By John Moore

New York State has awarded about $60 million in grants for localized health information technology projects, one of three rounds of grants recently issued under the state’s Health Care Efficiency and Affordability Law for New Yorkers (HEAL NY) initiative.

Gov. David Paterson announced grants totaling $436 million on Sept. 25. In addition to health IT, the grants will fund collaborative projects among hospitals and improvements to long-term care.

The state will allocate the funds through its Department of Health and the Dormitory Authority of the State of New York.

The health IT portion of the grants, HEAL NY Phase 10, targets community-based projects focused on information sharing. Examples include a $6.7 million grant to the Fort Drum Regional Health Planning Organization to help launch electronic health records and health information exchange to “improve coordination of care for adult patients with chronic pulmonary disease,” according to the health department.

HEAL NY Phase 11, meanwhile, provides more than $174 million in grants that aim to promote collaborative arrangements among hospitals in an effort to boost the quality and efficiency of care delivery. In HEAL NY Phase 12, more than $172 million in grants will be issued to 19 applicants for long-term care related projects.

Above article published on

http://www.govhealthit.com/newsitem.aspx?nid=72149

By Kim Landers for The World Today

United States President Barack Obama is battling slumping poll numbers as he tries to counter the growing criticisms of his economic and health policies.

Mr Obama has used a prime time media conference to defend his campaign to overhaul America’s health system, calling it vital to pulling the economy back from the brink.

It was his 10th news conference since taking office six months ago and the timing was critical.

The President held it during prime time in the US to guarantee a national television audience. And he did it in a bid to convince Americans and the Congress to back his ambitious health care reforms.

“This debate is not a game for these Americans and they can’t afford to wait any longer for reform. They’re counting on us to get this done. They’re looking to us for leadership and we can’t let them down,” he said.

With the US in a deep recession, unemployment rising and the deficit ballooning, healthcare reform is set to be Barack Obama’s biggest test yet.

Forty-seven million Americans do not have health insurance but the President’s far reaching plans to bring affordable health care to all Americans have left many worrying who will foot the bill.

The growing public unease with his approach is partly due to an onslaught from his Republican critics and some within his own Democratic Party remain sceptical.

But Barack Obama says the time is right for a health care overhaul.

“I’m the President of the United States so I’ve got a doctor following me every minute which is why I say this is not about me,” he said.

“I’ve got the best health care in the world. I’m trying to make sure that everybody has good health care, and they don’t right now. “

‘Back from the brink’

America’s health care costs are a huge factor in the skyrocketing deficit and the President has also used his prime time media appearance to defend his economic policies.

“We’ve been able to pull our economy back from the brink,” he said

“We took steps to stabilise our financial institutions and our housing market and we passed a recovery act that has already saved jobs and created new ones.”

But six months after taking office Mr Obama’s popularity is fading. A Gallup poll shows his approval rating has dipped to 55 per cent.

The White House says they are “darn good numbers” but at the same point in his White House tenure George W Bush was on 56 per cent, Jimmy Carter was on 67 and Bill Clinton was on 41 per cent.

Bill Clinton was the last President to try and very publicly fail to reform health care.

Policy concerns

Darrell West is the vice-prsdsesident and the director of Governance Studies at the Brookings Institution. He is not marking Barack Obama’s six month report card too harshly.

“His poll numbers are starting to slip, unemployment is getting close to 10 per cent and Americans are starting to have a few doubts about some of the current directions of his policy initiatives,” he said.

Jennifer Duffy is a senior editor with the Cook Political Report, an independent newsletter. She says any president who started with such high popularity has to endure some erosion.

“But what we’re really seeing here is not that so much that he’s becoming less popular but that voters have some concerns about his policy,” she said.

“They still like him. They just have concerns about health care. They have concerns about whether the stimulus package is working.”

President Obama has again stressed today that he inherited the worst recession in half a century.

But Ms Duffy says Americans seem keen to put talk of the past behind them and they are now grading the new President on how he is handling the economy, particularly the impact of his $2 trillion stimulus package.

“First of all Americans are pretty fond of instant gratification,” she said.

“The stimulus I think may be the very first example of that and I think the White House has tried to reset the expectations to a certain degree but in a number of states, especially in the mid-west, we have had failing economies much longer than other states. Asking for patience is a hard thing.”

As one commentator in the United States put it, the icy cool President Obama is finally starting to sweat.

Above article published on

http://www.abc.net.au/news/stories/2009/07/23/2634633.htm

Two provisions in President Barack Obama’s economic stimulus plan could give the federal government the authority to oversee the medical decisions made between doctors and patients, critics warn, which could result in the rationing of health care.

The plan to make all health records electronic and establish an effectiveness board to review health care costs was part of the $838 billion economic stimulus bill that passed the Senate Tuesday

The bill provides $3 billion to computerize health records, a measure intended to cut costs and reduce medical errors. Language in the stimulus bill calls for “the utilization of an electronic health record (EHR) for each person in the United States by 2014.”

This will require the establishment of the office of National Coordinator for Health Information Technology. The new office ‘‘provides appropriate information to help guide medical decisions at the time and place of care,” according to the language in the bill.

Further, the legislation also spends $1.1 billion to establish a Federal Coordinating Council for Comparative Effectiveness Research, which would serve as an umbrella group for all federal health programs, including Medicare, Medicaid, S-CHIP, and veterans’ care, with 15 members from various federal agencies making determinations about health care needs and cost-effective treatments

According to the bill, the secretary of Health and Human Services “shall seek to improve the use of electronic health records and health care quality over time by requiring more stringent measures of meaningful use” by health care providers.

The bill also indicates that a doctor who is not a “meaningful EHR user” in terms of using patients’ health records to provide the most cost-efficient coverage could face penalties.

President Obama, during his press conference Monday, touted the goal of modernizing the health care system, which he said would save billions of dollars and save lives

“We know that health care is crippling businesses and making us less competitive, as well as breaking the banks of families all across America — and part of the reason is we’ve got the most inefficient health care system imaginable,” Obama told reporters. “We’re still using paper. We’re still filing things in triplicate. Nurses can’t read the prescriptions that doctors have written out. Why wouldn’t we want to put that on an electronic medical record that will reduce error rates, reduce our long-term cost of health care, and create jobs right now?”

One problem critics note is that the electronic medical records will be mandatory.

“I am not against electronic records,” Betsy McCaughey, former lieutenant governor of New York, told CNSNews.com. “I am against coercing doctors to limit care. I certainly do not support vague guidelines. E-records are fine as long as they are not mandatory.”

McCaughey, an adjunct senior fellow at the conservative Hudson Institute, told CNSNews.com there is “no question” that the goal is to ration health care to control costs. That is achieved, she said, by first putting every individual in a medical treatment database, and secondly by putting the new effectiveness council in charge of providing doctors with guidelines for how to most effectively treat those patients based on the data.

“We plan to work closely with members of the House-Senate conference committee to craft a final bill that improves health care coverage, promotes widespread adoption of HIT (health information technology) that will work in physicians’ offices, and promotes independent clinical effectiveness research,” said Dr. Joseph Heyman, chairman of the AMA board.

While rationing is the likely goal of the Obama administration, these goals of an effectiveness task force likely will not make it through Congress, said Michael Cannon, director of health policy studies at the libertarian Cato Institute.

“It’s ironic that advocates of free market health care believe there is too much waste in government programs. The concern of the left is that this won’t lead to rationing,” Cannon told CNSNews.com. “Congress has been down this road before. There have been studies identifying low-value medical care. But the people providing low-value medical care are influencing Congress. There is no sense for either the left or the right to spend taxpayer money on this.”

A Cato study released last week blamed the government for high health care expenses. “Federal tax and entitlement policies, as well as state licensing of health insurance and medical professionals, inhibit the types of health plans best equipped to generate comparative-effectiveness information,” the study claimed.

“A better way to generate comparative-effectiveness information would be for Congress to eliminate government activities that suppress private production,” the Cato study said. “Congress should let workers and Medicare enrollees control the money that purchases their health insurance. Further, Congress should require states to recognize other states’ licenses for medical professionals and insurance products.”

Though the bill, still under final revision in Congress, states that privacy of electronic health records will be protected, Sue Blevin, president of the Institute for Health Freedom, is concerned that there is not an opt-out for people who choose not to have their records computerized and entered into the national network.

“Without those protections, Americans’ electronic health records could be shared – without their consent – with over 600,000 covered entities through the forthcoming nationally linked electronic health records network,” Blevin said in a statement.

“Unless people have the right to decide if and when their health information is shared or whether to participate in research studies, they don’t have a true right to privacy.”

Above article published on

http://www.cnsnews.com/public/Content/Article.aspx?rsrcid=43358

By now you’ve heard about the $850 billion American Recovery and Reinvestment act of 2009 - the stimulus bill recently passed by Congress. The bill is aimed at spurring economic growth across multiple industries by way of government spending.

What’s in it for you?

Well if you are a healthcare provider, you can take advantage of the $51 billion that has been allocated to the health care industry, $19 billion of which will be used to incentivize medical practices to adopt and implement Electronic Health Records (EHRs), also known as Electronic Medical Records (EMRs).

How does the subsidy work?
Starting in 2011, providers deemed to be “meaningful users” of EHR systems will be eligible to receive $40,000 - $60,000 in incentive payments paid out over five years in the form of increased Medicare and Medicaid premiums.

For the first year a physician is deemed to be a meaningful user, he or she will be eligible for payments of 75% of that year’s Medicare and Medicaid charges, up to a maximum of $15,000. The maximum payment is increased to $18,000 if the first year is 2011 or 2012. The incentive payments decline for each subsequent year within the five year period; $12,000 will be paid in year two, $8,000 in year three, $4,000 in year four, and $2,000 in year five.

No incentive payments will be available after 2015, and no payments will be offered to physicians who first become eligible after 2014. This creates a decreasing incentive for late adopters.

What is a “meaningful user”?
To qualify as a “meaningful user,” eligible providers must demonstrate use of a “qualified EHR” in a “meaningful manner.” The bill defers to the secretary of Health and Human Services (HSS) to set specific guidelines for determining what constitutes a “qualified EHR”; however, it does specify that e-prescribing, electronic exchange of medical records, and interoperability of systems will be determining criteria.

HSS will be working throughout 2009 to set the necessary criteria for certifying systems, and is expected to have a final report by January of 2010. Many expect CCHIT certification to play a major role in setting standards of interoperability. (See “Should CCHIT Influence Your EHR Selection” for more information). After all, HHS funded the creation of CCHIT to start certifying EHRs a few years ago.

How do I qualify for the maximum payment?
In order to receive the maximum payment, physicians must qualify as a meaningful user in 2011. Eligible physicians will receive a first year bonus of $18,000 (up from $15,000) and will max out the payment schedule over the next five years.

The table below illustrates the amount of a subsidy paid each year (columns) based on the year the provider first becomes eligible (rows):

No payments will be offered to physicians who first become eligible after 2014.

Practices with multiple physicians will be eligible to receive incentive payments for each provider. Remember that payments will be based on 75% of the correlating year’s Medicare and Medicaid charges. Therefore, in order to qualify for the maximum payment of $18,000 in the first year, each provider must bill Medicare or Medicaid a minimum of $24,000.

Should I purchase an EHR now or wait until 2010?
An obvious concern is whether an EHR implemented in 2009 will meet the standards set by HHS in 2010. Although a legitimate concern, waiting until 2010 to implement a system may be a mistake. Researching and selecting the right EMR can be a lengthy process, and many providers who wait may find it difficult to have a system in place in time.

Practices would be well-served to begin the research process now, allowing ample time to create a short-list of systems, perform demos with several vendors, check references, meet with vendors in person, negotiate terms, and complete the implementation and training process. To alleviate buyers’ concerns, vendors may provide binding agreements, guaranteeing their system will comply with all emerging standards.

Furthermore, buyers’ should consider CCHIT an important Certification relative to the requirement for “qualified EHRs.” While we have discussed the many opinions for and against CCHIT, we expect it to play a critical role in the EHR subsidy qualification.

What if I choose not to purchase an EHR?
Unfortunately, for physicians who choose not to implement an EHR, the stimulus bill is a double-edged sword. Not only will they forego thousands in incentive payments, but starting in 2015, they will be penalized by way of decreased Medicare and Medicaid payments. Physicians who fail to qualify as meaningful users will face decreases of 1% in 2015, 2% in 2016, and 3% in 2017, with a maximum reduction of 5% by 2020.

Above article published on

http://www.softwareadvice.com/articles/medical/
the-stimulus-bill-and-meaningful-use-of-qualified-emrs-1031209/