Author Archives: HITC Editor

The ACA, state modernization efforts, budget, technology advances – are all critical factors shaping, and in some cases forcing states to consider new ways to procure health care information technology. This session will explore the critical issues that federal and state leaders are grappling with as they look to adopt new technologies, fund extensive infrastructure needs, and improve procurement processes to build a modern health care system.

Keynote Panel: Medicaid IT Reform, Exploring New Models for IT Procurement

Moderator: Laura Groschen, Vice-President, Government Solutions, Optum
Jessica Kahn, Director, Data and Systems Group, CMS
Karen Parker, Director of the Bureau of Medicaid Operations, Michigan Department of Technology, Management and Budget
Linda Pung, Information Officer, Michigan Dept. of Technology, Management & Budget
Stuart Fuller, CIO, Montana Dept. of Public Health & Human Services

The 2015 State HIT Connect Summit, held March 23-24 in Baltimore, MD – is a national forum bringing together public and private thought leaders to share and benchmark implementation strategies of state health IT systems as they move forward with their diverse healthcare transformation and reform strategies.

You can register here>> to be directed to view the presentation in HD video with downloadable PPT.

Participation at the 2016 State HIT Connect Summit – subscribe here>> to receive the Healthcare IT Connect newsletter and updates for the 2016 meeting. You can also email victorias@healthcareitconnect.com to receive a speaking proposal and robw@healthcareitconnect.com to discuss sponsorship opportunities.

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A number of key Medicare and Medicaid health indicators have shifted since the Affordable Care Act was passed, and healthcare IT systems were behind many of these shifts, said Rahul Rajkumar, MD, Deputy Director of the Center for Medicare and Medicaid Innovation.

Speaking to a record-high audience from 40 states at the State Healthcare IT Connect Summit in Baltimore, Rajkumar said that

• Growth rates of Medicare and Medicaid costs slowed to practically zero (compared to GDP growth of three percent), since 2008.
• In their first year, Pioneer Accountable Care Organizations (ACOs) met all their clinical quality and patient experience measures.
• Dramatic increases in care quality were seen, from 72 to 85 percent.
• The Partnership for Patients model saw a 17% reduction in hospital acquired infections from 2010 to 2013, translating into 50,000 lives saved and $12 billion in savings.

How did this happen? Rajkumar compared two model systems, one in his grandfather’s India, in which a clinic that diagnosed and treated his relative’s stroke demanded cash payments up front. The other was in Arkansas, where a CMMI model called SAMA care delivers care in teams, each of which has a care coordinator that provides preventive care for 19,000 patients. Using Allscripts, the teams can determine missed treatments and necessary follow-up care. They also use risk stratification tools to determine necessary care before a patient even comes in for a visit.

Healthcare in the US is shifting from the first system, which Rajkumar described as “the more you do, the more we pay you,” to “one that sends a new signal to the market place, that demands care that is patient centered, sustainable, and coordinated.”

New systems being developed by CMMI are helping change the way we pay providers, the way we deliver healthcare, and our capability to deliver “the right information at the right time to make the right decisions,” Rajkumar said.

More healthcare systems are moving from pure fee-for-service, into a payment system with some links to value and quality (including hospital value-based purchasing and quality reporting, to a future that will see paying for value with expanded ACOs and patient-centered medical homes, to, ultimately a payment system that compensates providers for care to a whole population, without any triggers by specific services. “Three years ago, nobody was beyond the second system, with links to value and quality,” Rajkumar said. “But by 2016, 30 percent of Medicare payments will be in alternative payment circles. By 2018, the majority will be in alternate payment systems.”

But no healthcare official, whether in IT, finance or clinical care, should forget the primary objective of healthcare system changes. “My call to action to you is to, in your day to day work, wear the hat of a patient. If we live long enough, we all will be Medicare beneficiaries. We will all be patients.”

Rahul Rajkumar, MD, Deputy Director of the Center for Medicare and Medicaid Innovation recently presented at the 2015 State HIT Connect Summit, March 23-24 in Baltimore, MD – a national forum bringing together public and private thought leaders to share and benchmark implementation strategies of state health IT systems as they move forward with their diverse healthcare transformation and reform strategies.

You can register here>> to be directed to view the presentation in HD video with downloadable PPT.

Participation at the 2016 State HIT Connect Summit – subscribe here>> to receive the Healthcare IT Connect newsletter and updates for the 2016 meeting. You can also email victorias@healthcareitconnect.com to receive a speaking proposal and robw@healthcareitconnect.com to discuss sponsorship opportunities.

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With Round Two the of State Innovation Model (SIM) program grants, $660 million has been made available for states to continue changing how they deliver and evaluate healthcare. While each state is taking a different set of tactics, there is a lot that they have in common. Most importantly, they all need to demonstrate how IT can affect outcomes, panel participants told the audience at the State Healthcare IT Connect Summit in Baltimore.

Hunt Blair, a subject matter expert contractor for the Office of the National Coordinator, said “$660 million sounds like a lot, but it’s really just seed money. It’s a catalyst for change—to bring together and accelerate conversations about pay for performance and healthcare innovations.”

Kate Kiefert, State HIT Coordinator for Colorado, reviewed how the state created a foundation for long-term healthcare IT ecosystems. Colorado has two successful exchanges, and has connected 71 acute care hospitals with 10 in development. About 1.2 million Coloradans are now covered under Medicaid. The state has an all-payor claims database, and an active comprehensive primary care initiative with payors. “This was a lot of IT investment,” she said. Still, the state is working on coordinating governance and introducing meaningful use into health care. “We haven’t come up with a comprehensive cost, and quality measurement strategy.” Under SIM, a $65 million to provide access to integrated primary care and mental health services could help in this direction.

Camille Harding, Quality and Health Improvement Manager for LPC, said that Colorado was looking at lots of different data sources. “We started looking at the clinical measures available, what’s collected in public health and environment agencies, and human services offices,” she said. The Brookings Institution model for moving people out of poverty and into the middle class, she said, has been helpful for also looking at outcomes indicators that can make these social shifts. For example, screening new mothers for depression could be compared to data on depression at a state or local level, and connected to other indicators such as graduation rates, higher education attainment, crime, or unintended pregnancies.

William Golden, Medical Director for Arkansas Medicaid, noted that while Arkansas in its in fifth year of payment reform, a lot of IT work predated the SIM program. “We had a vision of working toward effectiveness and improved outcomes across all health care services.” For acute care, the state entered all episodes of care (patient treatments, admissions, etc.) into a spectrum. They could then look at risk-adjusted care per provider, for a year (since the state is entirely fee-for-service, this was valuable to showing providers how they fared with others). The state now has an extensive patient centered medical home program, with substantial savings incentives for keeping costs in control. Providers can now see if patients spend more on pharmacy, ER use, or pathology labs, for example. They’re now up to 150 practices with 700 doctors, a significant scale up in a short period of time.

In New Jersey, the state Department of Health studied and discovered six hospital conditions that could have been prevented at the public health of primary care level, with a savings of $6.1 billion, said CIO Cathleen Bennett. “These were not catastrophic or severe chronic conditions,” she added. For its SIM program, the state focused on birth outcomes. Medicaid births total a third of all state births, and the health department focused on low birth weights because of their health and family risks (as well as costs). “The biggest struggle was to figure out who is involved, or should be involved, in each care episode.” It turned out that 14 different groups or individuals are involved with just birth outcomes. They’re now using a SIM planning grant to improve coordination and ultimately outcomes, with a go al of an eight percent reduction in pre-term births. “For prevention, quality and integrating public and clinical health, we’re working to get disparate systems to talk to each other.”

Ohio also had made a lot of investments in technology infrastructure, but needs to look more at healthcare outcomes, said Rex Plouk, Enterprise Health IT Officer for the state. Ohio is largely managed care, and the state rolled out five models and tried to find ways to leverage data the state already has. “We have silos within silos of data,” he said. “There’s a lot of value here, and people have told us they could do more with it.” The state is creating “use cases,” essentially expanded healthcare/patient profiles, to “tie real life examples to technology,” Plouk said. “We use these to identify cases where gaps are, and we can apply technology.” SO far, the state has developed 50 such cases.

Overall, under the SIM program, “whether in planning, design, or testing, you’re making fundamental changes in payment, delivery systems; you’re looking at patients differently, and it’s multi-payor,” said Yvonne Powell, Senior Vice President for States and Payors, for the Lewin Group. “You’re fundamentally changing healthcare systems. It’s surprising how well it’s worked. But it’s a very heavy lift,” indicating the need to better match HIT with users, quality and outcomes.

The 2015 State HIT Connect Summit, March 23-24 in Baltimore, MD – is a national forum bringing together public and private thought leaders to share and benchmark implementation strategies of state health IT systems as they move forward with their diverse healthcare transformation and reform strategies.

You can register here>> to be directed to view the presentation in HD video with downloadable PPT.

Participation at the 2016 State HIT Connect Summit – subscribe here>> to receive the Healthcare IT Connect newsletter and updates for the 2016 meeting. You can also email victorias@healthcareitconnect.com to receive a speaking proposal and robw@healthcareitconnect.com to discuss sponsorship opportunities.

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In healthcare, modular, transferrable systems that can be shared among a multitude of agencies are replacing the monolithic, customized IT systems of the past, a panel of state CIOs observed at the State Healthcare IT Connect Summit in Baltimore.

“There’s a shift in IT focus, moving from buildings and architects to the city view, looking at the entire landscape and asking, where do the buildings all fit in our city,” said Ron Baldwin, CIO of the State of Montana and moderate of the keynote panel session.

“The next generation of healthcare systems must leverage a lot of things to be a holistic approach,” he said. “They will be more agile—more iterative and incremental, demonstrating results early and often. The patience and money for taking years to delivery something just isn’t there anymore.”

The three panelists—Mike Wirth, special advisor on eHHR integration for Virginia’s Department of Health and Human Resources, Sean Pearson, deputy cabinet secretary for New Mexico’s Human Services Department, and Chris Clark, executive director of Kentucky’s Office of Administrative and Technology Services—answered a series of questions on the direction of healthcare IT.

Question—How are you leveraging components of integrated eligibility systems?

Pearson—“We just finished a system to integrate other programs and health services. We saw a need to modernize our information systems. Medicaid touches several state agencies and federal partners, as well as providers. There’s a lot of commonality in what we are asking MMIS with what other agencies are asking, such as child support, WIC, child welfare.

Clark—Components were already in place to meet ACA requirements, such as document management repositories, identity and access management. We’re working on a workflow solution that could work for eligibility systems as well as the health exchange. We’re looking at SNAP, WIC, and other programs to be using the same technology.”

Wirth—“A lot of what we’ve done, can go to other secretariats. We’re looking at elections, because it’s good for them to improve voter rolls, or DMV.

QQuestion—How should the next generation of MMIS be built?

Clark—“There is no be-all, end-all solution. We need ability in operations today, to deal with changing business requirements and regulatory changes. Now, we expect real time data exchange, instead of overnight batch jobs.”

Wirth—“We’re about 65 percent managed care in Virginia. Continuing on the ACO model, what will be left in MMIS are the most challenging groups, compound needs individuals. We will need a lot of flexibility to handle groups, like age-blind disabled, the homeless, and veterans. Stable housing may even be part of decision criteria.”

Pearson—“We decided that this is not a pure information technology project. We needed to find services to integrate with our agencies and services, to improve health and services.”

Question—How can IT contain costs, even under Medicaid expansion?

Wirth—“Our previous administration sued the federal government over ACA, but now the new administration came in to expand it. We don’t know if expansion will continue. But moving enterprise services defrays the risk. The more agencies that use your services, the less of an impact any change will have.”

Clark—“Before the ACA, Kentucky had the 10th highest uninsured rate in the country. With the health exchange, 500,000 people enrolled in quality healthcare. We went form 10th highest in uninsured to 11th lowest. With the expansion, we identified over a billion dollars paid to providers, half of that to hospitals. There is a $30 billion economic impact. IT can save costs—the real savings are in health delivery programs, like ACOs, or patient centered medical homes. And there’s a value in a healthy workforce.”

Pearson—“We had 200,000 enrollees in the first year of Medicaid expansion in New Mexico. It caught us off guard. Analytics and big data are important here, so we understand the financial impact of people coming into the extended program.

Question—What were the results of integrated human services and healthcare?

Pearson—“We did the integration all at the same time, phasing in programs across the state, while expanding Medicaid. The big value was getting policymakers to talk about the whole person, and the expansion showed us the impact on other programs in the state.”

Wirth-“When we opened our new portal, we brought everything into that system. We saw opportunities to reach out to other groups, to make this a one-stop shop.”

Clark—“We’re expanding our current system to SNAP, TANF and other programs. We’re looking at correcting some of that history of being at the bottom. Smoking, obesity and diabetes are a key focus. Our providers want actionable data, and proactive applications. We may be able to meet some of those needs with technology.”

Question—What’s been the impact of incremental modernization, versus rip and replace strategies?

Pearson—“Old systems cost $250 million or more. We recognized that MMIS systems take a long time, that states want everything under the sun. But multiyear projects didn’t work for us. We are changing the that systems integration happens in New Mexico.”

Clark—“We started our exchange in October 2013. Now we’re heading down a path of reusing components created from that, as well as taking other components. A lot of systems stay in government longer than we anticipated.”

Wirth—“Modular incremental approaches make sense. But this isn’t something our states have traditionally done. When talking about an agile system, we may be scaring some folks. They’ve been used to doing something the same way for a number of years.”

The 2015 State HIT Connect Summit, March 23-24 in Baltimore, MD – is a national forum bringing together public and private thought leaders to share and benchmark implementation strategies of state health IT systems as they move forward with their diverse healthcare transformation and reform strategies.

You can register here>> to be directed to view the presentation in HD video with downloadable PPT.

Participation at the 2016 State HIT Connect Summit – subscribe here>> to receive the Healthcare IT Connect newsletter and updates for the 2016 meeting. You can also email victorias@healthcareitconnect.com to receive a speaking proposal and robw@healthcareitconnect.com to discuss sponsorship opportunities.

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Featured Keynote Presentation | Monday 23rd March 10:45 a.m. 11:45 a.m.


Keynote Panel: State CIO Leadership in Healthcare Transformation

Moderator: Ron Baldwin, CIO, State of Montana
Mike Wirth, Special Advisor on eHHR Integration, Virginia Department of Health and Human Resources
Sean Pearson Deputy Cabinet Secretary New Mexico Human Services Department
Chris Clark, Executive Director of the Office of Administrative and Technology Services (OATS), State of Kentucky

2015 will also prove a critical year for States who are streamlining operational models for State HIX whilst at the same time extracting valuable data to better inform carriers and State Medicaid on consumer behaviors and trends. At the same time, Federal agencies and state collaboratives are exploring Medicaid reform and new trends in IT procurement as levers for improved system and data interoperability that will also support improved service coordination between health and human services.

During this period of reform implementation States and the supporting Health IT infrastructure will play a critical role in the success of State transformation efforts, the summit convenes experts in health IT, policy and strategy to enable insights into these rapidly evolving technologies.

Attendees are encouraged to participate in an active dialogue with presenters and to introduce your own organization’s experiences during the conference sessions, industry roundtables and networking events.

Register to attend the 2015 State Healthcare IT connect Summit | Book your Accommodation at the Marriott Waterfront Hotel Rate ends Mach 10th

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Utah has been exploring methods to develop interoperability among enterprise Master Person Indices among Utah Department of Health (UDOH), the clinical Health Information Exchange (cHIE), Intermountain Healthcare and University of Utah Healthcare since 2010. Currently Utah MPIs strategy is evolving from building a centralized “Master of Masters” to a MPI-service network. For example, UDOH MPI offers death notifications from the death registrations and cHIE MPI provides patient identification cleansing services to its members. This roundtable will introduce Utah’s experience, invite others to share their experiences and suggestions, and form practical solutions to enhance interoperability of Health Information Exchanges.

Join Wu Xu, Ph.D., Director, Center for Health Data and Informatics, Utah Department of Health presenting at the States of Implementation Roundtables at the 2015 State Healthcare IT Connect Summit, March 23rd 24th

Register to attend | Book your Accommodation at the Marriott Waterfront Hotel Rate ends Mach 10th

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The Silver State Health Insurance Exchange began life as a State-Based Marketplace, managing both operations and exchange-related technology.  In the course of dealing with operational problems and in an attempt to resolve a critical issue – the nearly complete failure of the technology developed by its contractor – the Exchange Board decided to abandon its dysfunctional system and adopt the federal application and enrollment platform (Healthcare.gov).  With this decision, the Silver State Health Insurance Exchange became a never before contemplated hybrid – a state managed marketplace utilizing federal infrastructure. Learn about this new model which has allowed Nevada to continue to control our insurance market while leveraging federally-developed technology.

Join Bruce Gilbert, Executive Director of the Silver State Health Insurance Exchange presenting at the States of Implementation Roundtables at the 2015 State Healthcare IT Connect Summit, March 23rd 24th

Register to attend | Book your Accommodation at the Marriott Waterfront Hotel Rate ends Mach 10th

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As States struggle to find ways to define and pay for high value care, especially in fee for service models, Wyoming has developed a method that integrates Meaningful Use and the Patient Centered Medical Home model. Physician practices attest to meeting NCQA standards defining a PCMH and then report their Clinical Quality Measures into the State Level Registry that is used for MU. By tracking outcomes over time the State will be able to pay higher case management fees to those practices reporting the highest quality. 

Join James F Bush MD, FACP, Wyoming Medicaid Medical Officer presenting at the States of Implementation Roundtables at the 2015 State Healthcare IT Connect Summit, March 23rd 24th

Register to attend | Book your Accommodation at the Marriott Waterfront Hotel Rate ends Mach 10th

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onc_1520
The Office of the National Coordinator for Health Information Technology (ONC) has published a strategic plan detailing how the federal government views the nation’s current landscape and articulates the values and priorities in shaping tomorrow’s landscape. The plans aims delineate the flexibility of the participating federal entities in evolving definitions of health and healthcare along with the expectations and demands upon future information systems as both the users and demands of these systems increase.  

The Federal Health IT Strategic Plan 2015-2020 identifies the federal government’s health IT priorities. While this Plan focuses on federal strategies, achieving the vision and goals requires collaboration from state, local, and tribal governments. Efforts by health care entities and providers, public health entities, payers, technology developers, community-based nonprofit organizations, homebased supports, and academic institutions are also essential.

Download the Federal Health Strategic Plan Here

Source Healthit.gov

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health&human_services
Forward-thinking government leaders are adapting practices from the commercial world — from customer segmentation and geospatial mapping to advanced customer analytics — to customize the design and delivery of human services. Learning to think geospatially can offer huge benefits to human-services providers. Health-care pioneers are among those putting the power of geospatial analysis to good use. A more customized approach has the potential to improve the system, even as it lowers costs. Learn More

Source Governing 

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