Marilyn Tavenner, Administrator of the Centers for Medicare and Medicaid Services spoke at HIMSS 2014 in Orlando Florida about interoperability, and “reduced spending in healthcare,” she said. “We want to continue to reward programs that provide value and quality. Linking quality data, reporting, and cost of care to outcomes, patient quality for all care settings and tie that to payments.” She also spoke about ICD-10, Meaningful Use Stage 2, Healthcare.gov, interoperability and details about several quality and privacy initiatives.
- Payment to quality and cost reductions via Hospital Value Based Purchasing, ESRD, and physician value modifier.
- Transition from fee for service to population based payments, starting with Medicare and Medicaid in Maryland via the All Payer Model.
- Engage beneficiaries. There are over 300,000 new Medicare Beneficiaries per month.
Over half of our Medicare enrollees in Medicare Advantage are in 4-star or higher quality plans.
- Increased Meaningful Use compliance and to date over $21 billion in stimulus funds
- Over $500 million in PQRS payments.
Ms. Tavenner then commented on important 2014 programs
- Physician Payments Sunshine Act – Payment transparency program requires reporting of any transfer of value between covered drugs, devices, biologicals, and medical supplies and physicians is in the early stages in file exchange, operational in fall 2014. Requires
- ICD-10 deadline – “…no more delays, system going live October 1, 2014.” There will be no change in the deadline. International Classification of Diseases (ICD-10) is required for all HIPAA Covered Entities.
- ICD-10 testing, four prong approach Healthcare.gov – “substantial progress has been made” and we will continue to make improvements to the site to improve usability and reliability for Americans who want to purchase insurance via the federal web site.
- Internal testing
- March beta testing and Medicare testing week
- Tools for providers to test
- July testing – volunteers will be accepted starting in March, totaling 500 total
- Stage 2 Meaningful Use of Electronic Health Records – “we have to have the ability to exchange data among systems and patients so interoperability is key.” Now is not the time to stop moving forward. There will be flexibility in receiving hardship exemptions. “However we expect providers to comply with Stage 2 MU.” Meaningful Use is specified under Title IV, Division B of the HITECH Act specifying Meaningful Use of Electronic Health Records in 2009.
- Accountable Care Organization (ACO) providers will benefit from data interoperability in these initiatives including uniform transactions.