HHS Secretary Kathleen Sebelius writes in Kaiser Health News about “new momentum” behind the adoption of electronic health records.  In the column, Sebelius discusses the assistance available to providers to help them purchase and utilize EMR, as well as steps being taken by major health care stakeholders to adopt e-records.

The Recovery Act passed in early 2009 includes several provisions to help providers – physicians as well as hospitals – adopt EMR.  These include: IT Regional Extension Centers – of which there are 60 – to help providers find out which system is right for their needs and help with the switch from paper; grants to help states create health information exchanges to make sure that e-records can be shared among providers, while protecting patient privacy; and, bonus payments for providers who adopt e-records – up to $44,000 in Medicare and $64,000 in Medicaid for individual providers, and potentially millions for hospitals.

Secretary Sebelius also made note of a recent forum at Brandeis University which included industry stakeholders – insurers, hospitals, physicians, and others – pledging their commitment and assistance in the adoption of EMR across the medical system. Some insurers are even developing their own provider loan and training programs.

At this event, stakeholders endorsed the “meaningful use” regulations, which providers will have to follow to qualify for incentives for switching from paper to e-records. The “meaningful use” standards require that electronic health records improve the quality of care and are used to – collect health data, support better clinical decisions, and give patients access to their records.  Noting that some groups have expressed concerns about the regulations, calling them burdensome, Sebelius hailed the Brandeis event as a sign of momentum behind EMR and of a growing consensus that the “meaningful use” regulations are on the right track.

Robert Kocher, Emmanuel Ezekiel and Nancy Ann Deparle have published an article in the August 24th edition of The Annals of Internal Medicine urging physicians to embrace the change in the health care system associated with the Affordable Care Act. The article describes the numerous changes to the practice of medicine. These changes include technological innovation and medical records, working in teams with a variety of non-physician providers, including payment mechanisms aimed toward such, proactively managing preventive care and incorporating patient-centered outcomes research into practice. The article emphasizes how the act removes barriers to care for our patients by improving information about the care of our patients and by providing incentives to improve care and to focus on preventive care. The article acknowledges many physicians’ disappointment in the continuation of the sustainable growth rate formula. However, despite this frustration, the Affordable Care Act provides much that we as physicians can use to improve the ability to provide quality care to our patients.

As physicians, we have taken an oath to protect our patients. This act provides a new way for physicians to focus their energies on delivery of care to populations and to improve care with this end in mind. The Affordable Care Act is just the first step in providing high quality and effective care for our patients. We encourage you to become more familiar with the ways that you can improve your patient outcomes through the Affordable Care Act.

Consumer confidence in health care remained steady in July 2010, according to a survey by the Robert Wood Johnson Foundation. According to the Robert Wood Johnson Health Care Consumer Confidence Index, Americans remain confident in their ability to afford health care and to maintain their health insurance coverage.

The Recent Health Costs Barriers Index dropped slightly from 96.6 in June to 95 in July. This index measures whether respondents have experienced barriers to health care, including putting off a needed visit to a doctor due to cost, skipping a recommended medical test, treatment or follow up visit because of cost, not filling a prescription because of cost or having difficulty paying medical bills. In addition, Americans’ concerns about future health care costs decreased slightly as well.

NPA members Rupin Thakkar and Bob Crittendon were appointed a member of the Workforce Advisory Group and Lisa Plymate has been appointed to the Low Income Populations Committee of the Health Reform Implementation in Washington State. Congratulations to both! NPA appreciates your commitment to health care reform implementation.

Democrats’ uphill climb to maintain their congressional majorities this fall would not be so steep if they could convince seniors that health reform is good for them. Kaiser’s monthly health reform tracking poll reveals growing support for reform among the overall public, but lagging support among seniors. This wariness among seniors is especially notable with elections looming in November, as seniors vote in greater numbers than any other segment of the population.

Overall public support for reform held steady in July at 50% from the month before. 35% of respondents in Kaiser’s nationwide poll viewed reform unfavorably, down 6%. While these numbers are positive, and show support for reform continuing to trend up, results among seniors are almost the opposite. 46% of seniors viewed the new law unfavorably, while only 38% held a positive view.

As USA Today reported this week, much of the lagging support for reform comes from persistent misinformation spread during the lengthy congressional debate, like the non-existent Medicare “death panels.” In the Kaiser poll, more than four in ten respondents believed the panels exist. In another poll, only one in three seniors knew that because of reform Medicare will provide free annual wellness exams.

There are many resources available to help educate seniors and others about the benefits of reform, including NPA’s one-page handout Seniors Win with Health Reform, Families USA’s Health Reform Central, and the excellent new healthcare.gov website. Even Blue Cross of North Carolina has a user-friendly interactive timeline showing when key elements of reform kick in.

As a voting bloc, seniors are among the most – if not the most – consistent voters. In 2008, 70% of seniors aged 65 and older turned out to vote, while only 49% of voters aged 18 to 24 went to the polls. With the enthusiasm deficit facing President Obama and Congressional Democrats, they would do well to reverse seniors’ opinions of health reform before November. We can be sure that seniors will, once again, lead voter turnout.

Dr. Cheryl Bettigole, MD/MPH, President-Elect of the National Physicians Alliance, joined Congressman Joe Sestak (PA-07) and other health care advocates at a town hall hosted by Families USA to help explain the new health care benefits becoming available under the Patient Protection and Affordable Care Act. The Congressman and the others highlighted the ways that the PPACA will benefit Pennsylvanians, in particular working families and small businesses:

*By providing affordable health coverage to uninsured Pennsylvanians with pre-existing conditions;
*By expanding access to affordable coverage for Pennsylvanians who purchase their own health insurance.
*By eliminating all co-payments for preventative services (starting in September 2010).
*By providing much needed assistance to seniors by closing the Medicare prescription drug donut hole, which will be phased out by 2020. Seniors who hit the donut hole are already receiving a $250 rebate check.
*By eliminating co-pays for preventative care under Medicare starting in January 2011.
*By allowing young adults, the nation’s largest group of uninsured, to remain on their parents’ health care plan up to the age of 26 (starting in September 2010).
*By providing the largest middle class tax break in history, $464 billion in health care tax credits for working class families over 10 years.
*By encouraging small business growth due to $40 billion of small business health care tax credits over ten years and reducing small business health care costs by 18 percent.
*By eliminating discrimination against women by insurance companies.
*By reducing the federal deficit by $143 billion over ten years and as much as $1.2 trillion over the next twenty years, according to the Congressional Budget Office.

Thanks to Dr. Bettigole for helping to spread the word on the benefits of the PPACA to her fellow Pennsylvanians! These benefits apply to all states and we applaud her efforts to get the word out! See coverage of the town hall here.

The Los Angeles Times reports that since the passage of the Affordable Care Act many providers across the country are working together to create alliances which provide coordinated care for patients. In San Antonio, for example, three hospitals are competing to form alliances with local doctors, who are giving up private fee for service practices in order to be on the team.  This is a wonderful example of the type of unified approach to medical care which may result in improved quality and efficiency of care with reduced costs.  See the article here.

NPA President, Dr. Valerie Arkoosh spoke to the Pennsylvania HCAN group on July 21. She provided an overview of the changes that health care reform will bring to Pennsylvania. Check out this piece on her speech.

Families USA recently released a guide to the implementation of health care which highlights the important dates over the next 90 days. This guide highlights effective ways to make health care reform a reality in a consumer-friendly way. The guide highlights the provision which will allow young adults to stay on their parents insurance plans until age 26.

The guide also highlights the fact that small businesses with fewer than 25 employees are now eligible for a tax credit if they pay 50% of their employees health premiums.  Information on calculating the credit is available here.

Please check out the guide to see how you can make a difference in the next 90 days!

18 states have refused to administer the state-run insurance pools designed to provide insurance coverage to persons with pre-existing conditions, stating that the federal government has not allocated enough money for this purpose. As of Monday, 29 states plus the District of Columbia had pledged to implement these mechanisms. Others remain undecided. The insurance pools will be funded by July 1st but the time table to implementation varies. The health care law requires that the insurance pools be available within 90 days of the bill’s enactment. See the article in The Washington Post.

Another article by David Brown in The Washington Post discusses the efforts to create more efficient systems of care, particularly in primary care.  The goal is to create accountable care organizations and medical homes to improve communications between doctors and to make care more efficient in order to provide higher quality care for patients.  Part of the incentive includes increasing Medicare reimbursement for evaluation and management services.

If you are looking for specific information to help you understand and assist with implementation, NPA has gathered information to help you understand and engage in implementation of health care reform.  Educating the public and your colleagues is an important step in implementation.