WASHINGTON - The Obama administration announced $975 million in grants to help states, doctors and hospitals move from paper to computerized record-keeping.

Studies show electronic medical records help reduce medical errors and improve the quality of patient care. The grant money comes from the economic stimulus passed by Congress last year and is part of a push to get health care providers to adopt electronic record-keeping.

The White House says the awards will help make electronic record-keeping technologies available to more than 100,000 hospitals and primary care physicians by the year 2014 while helping train thousands of people for careers in health care and information technology.

The grants come from two federal agencies.

Health and Human Services Secretary Kathleen Sebelius announced $386 million in grants to advance electronic health records at the state level. Sebelius is also granting $375 million to 32 nonprofits for regional training of health care workers on these technologies.

Labor Secretary Hilda Solis announced around $225 million to support 55 job-training programs in 30 states. The administration says around 15,000 people should get training in the health records technology field. Solis said the training will lead those people to jobs offering career-track employment and good pay and benefits.

Above article publish on http://www.startribune.com/business/84237597.html

Although the federal economic stimulus package allocates billions of dollars to support health IT implementation, it remains to be seen whether the funding will improve health care quality or simply boost sales for health IT vendors, the Dallas Morning News reports.

Under the stimulus law, hospitals and physicians who demonstrate “meaningful use” of electronic health records can qualify for federal incentive payments.

The Obama administration contends that EHRs will allow physicians to better coordinate patient care, reduce medical errors and avoid duplicate testing. Medical errors alone cost the U.S. about $37.6 billion annually, according to the Institute of Medicine.

However, some advocates are concerned that health care providers will be unable to achieve the administration’s goals if meaningful use criteria tie stimulus funding to simply purchasing software.

They caution that such action could benefit health IT software companies at the expense of achieving interoperability and improved patient outcomes.

Conflict of Interest?

The federal stimulus package requires health care providers to purchase certified EHR systems to qualify for incentive payments.

In the past, certification responsibilities fell to the Certification Commission for Healthcare IT, which was founded by the trade group Healthcare Information and Management Systems Society.

Some critics argue that CCHIT is too closely linked with the health IT industry to be designated as the sole certifying body for EHRs.

However, leaders of the commission say CCHIT maintains its independence from health IT firms.

Although commission officials acknowledged that certification thus far has failed to promote EHR interoperability, they said the group is working to support system compatibility. In addition, CCHIT leaders say the commission is beginning to focus on alternative health IT systems and not just those developed by large software vendors (Michaels/Roberson, Dallas Morning News, 7/14).

Above article published on

http://www.ihealthbeat.org/Articles/2009/7/15/
Questions-Raised-About-Stimulus-Law-Benefits-for-Health-IT-Vendors.aspx

Back from his overseas trip, President Obama returns his focus to health care reform and the stimulus package, as the two issues face mounting criticism.

In an op-ed in the Washington Post Sunday, the president defended his $787 billion stimulus plan from concerns and accusations criticism that it has been ineffective, asking Americans to be patient.

“The American Recovery and Reinvestment Act was not expected to restore the economy to full health on its own but to provide the boost necessary to stop the free fall,” Obama wrote. “So far, it has done that. It was, from the start, a two-year program, and it will steadily save and create jobs as it ramps up over this summer and fall.”

Administration officials point to the roughly $100 billion that has been invested into infrastructure projects and tax cuts, and say that the bulk of the stimulus spending will occur in the next 12 months.

But some Republicans say the stimulus plan has failed to work the way it was intended.

There is also the issue of expectations. Asked by ABC News how the American people should measure whether his economic plans are correct, the president said “my initial measure of success is creating or saving 4 million jobs.”

But unemployment is a lagging economic indicator, meaning job growth will likely be one of the last parts of the recovery to start working. With unemployment rising to nearly 10 percent, the stimulus simply hasn’t begun to save or create four million jobs.

“We must let it work the way it’s supposed to, with the understanding that in any recession, unemployment tends to recover more slowly than other measures of economic activity,” Obama wrote in the Washington Post op-ed.

The president also faces a number of hurdles in his push for health care reform as the effort has gone from platitudes and rhetoric to cold hard legislation, with tough choices on how the program will be paid for, or whether it will include a public, government-run health insurance plan.

The president wants to see health care legislation pass through both the House and Senate before the August recess, but Republicans and even some Democrats say that is unlikely.

“We’re closer to that significant reform than at any time in recent history,” he said when asked to refocus on his domestic agenda at the speech in L’Aquila, Italy. “That doesn’t make it easy. It’s hard. But I’m confident that we’re going to get it done.”

When questioned whether it is a do-or-die before Congress breaks in August, Obama said, “I never believe anything is do-or-die. But I really want to get it done by the August recess.”

Above article published on

http://blogs.abcnews.com/politicalpunch/2009/07/
president-obama-refocuses-on-health-carestimulus.html

WASHINGTON – President Barack Obama’s expanded fiscal year 2010 budget signals continued commitment to advancing healthcare IT as a way to cut healthcare costs and save lives.

Obama’s $3.4 trillion federal budget, released May 8, expanded the outline he presented to Congress at the end of February. It includes $879 billion for the Department of Health and Human Services, an estimated $63 billion increase over fiscal year 2009.

The Agency for Healthcare Research and Quality (AHRQ) is expected to receive $372 million to conduct research on comparative effectiveness, prevention and care management, value research, health information technology and patient safety. In addition, the AHRQ will use the funding to support research it conducts with other agencies.
The president’s budget for AHRQ will be in addition to the $1.1 billion allotted for comparative effectiveness research under the stimulus package.

Obama’s plan calls for $635 billion over 10 years as a “down payment” toward health reform. Health and Human Services Secretary Kathleen Sebelius called it “a smart investment.”

“No one should underestimate President Obama’s commitment to getting healthcare reform this year,” she said. “This budget sends a clear message that we can’t afford to wait any longer if we want to get healthcare costs under control and improve our fiscal outlook,” she added. The president has made it clear that he considers health IT as a major aspect of containing costs into the future.

David Blumenthal, MD, National Coordinator for Health Information Technology, said his office is “totally focused” on President Obama’s initiatives to establish healthcare IT. He called health IT “a critical pillar” in the plan to build more quality into American healthcare. Obama’s goal calls for every American to have electronic health records by 2014.

Though Obama clearly has much support, some are not sold. At a Senate Finance Committee hearing May 11, Ranking Member Chuck Grassley (R-Iowa) was skeptical about spending a lot on health reform, including health IT.

“It will be some time before this fairy dust turns to gold,” he said. Grassley did say that President Obama’s leadership would be “essential” in figuring out how to pay for health reform.

Above article published on

http://www.healthcareitnews.com/news/obama-budget-reflects-it-promise

Saying it’s not logical to complain that the government ‘can’t run anything’ but will put them out of business, he also leaves room for compromise on a public plan as Congress tackles the issue.

By Noam N. Levey and Peter Nicholas

Reporting from Washington — In an effort to maintain control of the healthcare debate, President Obama on Tuesday ridiculed critics of his government-run insurance proposal, saying private insurers have nothing to fear if they are efficient and consumer-friendly.

“If private insurers say that the marketplace provides the best-quality healthcare — if they tell us that they’re offering a good deal — then why is it that the government, which they say can’t run anything, suddenly is going to drive them out of business?” Obama asked. “That’s not logical.”

t the same time, the president left the door open to compromise with the private insurance industry as Congress begins the process of tackling one of the most complex and politically sensitive issues on the national agenda.

In a news conference Tuesday, Obama framed his proposal as the only way to break the cycle of ever-higher medical costs that has sapped the financial stability of families and the government.

At the same time, however, he refused to rule out the possibility that he might sign a healthcare bill that did not include a public-plan option.

“We are still early in this process,” he told reporters at the White House. “We have not drawn lines in the sand.”

The president, who last week both challenged and sought to appease doctors in a speech to the American Medical Assn., will host a healthcare town hall at the White House tonight, the second such event in the last two weeks.

And with help from the Democratic National Committee, Obama supporters plan to hold events around the country Saturday aimed at promoting his healthcare overhaul — including blood drives, medical fairs and sessions on nutrition.

Fifteen years ago, the insurance industry was able to defeat President Clinton’s healthcare proposal by playing on the public’s fears with its “Harry and Louise” ad campaign, which featured a couple fretting about the government making their healthcare choices for them.

Now, Obama’s campaign website is urging people to share stories about their own battles with the healthcare system and to send letters to members of Congress.

“We think there are powerful stories to be told that argue for healthcare reform,” said Hari Sevugan, national press spokesman for the DNC. “Once you hear those stories, it demands reform this year.”

The administration’s push comes amid signs of division over Obama’s plan among some Democrats on Capitol Hill.

In recent days, the legislation being shaped by party leaders has drawn fire not only from Republicans and industry critics, but also from some moderate Democrats concerned about the cost of the overhaul and its potential to disrupt the current healthcare system. Obama’s plan is expected to cost at least $1 trillion over the next decade.

Several centrists, including Sen. Kent Conrad (D-N.D.), have indicated interest in pursuing alternatives to a government plan.

“You can have the greatest plan in the world on paper. If it does not pass, nothing changes,” said Conrad, who is working closely with senior Senate Democrats and Republicans on healthcare legislation and has championed the creation of health insurance cooperatives to compete with private insurers, rather than a government plan.

Illinois Sen. Richard J. Durbin, the No. 2 Democrat in the Senate, acknowledged Tuesday that preliminary work on the legislation would probably not be completed before Congress leaves town this week for its 10-day July 4 recess.

Senate Finance Committee Chairman Max Baucus of Montana, who is leading one of the two Democratic healthcare efforts in the Senate, sounded a sanguine note Tuesday. “I feel much more hopeful and encouraged,” he said. And Conrad noted that lawmakers were making progress in containing costs by reducing the size of the subsidy that the government would give people to help them buy insurance.

But neither would say when the negotiating might yield a bill.

noam.levey@latimes.com, peter.nicholas@latimes.com

Above article published on

http://www.latimes.com/features/health/la-na-obama
-healthcare24-2009jun24,0,3575870.story

The law offers bonuses for health IT adoption but will penalize physicians who don’t have adequate systems by 2015.

By Doug Trapp, AMNews staff.

Washington – President Obama on Feb. 17 signed a $787 billion stimulus bill that directs about $150 billion toward speeding adoption of health information technology and maintaining health care coverage, among other provisions.

The sweeping measure — the American Recovery and Reinvestment Act of 2009 — provides nearly $90 billion in temporary increased federal Medicaid funding, delays four cost-cutting Medicaid regulations and spends a net of about $19 billion to encourage physicians and others to adopt health IT.

Obama said the enactment of the stimulus package and the Feb. 4 enactment of the Children’s Health Insurance Program reauthorization are big steps in health care. “We have done more in 30 days to advance the cause of health care reform than this country has in a decade.”

The American Medical Association applauds the investments in health IT and coverage for the poor and newly unemployed, wrote AMA Executive Vice President and Chief Executive Officer Michael D. Maves, MD, MBA, in a Feb. 11 letter to Sen. Max Baucus (D, Mont.), chair of the Senate Finance Committee.

The stimulus also provides $500 million to help train physicians through the National Health Service Corps, a provision widely supported by physician organizations. “This program is integral to rebuilding the primary care physician pipeline,” said Ted Epperly, MD, president of the American Academy of Family Physicians.

$19 billion of the stimulus bill is for incentives to encourage health IT adoption.

But few Republicans backed the stimulus measure. The House adopted the bill Feb. 13 with no Republican support. The Senate approved it the same day with votes from only three moderate Republicans: Sens. Olympia Snowe and Susan Collins of Maine and Arlen Specter of Pennsylvania. The final bill is a compromise between earlier versions adopted by the House and Senate.

Many Republicans, including Senate Minority Leader Mitch McConnell (R, Ky.), lambasted spending in the measure that they said would not stimulate the economy quickly. McConnell also criticized Democrats for not accepting more GOP input on such a massive spending bill.

Some Republican lawmakers, such as Phil Gingrey, MD (R, Ga.), also worried that the stimulus is not offset by new revenues and therefore will increase the national debt. “I don’t know how our children and grandchildren are going to pay for this,” Dr. Gingrey said.

“Significant” health IT support

Under the stimulus law, physicians and other health professionals are eligible for tens of thousands in health IT incentive payments via Medicare or Medicaid through 2016. But in 2015, penalties for non-adopters begin.

Medicare-participating physicians who adopt a certified electronic health record system by 2011 or 2012 and use it in a way that the government deems “meaningful” — a term to be defined later — could receive up to $44,000 over a period of up to five years. The incentives will be limited to 75% of the physician’s Medicare charges in any one year.

Health IT grants and loans from the federal government won’t become available until 2010.

Physicians who have caseloads of at least 30% Medicaid patients and who also meet the health IT adoption standards are eligible for nearly $64,000 in support during the same time frame. Medicaid incentive payments are limited to 85% of physicians’ Medicaid charges. Pediatricians can qualify if their patient mix is 20% Medicaid, but they would be eligible for only two-thirds of the incentive payments available to physicians meeting the 30% standard.

This health IT funding is “very significant,” said Robert Doherty, the American College of Physicians’ senior vice president for governmental affairs and public policy. “Our sense is for a lot of physician practices, that may be the tipping point where it begins to make business sense to consider plunging into that pool and buying a certified EHR.”

Physicians cannot apply for incentives in both Medicare and Medicaid, but hospitals can, said Erica Drazen, ScD, managing partner for emerging practices at health IT consultant CSC’s Global Healthcare Sector.

Also, while physicians must use an EHR system to qualify for the stimulus incentive payments, they need not own one. The measure provides $2 billion to the Office of the National Coordinator for Health Information Technology for health IT grants and loans, but those won’t become available until 2010, Drazen said. She expected private firms to offer new financing options for the EHR systems or to offer them through leases.

But the stimulus measure will penalize physicians, beginning in 2015, if they have not become meaningful EHR users. These doctors face a 1% reduction in Medicare fees that year. The yearly cut would phase up to 3% in 2017 and beyond.

The ACP would prefer that the penalties not apply if, for example, a shortage prevents EHRs from being available to physicians or if another factor not in physicians’ control prevents them from meeting the health IT standards, Doherty said.

Drazen said existing EHR vendors and consultants will be strained by the demand created by the health IT stimulus. “We’re going to have a real short supply of people who know how to do this well.”

Sustaining Medicaid

The $87 billion in stimulus going to state Medicaid programs should help avoid health coverage cuts to low-income people. But states still may need to trim other parts of their Medicaid programs, because many have budget shortfalls exceeding their stimulus funding, said Ann Kohler, director of the National Assn. of State Medicaid Directors.

The enactment could be significant for physicians in California. State lawmakers and Gov. Arnold Schwarzenegger have been struggling to close a roughly $42 billion budget deficit.

California’s Medicaid program would receive more than $11 billion in stimulus funding over 27 months, according to the California Medical Assn. But to qualify for the additional funds, states first must maintain or restore Medicaid eligibility and renewal procedures to their status on July 1, 2008. California lawmakers would need to reverse legislation enacted late in 2008 requiring people on Medicaid to re-enroll twice a year instead of once.

“This is another great opportunity for state lawmakers to maximize federal assistance,” said CMA President Dev A. GnanaDev, MD.

The stimulus offers another boost to states by extending moratoriums on three Medicaid rules through July 1, 2009. Those regulations, issued by the Centers for Medicare & Medicaid Services, would have reduced federal Medicaid spending by billions. The new law also delays until July a CMS rule that reduces some states’ Medicaid rates by aligning the program’s hospital outpatient services definition with that of Medicare.

This content was published online only.

Above article published on http://www.ama-assn.org/amednews/2009/02/23/gvl20223.htm