010 standards until June.
CHIME News & Notes
Board Member Takes New Position in Georgia
CHIME Board member, and Advocacy Leadership Team Chair, Gretchen Tegethoff has accepted a new CIO position. Next Monday, she will begin employment as VP and CIO of Athens Regional Health System in Athens, GA (about an hour away from Atlanta). The System is one of Northeast Georgia's largest, serving 17 counties. It is comprised of an acute care facility with 350-plus beds, 4 urgent care centers, a quality network of physicians and specialists, a health maintenance organization, and a home health agency. Tegethoff will be responsible for information services (75 employees), telecommunications, eHealth, and clinical informatics. And she will report to the SVP of Health System Operations with a dotted line to the CEO. Happily, the CEO of the health system is very excited to have someone with a leadership/Board position with CHIME on his team and has assured her that he will be fully supportive of her Board commitments. From those of us in CHIME Advocacy, we wish Gretchen the best and are excited for her new opportunity.
CHIME and eHI Announce Webinar
As healthcare organizations aim to demonstrate the meaningful use of electronic health records in Stage 1
of the HITECH program, one of the core objectives that a provider must meet in order to qualify for stimulus
funding is to have the capability to "exchange clinical information electronically with other providers and
patient-authorized entities." While providers only have to test these capabilities in Stage 1, Stages 2 and
3 are expected to further emphasize the need for robust health information exchange (HIE). To help healthcare
CIOs make the complex decisions required to develop HIE, CHIME and eHI collaborated to create the HIE Guide for
CIOs. On February 8, 2012 at 3pm Eastern, CIOs will share their experiences building HIE at their organizations
as they discuss the recommendations of the guidebook. Speakers include Bill Sorrells, Executive Director of the
Alaska eHealth Network, George Hickman, EVP and CIO at the Albany Medical Center, and Joanne Sunquist, CIO of
Hennepin County Medical Center.
HIMSS 12 Public Policy Breakfast Announced
Register Now! The webinar takes place February 8 at 3pm-4pm Eastern.
The HIMSS Public Policy Breakfast will Feature Keynote Speaker Dr. Connie Mariano, the White House Doctor
to Presidents George H.W. Bush, Bill Clinton, and George W. Bush. CIOs attending HIMSS 12 are invited to
attend this annual event. The breakfast will be held at the Venetian-Sands Convention Center, Room Bellini
2105, Wednesday, February 22, from 7:00 – 8:30 am. Please click here to RSVP.
CHIME Policy Docs & Calendar
CHIME Advocacy Documents
CHIME Advocacy Calendar
Interested in joining the Advocacy Leadership Team? Click here to learn more. Or, go to StateNet and be sure to answer "YES" or "Interested" on your profile.
- Advocacy Leadership Team Meeting & Webinar (February 16)
- CHIME Members-Only StateNet Meeting & Webinar (February 29)
Want to know more details about Meaningful Use Stage 2? Interested in knowing where CHIME will be during HIMSS12? Please contact Sharon Canner or Jeffery Smith.