This page contains a Flash digital edition of a book.

Mostashari appointed national coordinator for health IT ONC

U.S. Department of Health and Human Services Secretary Kathleen Sebelius

named Farzad Mostashari, M.D., ScM, as the new national coordinator for health information technol- ogy within the Office of the National Coordinator for Health Information Technology effective April 8. Mostashari joined ONC in July 2009. He re- places Dr. David Blumenthal, who is returning to academia. Previously, Mostashari served at the New York City Department of Health and Mental Hygiene as assistant commissioner for the Primary Care Infor- mation Project. There, he facilitated the adoption of

prevention-oriented health information technology by over 1,500 providers in underserved communities. Mostashari also led the CDC-funded NYC Center of Excellence in Public Health Informatics and a project funded by the Agency for Healthcare Re- search and Quality focused on quality measurement at the point of care.

Are we all accountable? Shared savings, shared responsibilities ACOS

Commentary on CMS’ Medicare Shared Savings Program: Accountable Care Or-

ganizations notice of proposed rulemaking (NPRM) by Justin Barnes, chairman emeritus, Electronic Health Record Association (EHR Association) and vice president of marketing, corporate development and government affairs, Greenway Medical Tech- nologies.

Anticipated for publication as far back as De-

cember, and with a prescribed start date of Jan. 1, 2012, what is now the most far-reaching, and maybe the most hopeful, healthcare delivery and cost-containment proposal in decades arrived on the eve of April Fools’ Day.

But it’s no joke that among some 47 million U.S. Medicare patients, one in five who are hospitalized are readmitted within 30 days, and most suffer from more than one chronic ailment, contributing to an- nual healthcare costs approaching $2.5 trillion. The proposed shared savings program forming accountable care organizations (ACOs) seeks vol- untary three-year commitments from primary care and/or multi-specialty physician groups, hospitals, home health services, rehabilitation centers and other institutions to form communities of health committed to serving at least 5,000 patients for an initial three-year period. Essentially, the ACO model takes a logical ap- proach by building upon the physician quality re- porting system (PQRS), hospital inpatient quality reporting (IQR) and the meaningful-use program – all established initiatives to improve patient care through quality reporting, namely the electronic

6 May 2011

health record (EHR). It also proposes establish- ing 65 quality measures, grouped in five categories, that align with meaningful use.

The proposal also offers risk and reward choices so that ACO participants can find their own levels of confidence, allowing care providers already using EHRs at the point of care to take on greater reward

and risk throughout the three-year commitment. Or they can take on smaller rewards in years one and two, and then assume more risk of below-benchmark penalties only in year three.

Though ambitious in its current scope, the proposal hints at the ability for rolling start dates beginning in 2012, and initially it would allow for reporting of quality measures, followed by proof of performance, much like what transpired with the original meaningful-use proposal. I expect that the provision that 50 percent of primary care ACO providers be meaningful EHR users by year two will incur much commentary between now and June 6. I hope that providers closely study the success their peers have had with PQRS and meaningful use to date. Shared savings is a quality reporting system with a delivery, reporting, coordination and health IT structure that is already in place and has been shown to succeed in several arenas.


Page 1  |  Page 2  |  Page 3  |  Page 4  |  Page 5  |  Page 6  |  Page 7  |  Page 8  |  Page 9  |  Page 10  |  Page 11  |  Page 12  |  Page 13  |  Page 14  |  Page 15  |  Page 16  |  Page 17  |  Page 18  |  Page 19  |  Page 20  |  Page 21  |  Page 22  |  Page 23  |  Page 24  |  Page 25  |  Page 26  |  Page 27  |  Page 28  |  Page 29  |  Page 30  |  Page 31  |  Page 32  |  Page 33  |  Page 34  |  Page 35  |  Page 36