Bulletin Board what’s happening in healthcare
Medicaid RAC Program Begins January 2012
SUSTAINABLE SUCCESS: STATE CIOS AND
HEALTH INFORMATION EXCHANGE
www.nascio.org/publications
A report from the National Associa-
tion of State Chief Information Officers
urges state CIOs who are develop-
ing health information exchanges to
improve their business strategy. An
HIE’s business strategy has to gener-
ate revenue to cover operational costs
and provide sustainability before public
funds run out, the report stresses.
ESSENTIAL HEALTH BENEFITS: BALANCING
COVERAGE AND COST
www.iom.edu
A report from the Institute of Medicine
examines the criteria used to define
essential health benefits. It finds that
the criteria used to define essential
health benefits should include medical
effectiveness, safety, and their relative
value compared with alternatives.
In January 2012 Medicaid will launch
its version of the Recovery Audit Contractor (RAC) program, a healthcare
claims auditing initiative that analyzes
billing claims submitted to the Centers
for Medicare and Medicaid Services
for over- and underpayments.
CMS published a final rule establishing the program on September 16,
2011. The Medicaid program is largely
modeled on the Medicare RAC program, which has recovered $670 million in overpayments during 2011.
By instituting the Medicaid RAC pro-
gram, the government estimates it will
save $2.1 billion over five years in over-
payments to providers, with $900 mil-
lion being directly returned to states.
EDIS 2011: DELIVERING ON GREAT EXPECTA-
TIONS
www.klasresearch.com/store/reportde-
tail.aspx?ProductID=682
A report from KLAS finds that about 83
percent of healthcare providers expect
to use their emergency department
information system to help them at-
test to stage 1 of the meaningful use
program. However, only one-third of
healthcare providers said that their
vendor is ready for the meaningful use
program.
BENCHMARKS FOR VALUE IN CANCER CARE:
AN ANALYSIS OF A LARGE COMMERCIAL
POPULATION
http://jop.ascopubs.org/con-
tent/7/5/301.abstract
According to a study in the September
2011 issue of the Journal of Oncology
Practice, the use of health IT to treat
cancer patients could be a cost-
effective way to improve the quality of
cancer care and patient outcomes. The
study found that commercially insured
cancer patients receiving chemo-
therapy treatment had an average of
$111,000 total medical and pharmacy
costs annually. ¢
Six More States Open Medicaid EHR
Incentive Programs
Six more states have opened their
Medicaid EHR incentive payment programs to providers, bringing the total
to 33 states as of early October. California, Maine, Maryland, Massachusetts, Utah, and Vermont opened their
programs October 3, which will pay
healthcare providers for meaningfully
using certified electronic health record
systems.
In total, 33 states have operational
programs, with most having begun
making payments to providers who
have demonstrated they have adopted,
implemented, or upgraded a certified
EHR. The Centers for Medicare and
Medicaid Services maintains a list of
operational state plans at www.cms.
gov/EHRIncentivePrograms.
SAMHSA Grants to Expand Health IT Use
In October the Substance Abuse and
Mental Health Services Administration
announced up to 29 new grants, totaling up to $25 million over three years,
to expand use of health IT to increase
access to behavioral health services.
The program will leverage technology
to improve access and coordination of
the treatment of mental and substance
use disorders, especially for Ameri-
cans in remote areas or in underserved
populations. The program is part of a
SAMHSA health IT initiative.
Each grantee may receive up to
$280,000 annually over three years.
The actual amounts may vary, depending on availability of funds and progress achieved by the awardees. ¢
