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Home / News & IndustryManaged Care Insight and Analysis
Updated: July 20, 2010
Reimbursement And HIT Study Fueled By $1 Million HHS Grant

Reimbursement strategies and integration of HIT incentives will be examined by a two-part study at the George Washington University under a $1 million grant from HHS.

"The purpose of this contract is to conduct two projects required under the American Reinvestment and Recovery Act of 2009. This statute includes the Health Information Technology for Economic and Clinical Health Act of 2009 (HITECH Act) that sets forth a plan for advancing the appropriate use of health information technology to improve quality of care and establish a foundation for healthcare reform," HHS said.

The Office of the National Coordinator (ONC) for HIT will supervise the project, specifically concentrated on reimbursement policies for federally qualified health centers (FQHCs), rural health clinics (RHCs) and free clinics.

HHS said those medical centers were selected for the study because of their unique payment methodologies, using an institutional claim form lacking data collecting elements that could include them in quality incentive programs.

The first half of the study will determine effective reimbursement incentives that can be applied to FQHCs, RHCs and free clinics to improve their quality of care. Through review and assessment of past incentive programs from public, private and state payers possible incentive models should be identified and tested to see if they can be applied to safety-net providers.

"The current basic payment systems reward overuse of services and use of high-cost complex procedures; it is understood that there is a wide variation in practice patterns and that these variations do not necessarily correlate with improved care," HHS said. "Payment reforms are recognized as a key ingredient to promote high quality clinical, patient-centered and efficient care."

Because the shift is now taking place from rewarding volume to encouraging quality, HHS said this study is necessary. One focus of the study will be on implementing HIT incentives and reimbursement for telehealth services.

Goals for the first half of the study is to understand and assess reimbursement incentive programs; "the assessment will examine how these programs have been structured in the past and how they have evolved over time and the extent that these incentive programs are effective at achieving the intended outcome," HHS said.

The assessments will determine possible approaches to include FQHCs, RHCs and free clinics in the quest for quality; after identifying the barriers preventing the medical centers from quality-related reimbursement incentives, a panel will be constructed to re-evaluate and report to Congress.

"The second project will investigate the impact of HIT, including electronic health records (EHRs), in communities with health disparities and in areas with a high proportion of individuals who areuninsured, underinsured and medically underserved," HHS said. "This project will also identify practices to increase adoption of HIT by healthcare providers in such communities and the use of HIT to reduce and better manage chronic disease."

The study will assess the impact HIT has had on the communities and identify the best practices to boost adoption and use. A panel of HIT experts will be constructed to evaluate and conduct an environmental scan and literature review to determine the impact on health disparities as well as on the communities.

Address: U.S. Department of Health and Human Services, 200 Independence Ave. SW, Washington DC 20201; (877) 696-6775, www.hhs.gov.


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