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D'Arcy Gue
March 10, 2016
CMS made a center stage announcement at last week’s Las Vegas HIMSS conference that it is expanding financial help to a broader base of providers to purchase interoperable technology. This seemed like great news, especially to behavioral health, substance abuse and long term care facilities. The announcement went viral at the conference. Alas, the proverbial devil is in the details.
Andy Slavitt, CMS’ Acting Administrator, announced that states can now receive 90 percent matching funds to pay for technologies “to help bridge an information sharing gap in Medicaid … to connect a broader variety of Medicaid providers.” The new variety of providers includes long term care, behavioral health, addiction treatment, home health and others that have been ineligible for any technology financial support including Meaningful Use / MIPS incentives.
For many, the news suggested that these “outlier” providers would finally get financial help in purchasing an EHR. After all, what does support for interoperability mean if you don’t have an EHR to share information with other providers? You get help with buying an EHR, right? No, you do not. Let’s read the fine print.
The focus of CMS’ enhanced funding initiative is on helping MU eligible providers (EPs) achieve health information exchange with non-eligible providers. It is not on helping non-eligible providers to develop or broaden their “wiredness” unless they already have an EHR. Medicaid’s Data and Systems Group and the ONC Office of Policy have partnered to more aggressively support eligible Medicaid providers in coordinating care with non-eligible providers and in attesting to Meaningful Use / MIPS Stages 2 and 3.
HHS representatives spelled out the details succinctly in a presentation at the HIMSS conference;:
The speakers suggested that the enhanced funding will enable state Medicaid agencies to on-board Medicaid providers that are not MU incentives eligible, e.g. behavioral health organizations, into HIEs. Examples included on-boarding them to statewide provider directories, encounter alerting systems, drug reconciliations systems and query exchanges.
Unfortunately, press statements didn’t discuss these significant funding limits. Instead, according to Slavitt: “We’re announcing funding to connect many of the remaining parts of the system that are not part of the EHR incentive programs but serve our neediest patients every day….Finally, we are going to wire up long-term care, behavioral health and substance abuse providers.” He noted that CMS sees many benefits to the initiative, from care coordination to medication reconciliation to public health reporting.
This sounds great.
But, how can a paper-based behavioral health hospital be “wired up” to a drug reconciliation or encounter alerting system? Hmmm…a FAX or telephone comes to mind; they have wires, don’t they?
As long as this gap remains, nation-wide systems interoperability, the potential for a complete continuum of care, and increasingly needed population health management will remain elusive.
I urge you to review the HHS presentation for the details of its new funding initiative.
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