The Department of Health and Human Services (HHS) recently announced through the Office of the National Coordinator (ONC) for Health Information Technology (HIT) its initiative for accelerating health information exchange (HIE) across a wide spectrum of providers in acute and long-term post-acute care (LTPAC) settings. Home health was included as one of these providers.
ONC and the Centers for Medicare and Medicaid Services (CMS) held a webinar on their Principles and Strategy for Acceleration Health Information Exchange and Advancing Interoperability and also released a corresponding paper. The paper outlines CMS/HHS existing policies regarding HIE and also includes feedback from a joint request for information (RFI) issued in March 2013, which received responses from more than 200 stakeholders including ling-term and post-acute care and behavioral health providers.
Among the numerous comments on advancing HIE in the RFI, the following are the most pertinent to home health care providers:
- HHS could establish methods to support the adoption of interoperable EHRs among providers ineligible for incentive payments
- CMS could include an adjustment in the fee-for-services payment model for the use of EHRs and HIE
- HHS could require HIE as a condition of participation in home health
- The ONC HIT Certification Program could be expanded to include LTPAC and behavioral health setting-specific certification criteria for use in certification
- HHS could develop an EHR certification program for all health care providers
HHS/CMS announced their plan to leverage available authorities in the Health Information Technology for Economic and Clinical Health (HITECH) Act, the Affordable Care Act (ACA) delivery reform programs, and Medicare and Medicaid payment to accelerate interoperability and electronic exchange of health information across the health care system through incremental and deliberate steps.
These program-specific changes to accelerate HIE would be intended to expand patient access to their health information, as well as routine sharing of health information between multiple stakeholders, including home health providers and other community-based providers. This would also include the development of a voluntary HIT certification program by ONC for LTPAC providers, including home health.
HHS action steps to advance interoperability and HIE include advancing multi-stakeholder development of standards though the S&I Framework and coordination with standards development organizations, encouraging widespread use of HHS-adopted HIT standards through Medicare and Medicaid, and working to align HIT standards and specifications for quality measurement and improvement across Medicare and Medicaid.
CMS action steps included supporting HIT and HIE among LTPAC providers participating in delivery models in testing, such as the State Innovation Model Initiative, using existing Medicaid, CHIP and state plan amendment and waiver process to incorporate HIE into payment policies and move forward with determining potential scope and criteria for LTPAC and behavioral health HIT certification through the HIT Policy Committee.
Home care providers interested in learning more about federal efforts in advancing interoperability and HIE are encouraged to attend session 305 entitled, Town Hall Meeting on Health IT Interoperability, Standards & Certification, at the NAHC Annual Meeting on Friday, November 1, 8 9:30 a.m.