Congress Adjourns for the Year, 115th Congress Sworn in Jan 3
Key Takeaway: Members of Congress have left town for the year, and the 115th Congress will take their places on January 3, 2017.
Why It Matters: With healthcare reform likely to take center stage in 2017, it’s worth considering what we can expect from the 115th Congress and where health IT falls into the mix.
The House and Senate will look mostly the same, with minor shifts in voting margin. The Senate Republicans hold a 52-46 (with 2 independents caucusing with the Democrats) majority, while in the House Republicans hold a 241-194 margin over the House Democrats. A major change in Senate leadership to note, Senator Charles Schumer (D-NY) takes over the role of minority leader from retiring Nevada Senator Harry Reid.
Among the Committees of Jurisdiction, in the House, Representative Greg Walden (R-OR-02) takes over the reins of the Energy & Commerce Committee from term-limited Representative Fred Upton (R-MI-06). The chairman of the health subcommittee of Energy & Commerce is yet to be announced as Representative Joe Pitts (R-PA-16) is retiring. Congressman Richard Neal (D-MA-01) takes over as the top Democrat on the Ways and Means Committee.
Senators Lamar Alexander (R-TN) and Patty Murray (D-WA) will remain as the leadership of the Senate Health, Education, Labor and Pensions Committee, while Senators Orrin Hatch (R-UT) and Ron Wyden (D-OR) will continue to lead the Finance Committee.
In 2017, Congress will both be tasked with the potential repeal and replacement proposal for the Affordable Care Act (ACA), as well as delivering on some must-pass legislation like the reauthorization of the Food and Drug Administration User Fee Amendments and the Children’s Health Insurance Plan (CHIP). The “user fees” may be an opportunity to raise concerns about cybersecurity and interoperability, particularly with the medical device user fee amendment (MDUFA).
While health IT policy may appear to take a backseat, the “A Better Way” ACA replacement proposal does include directives to ensure that patients have electronic access to their health information in their so-called healthcare “backpack.” CHIME will monitor the ACA reform efforts closely to account for how any changes may impact delivery system reform efforts such as accountable care organizations (ACOs) or Alternative Payment Models (APMs.)
Further, discussion of reforms to the Meaningful Use program, such as timeline changes or construct changes are likely with a Republican-controlled House and Senate and a likely Secretary of Health and Human Services (HHS) that has been sympathetic to clinicians in their concerns about the regulatory burden imposed by the EHR Incentive Program. The CHIME-supported EHR Regulatory Relief Act (S.3173) introduced by a group of Republican Senators known as the REBOOT group, may be a bill for consideration in the new Congress. Meaningful Use reform efforts will likely be aimed are streamlining the requirements across Medicare and Medicaid Meaningful Use for hospitals, Medicaid physicians and the Medicare physicians in the Merit-based Incentive Payment System (MIPS.)
The Health Care Industry Cybersecurity Task Force, established in the Cybersecurity Information Sharing Act of 2015, will submit a report to Congress, as early as next March on how to improve the cybersecurity stature of the healthcare industry. Their recommendations are to cover topics including the sharing of cybersecurity threat information and securing medical devices recognizing some of the unique properties of the healthcare industry.
The current government funding package expires on April 28, 2017, therefore Congress will need to pass a funding package or packages, to allow federal agencies to be funded.
Quality
Need Help Tracking CMS Reporting Requirements?
Key Takeaway: Sign up for their new Quality Payment Program Listserve.
Why it Matters: Keep tabs on the latest from CMS by signing up for their new listserve. The start of 2017 brings with it the start of the Merit-based Incentive Program. The new listserve will have resources, timeline reminders, and information on CMS training and webinars. You can sign up by going here and selecting “Subscribe to Email Updates” in the footer.
ICD-10 Update on eCQMs
Key Takeaway: CMS will update all impacted electronic clinical quality measure (eCQM) value sets for the 2017 performance period.
Why it Matters: CMS will issue an addendum to the 2016 eCQM Specifications to update relevant ICD-10-CM and ICD-10-PCS eCQM value sets for the 2017 performance year. These changes will affect:
- The Hospital Inpatient Quality Reporting (IQR) Program;
- The Medicare Electronic Health Record Incentive Program for eligible hospitals and critical access hospitals;
- The Merit-based Incentive Payment System (MIPS) for MIPS eligible clinicians.
These changes will only affect the value sets for the eCQMs. The Health Quality Measure Format (HQMF) specifications, the value set object identifiers (OIDs), and the measure version numbers for 2017 eCQM reporting will not change. All changes to the eCQM value sets will be made available through the National Library of Medicine’s Value Set Authority Center (https://vsac.nlm.nih.gov/) starting in early to mid-January 2017.
Payment & Delivery Reform
ACO Update
Key Takeaway: CMS Makes Several Announcements
Why it Matters: According to CMS there are 433 Shared Savings ACOs covering 7.7 million lives with most providers participating in ACOs that do not carry risk of financial loss. With weeks to go before 2017 CMS makes a series of announcements including:
- New Medicare-Medicaid ACO: The Medicare-Medicaid ACO Model builds on the current Medicare Shared Savings Program and advances efforts to partner with states in transforming the health care delivery system.
- The Beneficiary Engagement and Incentives (BEI) Models: Aimed at patient engagement CMS announced two new models:
- The Shared Decision Making Model: will test a specific approach to integrate a structured Four Step shared decision making process into the clinical practice of practitioners who are participating Accountable Care Organizations (ACOs). The shared decision making process is a collaboration between the beneficiary and the practitioner.
- The Direct Decision Support Model: will test an approach to shared decision making provided outside of the clinical delivery system by an organization that provides health management and decision support services.
Interoperability
ONC Update
Key Takeaway: ONC keeps at it with new announcements on interoperability.
Why it Matters: ONC makes several announcements intended to spur interoperability including including free workforce training at several universities nationwide!
- Medications: Coordinating a live demonstration of consumer-friendly applications (apps) that import data from some of the largest health information technology (IT) vendors in the country to allow individuals to access a consolidated list of their medications from a variety of sources in one place using Fast Healthcare Interoperability Resources (FHIR). For more information go here.
- Privacy: Announcing the Privacy Policy Snapshot Challenge which calls on stakeholders to use ONC’s Model Privacy Notice template to create an online tool that can generate a user-friendly “snapshot” of a product’s privacy practices. ONC will award a total of $35,000 in prizes through this challenge. Enter your submissions now! The deadline for submission is April 10, 2017 with winners expected to be announced in mid-2017. For more information, view the Federal Register Notice. ONC is hosting a webinar on Thursday, January 12, 2017 at 2:00pm – 3:00pm ET for interested parties. Register for the webinar here.
- Public Health: ONC together with the and Office of Civil Rights (OCR) published a new fact sheet explaining how providers are permitted to share electronic protected health information (PHI) with public health agencies without obtaining an individual’s written authorization. Read the full blog post at the Health IT Buzz Blog.
- Workforce Development: ONC is sponsoring free, online health IT trainings hosted by numerous institutions across the nation. Registration is open but space is limited at the universities’ discretion.
