On Thursday, March 7, 2013, the Office of the National Coordinator for Health Information Technology and the Centers for Medicare and Medicaid Services (CMS) released a notice and request for information concerning using additional policy levers to accelerate the adoption of electronic health record systems (EHRs). In part, the agencies are looking to increase the number of provider practices satisfying the core requirements for Meaningful Use under the Health Information Technology for Clinical and Economic Health (HITECH) Act.

In the notice, the agencies state that they are looking to accomplish this acceleration by “engaging other policy areas” within the jurisdiction of the U.S. Department of Health & Human Services (HHS), and may include a combination of incentives, payment adjustments, and new requirements. The agencies have identified three main areas in which to use the policy levers:

  • Low rates of EHR adoption and exchange of health information among post-acute and long-term care providers;
  • Low rates of health information exchange across settings of care and providers (including ambulatory, behavioral, lab, post-acute, and long-term); and
  • Low rates of consumer and patient engagement in accessing and using health information and electronic communication with health care providers.

Some of the identified policy levers include:

  • Allowing and encouraging states to establish the use of EHRs and health information technology (HIT) as a required benefit in Medicaid health homes;
  • Requiring the use of EHRs and HIT as a special term and condition for current and future demonstration projects;
  • Setting forth new Conditions for Participation or Coverage to “ensure timely, electronic exchange of health information to support patient admissions, discharge, and transfers as well as care planning to ensure continuity as patients receive care across inpatient, post-acute, and long-term care providers”;
  • Requiring Medicare Accountable Care Organizations to adopt or implement EHRs and HIT (currently meaningful use of EHRs is only used as a quality measure for determining an ACO’s eligibility for shared savings and/or losses);
  • Changing the payment approach for dual eligibles as part of CMS’ Capitated Financial Alignment model to adjust the blended payments to health plans; and
  • Amending rules and regulations under the Clinical Laboratory Improvement Amendments of 1988 (CLIA) and the Health Insurance Portability and Accountability Act of 1996 (HIPAA).

Our Insight. Your Advantage. While the agencies are not taking action at this point, providers across the continuum of care should carefully review the regulatory, business, and financial impact of these proposed approaches. The agencies are accepting public comments until 5:00 pm (EST), April 22, 2013.

To read the entire notice, click here.