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HIT Policy Wonk: EHR, Meaningful Use and the State of the Union

by Lauren H. Fifield, Senior Policy Advisor

The first half of January was quiet for the Government Affairs team with the nation’s capital having been closed for the holidays. OK, fine, and maybe I was being a lazy blogger as some of you have pointed out.

But last week, to the delight of idling cab drivers and bored policy wonks alike, lawmakers came back from their districts and DC was back in business! And it quickly became clear that the spotlight will continue to shine hot and bright on health care—and our HIT corner of it.

Here’s how 2012 started off inside the Beltway:

Monday, Jan. 23

The Senate returned, joining the House, to begin their longest combined work period of 2012. Because of the presidential election, this year will likely be light on legislation after a more permanent solution to the payroll tax holiday-UI- Sustainable Growth Rate (SGR) extension is passed. Fortunately, we can count on the Centers for Medicare and Medicaid (CMS) and the Office of the National Coordinator (ONC) to keep us busy with… Meaningful Use!

Tuesday, Jan. 24

The House and Senate Conference Committee for H.R. 3630, the “Temporary Payroll Tax Cut Continuation Act of 2011” held its first meeting, which fondly brought back divided Super Committee memories, with high level statements coming from both parties. You can check out the meeting and read statements from Sen. Max Baucus, D-Mont. and Rep. Dave Camp, R-Mich. We in health care are paying close attention to their decision-making because without a fix to the SGR, physicians face a 27.5% cut to Medicare reimbursement starting on March 1. Ultimately, the debate will come down to the funding source  for an extension of some sort. The committee met again on February 1st and, right now, with so many details up in the air, many expect a decision to come down to the wire.

President Obama also gave the 2012 State of the Union address. He surprised many of us by leaving health care almost entirely off the agenda. He did reference Medicare and Medicaid, but mostly focused on job creation, education reform, energy and personal responsibility. We were, of course, happy to hear him call out the need for innovation. (Cloud! Cloud! Cloud! Just sayin’…)

Wednesday, Jan. 25

CMS sent Meaningful Use (MU) Stage 2 Notice of Proposed Rulemaking (NPRM) to the Office of Management and Budget (OMB) for regulatory review. CMS had previously sent the proposed rule for new and revised standards, implementation specs and certification criteria for electronic medical records (EHRs). In case you were wondering… the rules get sent to the OMB because they have an effect on our budget.

Besides the budget implications, the Stage 2 NPRM matters because it will define the Stage 2 criteria eligible providers must meet beginning in 2014, using a certified EHR, in order to meet Meaningful Use (MU). In contrast, the certification proposed rule will inform HIT vendors of standards that they must incorporate into their development for Stage 2 certification. Some items we expect to see include more specialty-specific measures, usability requirements, certification process details and interoperability and standards specifications.

The HIT Policy Committee met again on Feb. 1, though CMS informed the committee that, due to the timing, it would not be prepared with an updated analysis of MU performance results. You can refer to their January analysis for national trends and check out our Meaningful Use dashboard for athenahealth results.  Because of the February 29th attestation deadline, we don’t expect final Year One numbers until March.

Thursday, Jan. 26

CMS and the ONC hosted The Care Innovations Summit, with over 1,000 attendees from across the health care spectrum. It’s always a treat to hear Atul Gawande speak and see Todd Park, Farzad Mostashari and Aneesh Chopra bring enthusiasm that I’m not accustomed to finding in health IT outside the walls of athenahealth. (As a side note, we’re sad to see Aneesh Chopra leave his federal role.) I’ll focus on the summit in a subsequent post, but the biggest highlight was a clear, broad consensus on the need for VALUE-based care.

Friday, Jan. 27

On Friday, the Bipartisan Policy Center released a report, “Transforming Health Care: The Role of Health IT,” at a morning event in DC. Whether you’re looking for good data, big ideas, or a good summary view of the status of HIT and its role in health care reform, I recommend reading the report. This one is right in our wheelhouse and we’ll circle back to it soon.

En fin

If you find your brain spinning (don’t worry, mine was too), stay tuned for deeper coverage of all these topics and events in the coming months. Think of this as a cheat sheet for what’s on deck in 2012. As always, we appreciate all your comments and questions, so send them in.

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