February 3, 2012 - Advocacy Corner

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solution must be found for the flawed Medicare physician reimbursement system – or at a minimum the formula should be repealed while lawmakers continue to search for a fix.

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.

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.”

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 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.

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.

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 Medicare-wide EHR Quality Measures Reporting Snapshot (January 2012)
• CHIME Regulatory Outlook (January 2012)
• CHIME Regulatory Crosswalk (January 2012)
• CHIME Medicare Shared Savings Program Comparison (November 2011

• 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.