1.The Affordable Care Act and its Impact on Health IT

2. 3 Health IT Themes in ACA Enhance Quality Reporting andMeasurement Expand quality reporting (PQRS, ACO performance measures, etc.) Improve quality of care (evidence-based guidelines, CDS) Encourage quality through reimbursement modeling (CMMI) Needed for reimbursement reform 3. 3 Health IT Themes in ACA Establish Uniform Operating Rulesand Standards Promote Health IT WorkforceDevelopmentRemember: The ACA ruling may impactcertain funding provisions. 4. ACA and Health IT - Data 2717 Establishment of quality reporting forinsurers o CMS is an insurer (Medicare and Medicaid), extends to private insurers o Priority given to: Health care outcomes Management across episodes of care / transitions of care Use of health IT Informed treatment decisions and shared decision- making 5. ACA and Health IT - Datao If upheld, Preference for Clinical Care must bedefined by HHS Use of CDS to guide preference-sensitive treatment choices Drives reimbursement Controversial for government My doctor should decide, not my government. 6. ACA and Health IT - Data 3004 and 3005 Submission of qualitymeasures to HHS o Affects LTC, Hospitals, Inpatient Rehab, Hospice and Cancer Hospitals 3013 Grant awards for purposes of developingHealth IT Quality Measures o Focus on where no measures exist o Seeks to create standards for measuring population improvement o Quality Reporting becomes a broad federal initiative 7. ACA and Health IT - Data 4302 Federal data collection at the smallestlevel possible o HHS/ONC to develop national standards for data collection, interoperability and security for data management o Includes federally conducted/supported health care programs or surveys 8. ACA and Health IT - Educate 6301 Communication and KnowledgeTransfer (ARHQ) oRFP issued for preferred vendors for Knowledge Transfer o $150M in Grant awards earmarked 10332 Medicare A, B, and D Claims Data o Probabilistic Matching between unrelated databases Leveraged with ACOs o Impact Physician Compare rating website o Patient Privacy issues? Challenged in other courts (Patient de-identified, Provider Identity intact) 9. ACA and Health IT - Educate 10333 Grants for Community-basedCollaborative Care Networks Example: Tele-health services 10109 HHS to receive input Input from NCVHS, HIT Policy Committee, HIT Standards Committee, Standards Orgs and Stakeholders will be considered 4103 Annual Wellness Visit for eachMedicare Patient o Increase Self-Management through use of Health IT 10. ACA and Health IT - Educate 5405 Primary Care Extension Programs o Education / Technical Assistance in Evidence- based Practices o HHS to consults with agencies experienced in health care / prevention, including ONC 934 Technical Assistance Grants o Provide education / technical assistance to health care providers o Must coordinate with RECs regarding quality improvement, reform and best practices 11. ACA and Health IT - Educate 5604 Grants to Community Mental HealthPrograms o Includes for provisions of Health IT 6701 Grants for LTC Facilitates for CertifiedEHR Technology 12. ACA and Health IT - Measure 10305 Public Reporting of PerformanceData o Requires alignment with other Health IT efforts 1322 Consumer Operated and Oriented Plan(CO-OP) o Non-profit health insurance companies o CO-OP Organizations Collective Purchasing for items and services, including HIT 13. ACA and Health IT - Measure 1323 Community Health Insurance, orExchanges o Use Health IT for real-time data for investigation of fraud/abuse 2401 Home/Community-based services andsupport o To help eligible patients with care such as daily living o Includes back-up systems for Continuity-of-Care 14. ACA and Health IT - Measure 2703 Chronic Condition Consumers receivepayments o Provision for home health services o Includes use of Health IT for care management 15. ACA and Health IT Pay-for-Value 10410 Grants to establish National Centers ofExcellence for Depression o Includes use of EHR and Tele-Health technologies 1311 Reformed Provider Reimbursement Ind. & SBA o Increased pay for best practices, evidence-based medicine and use of Health IT 16. ACA and Health IT Pay-for-Value 2706 Pediatric ACO Demonstration Incentives for Quality 3002 PQRS integration with MU CQMs o Establishes informal review process 3021 CMMI Created ($10B in funding) o Innovative payment and service delivery models o Includes ACOs and Health IT enabled networks 17. Learn more!Our website hosts a wealth of freeresources, including white papers,case studies, an industry blog, anewsletter covering current events inhealth care, tips and tricks for yourpractice, and other informative articles. www.successehs.com