CMS BQI Project Expands
With the recent additions of California and Arizona, the total is now up to six regional healthcare collaboratives that have joined the Centers for Medicare and Medicaid Services’ (CMS) Better Quality Information (BQI) project. The California Cooperative Health Care Reporting Initiative and Arizona State University’s Center for Health Information and Research are the latest to combine claims data or clinical information with that of Medicare in an effort to provide consistent measures of quality for provider services. The Delmarva Foundation for Medical Care has entered into subcontracts with each region. As one of CMS’s quality improvement organizations, the Delmarva Foundation is a national nonprofit that implements quality improvement projects and CMS-related initiatives with healthcare providers, organizations and health plans in Delaware, Maryland and Virginia. The other four collaboratives in the BQI project include Indiana Health Information Exchange, Massachusetts Health Quality Partners, Minnesota Community Measurement and Wisconsin Collaborative for Healthcare Quality. All of the regional collaboratives are part of the Value Driven Health Care Initiative spearheaded by Secretary of Health and Human Services Mike Leavitt.

CMS Consolidates Medical Claims System
The Centers for Medicare and Medicaid Services (CMS) moves a step closer to consolidating data centers with the awarding of the third task order to Electronic Data Systems Inc. (EDS). The company will provide application hosting and production support at its data center for 180 million Medicare claims from twelve states at a cost of $92 million. The EDS indefinite-delivery, indefinite-quantity contract vehicle goal is to reduce the CMS data centers, which house computer and network equipment supporting agency program operations, from 20 to four. The EDS third task order contract will last for one year with five 1-year options for full fruition of the award. EDS also was awarded an earlier task order to provide Web hosting services to support all of CMS’s outward facing Websites, as well as the task order to provide processing of fee-for-service Medicare claims.

South Carolina-based Companion Data Services (CDS) also has been awarded a 6-year $200 million task order to provide electronic data processing and hosting services for about 650 million claims filed annually by hospitals and physicians in 30 states, the District of Columbia and Puerto Rico. CDS will be required to process about 54 percent of the 840 million Medicare claims filed annually by January 2008. CDS, EDS and IBM are the three companies competing for task orders under the 10-year, $1.9 billion EDC contracts. CMS will move software applications and hosting operations for Medicare, Medicaid and the states’ children’s health insurance program to the new data center over the next five years.

Massachusetts Introduces Mandatory Health Plans
The Massachusetts Commonwealth Health Insurance Connector Board recently approved 28 low-cost plans offered by seven insurers. The move is part of Massachusetts’ effort to extend healthcare insurance to every resident. Beginning July 1, uninsured residents will face growing penalties such as losing their personal state income tax deduction. The plans, known as Commonwealth Choice are intended to cover the state’s nearly 200,000 residents who earn too much for subsidized coverage. Previously, the state introduced free health coverage for low income residents and subsidized plans for those earning up to three times the federal poverty level, or about $29,000 a year for an individual.

Among the basic plan designs are the "Bronze" level, which provides lower monthly premiums but higher out-of-pocket expenses in the form of copayments, deductibles and coinsurance, and a "Gold" level with higher premiums but fewer out-of-pocket expenses. There are also low cost plans for young adults, with all of the plans providing comprehensive coverage options as determined by the Connector Board.

Critics worry about the plan’s affordability for the working and middle class. Many cite the coinsurance aspect, which they say requires a patient to pay a percentage of the total healthcare cost rather than a set copayment. State officials are considering exemptions. Insurers participating in the plan include Blue Cross and Blue Shield of Massachusetts and Harvard Pilgrim Care, who will offer statewide coverage, as well as ConnectiCare, Fallon Community Health Plan, Health New England, Neighborhood Health Plan and Tufts Health Plan who will provide regional coverage.

Medical Information Wiki
AskDrWiki.com is the latest Wikipedia-style medical information site to go online. Started by four doctors from the Cleveland Clinic, the site primarily focuses on cardiology and electrophysiology clinical notes—the specialties of three of the four founding physicians. Ask Dr Wiki has more than 350 articles with 50 percent of the nearly 200 unique daily visitors coming from outside the United States. There are currently more than 20 wiki medical information sites that deal with a variety of approaches and specialties, some open source and some peer reviewed. Most require posters to register with verifiable credentials. Physicians are generally skeptical of the accuracy and therefore safe use of the information contained on many of the open source medical information sites. However, an equal number see them as having definitive benefits to physicians and the general public. Ask Dr Wiki recently went from an open source setup where virtually anyone could update the information, to a registration-based approach where the posters must verify their credentials before being allowed to post or change information.