FCC Makes $417 million Grant Money Available for TeleHealth Investment

SUMMARY:  The Federal Communication Commission announced on Nov 20 that the agency is appropriating $417 million in telehealth network grants as part of the Rural Health Pilot Program and the money will be distributed in 42 states and three U.S territories. Recipients of the grants are hospitals, clinics, universities and research centers, behavioral health sites, correctional facility clinics, and community health centers. The FCC commissioner Kevin Martin estimated that by the end of the three-year program, about 6,000 healthcare providers would ultimately get connected for telemedicine, electronic medical records and other broadband-based health services

AMA Endorses Tax Credit for Physicians to Adopt EMR

SUMMARY:  Based on an AMA survey in 2007 in which 79% of the physicians respondents endorsed the idea of an EMR tax credit, the American Medical Association's House of Delegates recently recommended that physicians receive a full, refundable tax credit to help them buy and use healthcare information technology. In addition, AMA is to formulate contracting guidelines to help physicians comply with the federal Stark regulations which give the green light to physicians to accept healthcare IT solution from hospitals

ONCHIT Releases Six Use Cases to Drive Health IT Adoption

SUMMARY:  The Office of the National Coordinator for Health IT has released six prototype use cases of health IT applications for public comments. Among these six cases, two are related to public health initiatives such as epidemic reporting and immunization, the other four are clinical care-focused, including remote care monitoring, remote consultation, and personalized health care, the digital health initiatives that the private sector is also promoting. After the comments on the prototypes are collected, detailed use cases will be published for further comments before standardization and technology harmonization efforts will be initiated to drive adoption.

Health IT Spending Bill Waits for Reconciliation at the Congress

SUMMARY:  Upon the Congress' return from summer recess, two versions of the 2008 Health IT spending bills are pending for reconciliation. The House version, passed on July 11, is to allocate $61.3 million for the Office of the National Coordinator for Health IT (ONCHIT) , but the Senate version, sent to the full Senate on June 2, would provide ONCHIT with 10 million more. The two chambers must produce a reconciled version before Oct 1, when the new fiscal year kicks in.

Chronic Conditions to Cause Greatest Health Care Costs Increases

SUMMARY:  HealthPartners Research Foundation released results of a new study in the April issue of Disease Management Journal, which projects that chronic conditions will account for the greatest per capita cost increases over the next several decades as a result of the aging U.S. population. Specifically, the study estimated that per capital cost of treating congestive heart failure will increase 75 percent from 2000 to 2050. 48 percent increase is expected for coronary artery disease and 24% for diabetes.

Healthier U.S. Starts Here: Initiative Unveiled by HHS, CMS Officials

SUMMARY:  The U.S. Department of Health and Human Services (HHS) and the Centers for Medicare & Medicaid Services (CMS) on April 20, 2007 launched "A Healthier US Starts Here," an initiative focused on motivating seniors and others with Medicare to make the most of Medicare's preventive services. The initiative will include the Medicare Prevention tour bus that will visit 48 states to promote awareness of preventive care among seniors. Many disease prevention advocates, employers, and civic and state leaders have joined the efforts to promote disease prevention and wellness.

Thirty Percent of Employers Offer Wellness Programs

SUMMARY:  Willis of Tennessee Inc., a Knoxville-based employee benefits brokerage and consulting company, released a survey result on April 20, 2007 showing that 30 percent of U.S. employers now offer a wellness-related program and another 30 percent plan to offer one in the future, according to Knoxville News. However, survey respondents cited financial considerations as the main barrier to offering wellness and disease-management programs. Lack of data supporting such programs is one of the problems in convincing management. Only 23 percent of survey respondents with wellness programs are actually measuring the return on investment

Half of All British Adults Will Suffer High Blood Pressure by 2025

SUMMARY:  A stern warning from the London School of Economics said in a report that 22 million Britons will be affected by high blood pressure, which doubles the risk of dying of a heart attack or stroke. One of the report's authors, Dr Panos Kanavos, warned that if the condition went unnoticed, a significant proportion of adults will be transformed from workers who benefit the economy into "long-term recipients of social benefits with increased healthcare needs".

Federal Advisory Group to Recommend Rewarding Physicians for EHR Use

SUMMARY:  The American Health Information Community on April 25, 2007 accepted in principle a pay-for-performance recommendation from its Electronic Health Records Workgroup that called for federal contracts with health plans and insurers to include provisions to reward physicians for quality performance, including the use of certified electronic health records, according to Government Health IT. AHIC rejected another recommendation from the work group to urge Medicare to increase payments to physicians who use EHRs. The work group will revise the recommendation and could resubmit it after determining whether CMS can set up a differential reimbursement scheme and how "using EHRs" should be defined.

USDA Steps Up Rural Telemedicine Funding

SUMMARY:  Healthcare IT News reported on April 6 that USDA announced that in 2007 it will provide $128 million in loans and grants for telemedicine and distance learning. The federal agency since 2002 has invested more than $166 million in telemedicine and distance learning programs, and about 2,226 health care facilities have used the programs to adopt or develop telemedicine applications.

California Legislature Amends Telemedicine Bill

SUMMARY:  The bill AB 329 originally introduced in the California legislature in February was amended in the Assembly on March 29, 2007. The proposed legislation would enable the Medical Board of California to regulate the practice of telemedicine, authorize the Board to establish a pilot program to expand telemedicine, and create a working group to find ways to best deliver healthcare to individuals with chronic diseases using health IT. The bill would require the board to make recommendations to the legislature on or before January 1, 2009, and include ways to improve healthcare services.

CMS Releases Details on Pay-for-Performance Bonuses

SUMMARY:  CMS has released 74 performance quality measures that will determine 2007 bonuses for physicians who treat Medicare patients, according to Government Health IT’s article on April 5, 2007. The quality measures are part of CMS' voluntary Physician Quality Reporting Initiative, which provides an additional payment of up to 1.5% to physicians who report quality data. The first period of the reporting initiative is from July 1 through Dec. 31. Participating providers report on measures relevant to their patient care by submitting the quality-data codes associated with the Medicare claims forms. CMS noted that the 2007 quality data will not be publicly reported.

Hospital Errors Continue to Drift Higher

SUMMARY:  HealthGrades, an online health quality rating and benchmarking company, released a study on April 2 showing that patient safety incidents in U.S. hospitals increased by 3% from 2003 to 2005, but top-performing hospitals had a 40% lower rate of medical errors compared with the worst performing hospitals. For the study, researchers examined the records of Medicare beneficiaries treated at nearly 5,000 hospitals between 2003 and 2005. About 1.16 million preventable patient safety incidents occurred in 40.6 million hospitalizations of Medicare beneficiaries from 2003 through 2005. However, the report found that between 2003 and 2005 patient safety problems worsened by 2.03 incidents per 1,000 hospitalizations. According to the report, 247,662 deaths could have been prevented during those years if hospitals had made fewer medical mistakes.

Baby Boomers Expect to Drive Up Health Care Spending

SUMMARY:  Baby boomers will contribute to an 18% increase in health care costs by 2050, according to a study conducted by Minnesota-based insurer HealthPartners, the St. Paul Pioneer Press reports. The study, published in Health Services Research, found that costs are not projected to increase uniformly across major categories of medical practice. The estimated change in per capita costs due to aging will be highest in the field of kidney disorders, where spending is projected to rise by 55% between 2000 and 2050. For heart and vascular conditions -- the largest major practice category -- per capita spending is projected to increase 44% during that time period. However, per capita costs are expected to decrease for post-natal care, chemical dependency and pregnancy/infertility care as a result of demographic change, according to the study. Researchers also found differences based on gender, with male costs for heart and vascular conditions up to 60% higher than female costs.

HHS Unveils Plan for "Value Exchanges" to Report on Health Care Quality and Cost at local level

SUMMARY:  HHS Secretary Mike Leavitt on Feb 28, 2007 announced a new initiative that would create a system of local quality-improvement collaboratives to provide public reports on the cost and quality of health care. Under the plan, HHS would select qualified regional collaboratives to be chartered as Value Exchanges. In such collaboratives, local area physicians, nurses, hospitals and other health care providers are working collaboratively with health plans, employers, unions and other health care purchasers to achieve reliable public reporting on quality and cost of care.

Cigna Official Urges Health Plans To Focus on Transparency, Preventive Care

SUMMARY:  The Pittsburgh Post-Gazette reported on February 28, 2007 that Cigna, one of the nationÂ’s largest health plans, has call on increased focus on price transparency and preventive care to reduce health care costs. Speaking at a forum sponsored by the Pittsburgh Business Group on Health, Joseph Gregor, general manager for Cigna in western Pennsylvania and Ohio, said that health insurers and employers should provide members and employees with more information on the price and quality of medical services. According to Gregor, Cigna has begun to provide members with information on medical procedures with highly variable prices, such as MRIs. He also said that health insurers should begin to serve as "health coaches" for members, adding that "we must reach into people's lives sooner" to prevent chronic diseases. For example, nurses could inform overweight patients that they have "five years to lose 50 pounds or will get type 2 diabetes.”

Pennsylvania Bill Steps Up Health Care Price Transparency

SUMMARY:  The Pittsburgh Post-Gazette reported on March 21, 2007 that Pennsylvania state Rep. Todd Eachus (D) has proposed a bill that would require hospitals and pharmacies in the state to post drug prices and hospital payments online in an effort to reduce health care costs and provide uninsured residents with easier access to affordable care. The legislation would require state pharmacies to submit the retail prices for the 150 most popular drugs and their generic equivalents to the Pennsylvania Health Care Cost Containment Council, which then would post the data online for consumers. Under the bill, pharmacies would update their lists each month and could change their prices at any time as long as their in-store lists were updated weekly.

Massachusetts Unveils Benefits in Universal Health Care Plan

SUMMARY:  The New York Times reported on March 20, 2007 that MassachusettsÂ’ Commonwealth Health Insurance Connector Authority will vote in the following Tuesday to require insurers to provide certain minimum benefits, including coverage of prescription drugs.
The decision, subject to final approval in June, would make Massachusetts the first state to establish standards that apply to every resident and every health insurer. The board has agreed to phase in some of its requirements, giving residents and employers an extra 18 months to buy health plans that meet all the new criteria. The goal of the health insurance law, passed in April 2006, was to make sure that most of the state's uninsured residents, about 515,00 people, would be covered. Those who fail to get insurance would face penalties that could include the loss of a personal income tax deduction. Earlier in March, the authority approved plans from seven insurers with premiums ranging from $175 to $288 a month and deductibles ranging from nothing to $2,000 a year.

California, Pennsylvania Join Federal Health Care Transparency Efforts

SUMMARY:  The Sacramento Business Journal reported on March 14, 2007 that a unit of the Pacific Business Group on Health will compile information on physician performance from Medicare and three California health plans (Blue Cross of California; Blue Shield of California; and UnitedHealth/PacifiCare). The initiative is part of a federal pilot project intended to help people make informed health care decisions. The project will also give doctors access to quality report cards by mid-2007. Leaders from more than 30 employers have signed contracts to participate in the project, which will cover about 25,000 physicians, making it the largest effort of its kind in the U.S. Similarly, the Pittsburgh Post-Gazette reported that more than 80 public and private Pittsburgh-area businesses and organizations have pledged to work together to provide greater transparency in medical pricing and quality of care.

Most American Seniors Live With Chronic Disease

SUMMARY:  The U.S. Centers for Disease Control and Prevention (CDC) released a report concluding that eight of 10 Americans age 65 or older are living with heart disease, diabetes or some other form of chronic illness. HealthDay News reported the findings on March 8, 2007.
The report, titled “The State of Aging and Health in America 2007” includes up-to-date information on 15 key health indicators for older adults. The number of Americans 65 and older is estimated to reach 71 million by 2030, about 20 percent of the population. By that time, U.S. health care spending is estimated to increase by 25 percent because of an aging population, according to the report. The report looks at seniors' "health status" - the number of physically unhealthy days seniors experience, their frequency of mental distress, their oral health and levels of physical disability. There is also an evaluation of health behaviors, such as physical inactivity, nutrition, obesity and smoking.

California Health Plans Tout Success of Pay-for-Performance Program

SUMMARY:  The Healthcare IT News reported on March 13 that the Integrated Healthcare Association recently shared a business case for its pay-for-performance program. The program awarded a total of $55 million to California physician groups in exchange of increased use of IT to measure care delivery and quality. The participating physician groups demonstrated improvement in all quality areas and that there was a significant increase in IT use, with more than half of the physician groups having IT capabilities. IHA also has demonstrated a business case for collaboration among health plans. Insurers traditionally have established their own quality standards and goals, creating significant work for physician groups to gather and report data. However, IHA combined the data and standardized the measurements.

Group Releases First EHR Functional Requirements Standard

SUMMARY:  Health Level Seven on Feb 21, 2007 released the first standard that identifies functional requirements for electronic health record (HER) systems to be approved by the American National Standards Institute (ANSI). The HL7 standard describes 1,000 conformance criteria across 130 functions, including medication history, problem lists, orders, clinical decision support, plus supports for privacy and security. The standard should also serve as the basis for additional functions of electronic health-records systems, such as the ability to serve as a legal record for business purposes. The standard is also designed to accommodate EHR systems aimed for special purposes, such as disaster preparedness, long-term care, behavioral health, children and clinical research. The group will submit the standards to win approval from the American National Standards Institute, a key standard-setting body.

Scholar Advocates Use of Online Surveillance System to Track Device and Drug Safety

SUMMARY:  Kevin Schulman, professor of medicine and business administration at Duke University, in his opinion column appeared in the Feb 21, 2007 issue of the Raleigh News & Observer argued for a nationwide real-time, online safety surveillance system to track the effects of medical devices and new prescription drugs. Current practices are sporadic and limited in scope and effectiveness. For instance, some hospitals track devices through an electronic registry that can send the manufacturer a report, but such problem report will not be merged with the nation's safety surveillance system. Professor Schulman argued that upon leaving the hospital, the patient could be registered on a Web site that would allow for the communication among the FDA, the manufacturer, the physician and the patient about potential problems with the product.

Total Healthcare Spending to reach $4.1 trillion in 2016

SUMMARY:  Health Affairs published a study from government economists predicting that healthcare spending in the United States will nearly double over the next decade to top $4.1 trillion, or 20% of GDP in 2016. The healthcare bill will average $12,782 for every man, woman and child in 2016, an increase from $7,498 this year, said the report. It also forecast that by 2016 -- even before most baby boomers retire and become Medicare recipients -- federal, state and local government will be picking up nearly half the national healthcare tab, putting pressure on Congress to curb benefits, raise taxes or both.

Rural Health IT Bills Propose Medicare Coverage of Remote Patient Monitoring

SUMMARY:  Sen. Norm Coleman (R-Minn.) has introduced two bills aimed at increasing the use of health IT in rural areas. The first one, S 628, would establish a grant program to aid rural providers in adopting health IT, and the second one, S 631, would encourage the use of IT to remotely monitor patients who live in rural areas by creating a new benefit category for Medicare payment of remote patient management services. The legislation calls for Medicare to cover the remote monitoring of patients with congestive heart failure, diabetes and cardiac arrhythmia under the physician fee schedule.

HIMSS Survey Says Most Organizations Not Ready for Pay-for-Performance Reporting

SUMMARY:  A Healthcare Information and Management Systems Society survey released on Feb 8, 2007 showed that only 30% of the health care organizations are ready to collect quality and performance data. While most health care organizations recognize the need to do so, only 20% who did not already collect the information said they thought they would in the future.

New York Governor Unveils New Health Care Plan

SUMMARY:  New York Governor Eliot SpitzerÂ’s new health agenda is composed of two broadly defined initiatives: cover hundreds of thousands of uninsured people with government health plans, and re-allocate Medicaid spending. The proposal will extend childrenÂ’s insurance coverage to 400,000 uninsured children under current regulations and simplify Medicaid coverage renewal process that Mr. Spitzer said would increase Medicaid enrollment by 100,000. But his plan also includes cut in Medicaid benefits that would reduce hospitals' overall income by about 1 percent, a significant hit for a money-losing industry that may face other cuts from Washington. But the governor and members of his staff say they are after something more subtle and audacious than cost-cutting. The goal, they say, is to make Medicaid make sense, starting with revising old financing formulas that no longer reflect reality.

CMS Might Seek To Promote Through Regulation

SUMMARY:  Acting CMS Administrator Leslie Norwalk on November 1, 2006 in a keynote speech to the World Healthcare Innovation and Technology Congress said that, without the enactment of legislation to promote health care information technology, CMS "might have to help forward health IT on a regulatory basis." CMS might seek to promote health care IT through demonstration projects that test new forms of reimbursement and health care delivery and through Medicare Quality Improvement Organizations.

Former Intel CEO Proposes Healthcare Reform

SUMMARY:  Intel former CEO Andy Grove is concerned about the large number of uninsured U.S. residents, who often visit emergency departments for primary care. According to the Wall Street Journal story, Grove supports the concept of low-cost, walk-in clinics that provide primary care to uninsured residents and reduce overcrowding in emergency departments. Grove supports an electronic health records system that uses a "generic but Web-accessible word-processing file," rather than "an elaborate and technically sophisticated medical-database system."

Advisory Panel Sets Goals, Accepts Health IT Standards

SUMMARY:  The American Health Information Community, an advisory committee to HHS, on November 1 met with its six work groups and other stakeholders to establish goals aimed at facilitating IT adoption for 2007.
The Healthcare IT Standards Panel at the meeting also provided AHIC with its first set of harmonized standards. President Bush's executive order on health IT requires federal agencies to adopt HITSP-approved standards. AHIC approved the HITSP standards and sent the report to Mike Leavitt, the HHS Secretary who did not provide a timetable.

Report Checks Progress on Network Recommendations

SUMMARY:  A progress report examines action taken on the 14 recommendations set in 2005 by the Commission on Systemic Interoperability to establish a national health information network. HHS has "acted to some degree" on eight of the recommendations, but Congress has not acted on any, according to the report by the National Alliance for Health IT. The commission urged HHS to implement or seek Congressional authorization to implement financial incentives for adopting "standards-based IT," which currently is in the stalled legislation.

HHS Advisory Group Agrees on 30 Standards

SUMMARY:  The American Health Information Community, an HHS advisory group, agreed in late October, 2006 on a set of health care information technology standards for maintenance of personal health records, transmission of laboratory results and disease outbreak management. The committee agreed on about 30 standards for the three areas after a review of 700 standards developed by 261 organizations. These standards cover many areas including the use of personal health records (PHRs), standardization of the reporting of lab tests, procedure calls for public health alert, etc.

FDA Strengthens Monitoring Medical Devices in the Marketplace

SUMMARY:  The FDA is strengthening the monitoring of medical devices after they reach the marketplace. In January, FDAÂ’s Center for Devices and Radiological Health (CDRH) formed a team to develop an action plan to address the post marketplace. Proposed action items include creating a cross-cutting organization structure, developing performance measurements to handle issues, developing a unique identifier system to identify devices, mandatory electronic reporting for adverse event reports, increasing the use of MedSun programs to help to obtain data from additional hospitals, providing clearer and more timely information on public health news, and increasing coordination with FDAÂ’s compliance and enforcement programs.

HIPAA Compliance Remains Low

SUMMARY:  A recent survey by Phoenix Health Systems and the Healthcare Information and Management Systems Society found that provider and insurer compliance with HIPAA rules remains low in certain areas and has stalled in other areas.The biannual survey found that 80% of insurers and 56% of providers said they have implemented the security rule's provisions. However, many of the respondents could not verify that they had adopted all major provisions required by the rule. The survey also found that 22% of provider respondents and 13% of insurer respondents remain noncompliant with the HIPAA privacy rule more than three years after the compliance date.