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3 posts from May 2013


Christine Bechtel Discusses the State of Health Information Technology (HIT) Adoption and Use (May 28, 2013)

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The health care sector has substantially lagged all other major industries in the adoption and use of information technology.  For example, per the CDC, in 2011 still slightly more than half of physicians (54%) used an electronic health record (EHR) (though compared to 17% in 2008), among of solo practitioners only 29% and among specialities only 48% of surgeons.  However, since 2009 the federal government has made substantial financial investments in incenting the adoption and use of heath information technology (HIT) such that by the end of 2013 it's anticipated 80 percent of hospitals providing Medicare or Medicaid (ostensibly all hospitals) will be using EHRs (compared to 9% in 2008). 

During this 27-minute podcast, Ms. Christine Bechtel discusses the 2009 ARRA's HITECH provision that incented hospitals, physicians and others to adopt HIT.  She addresses the law's policy and standards' committee activities, specifically the law's "meaningful use" provision, what meaningful use stages 1, 2, 3 are intended to accomplish and the extent to which HIT adoption has succeeded over the past four years.   She explains Health Information Exchanges (HIEs and what level of success they've achieved to date.  The interview concludes with her assessment of the extent to which HIT has produced cost savings.        

Ms. Christine Bechtel is President of the Bechtel Health Advisory Group, an organization that advises clients on how to implement patient- and family-centered, IT-enabled health care and policies.  Among other clients are the National Partnership for Women & Families, where she previously served as Vice-President and the Casey Health Institute, a new non-profit primary care practice in Gaithersburg, MD.  Ms. Bechtel also served previously as vice president of the eHealth Initiative (eHI), a Washington D.C.-based non-profit organization dedicated to improving the health care 6e3a04_7e1e64113ad3ddc4f83b6dbf963602cc.jpg_srz_249_249_75_22_0.50_1.20_0[1]quality via information technology.  Prior to eHI, Ms. Bechtel worked with American Health Quality Association, she also served as senior research adviser at AARP, worked as Director of Community Development for Louisiana's Medicare Quality Improvement Organization and served on the staff of Senator Barbara Mikulski (D-MD).  Her BS is in politics and public policy from Goucher College and her master's is in political management from George Washington University.




Matt Hourihan Discusses the NIH Budget (May 23, 2013)

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After the doubling of the National Institutes of Health's (NIH) budget between 1998 and 2003, federal funding for medical research and more widely federal R&D has been falling or stagnate over the past several years.  Most recently, the federal budget sequester slashed NIH funding by 5.5  percent leading to a $1.6 billion funding reduction in 2013, the largest cut in the agency’s history.    (The president's proposed 2014 budget calls for a repeal of sequestration and a slight increase in the NIH budget of 1.6 percent or $471 million over the 2012 budget.)   The decline in federal research funding is particularly concerning in light of the growing importance of knowledge-based industries in a global economy.   If current trends in biomedical research investment continue the US government's investment in life sciences research over the ensuring half decade is likely to be barely half that of China's in current dollars and one-quarter of China's level as a share of its GDP.  (China already has more gene sequencing capacity than the US.)   Korea, Singapore, Taiwan, the UK and France also fund more as share of their economies.  

This 27-minute podcast begins with a brief description of AAAS's work.   Mr. Hourihan discusses next federal R&D funding generally and NIH funding specifically compared to other developed countries, the recent history of federal NIH funding, proposed White House and Congressional NIH FY'14 funding  (or moreover how Democratic and Republican proposals substantially differ), the effect of budget sequestration on the FY'13 NIH budget and sequestration's effect on NIH funding should sequestration persist through 2021, the consequences funding restraints have had on life sciences research and the economy and the prospects for future NIH funding over the next five to 10 years.     For more on Mr. Hourihan's NIH analysis (and federal R&D funding more generally) see: http://www.aaas.org/spp/rd/.

Mr. Matt Hourihan has been Director of the R&D Budget and Policy Program at the American Assocation for the Advancement of Science (AAAS) since 2011.  Prior to joining AAAS, he served as a Clean Energy Policy Analyst at the Information Technology & Innovation Foundation (ITIF).   0417rnd_briefing_hourihan_150x194[1]Previous to that, Mr. Hourihan served as Jan Schori Fellow at the Business Council for Sustainable Energy, a coalition of energy firms and utilities working to engage policymakers for market-based solutions to sustainable energy development and climate change and prior still he worked as a journalist at the Ocean Conservancy.   Mr. Hourihan earned a masters degree in public policy with an emphasis on science and technology policy at George Mason University and a undergraduate degree in journalism from Ithaca College.


Dr. Brian Biles Discusses the Status of Medicare Advantage (May 6, 2013)

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Since the 1970s Medicare beneficiaries have had the option of receiving their Medicare benefits via private health insurance plans.  Today 27% of Medicare beneficiaries, or 13.3 million seniors, are enrolled in these private plans.  MA program growth in the past few years has been rapid, enrollment almost tripled between 2003 and 2012 and the program is estimated to add another 1.5 million beneficiaries this year.  Medicare, which pays MA plans a capitated rate rather than on a FFS basis, reimbursed MA plans $136b. in 2012.  The program has not been without controversy largely due to payments or over payments made to MA-participating plans.   For example, just prior to the 2010 passage of the Affordable Care Act the CBO estimated equalizing payments between Medicare Advantage programs and the traditional fee for service Medicare program would generate $170 billion in savings over the ten year budget window.   Despite ACA reforms to MA, MedPAC (the Medicare Payment Advisory Commission) estimated in 2013 overall payments to plans will equal $6 billion more for MA enrollees than would have been paid to cover the same enrollees in Medicare fee for service.  

Dr. Biles begins this 27-minute interview by explaining how private insurance plans participte in the MA program including how they bid for services against county benchmark rates.  He explains why MA participation has nearly tripled over the past decade, what MA payment and quality incentive reforms were included in the Affordable Care Act including the star bonus program, MA risk adjustment, the quality of care provided by MA plans and possible future reforms to the MA program are also all discussed.       

Since 2000 Dr. Brian Biles has been a Professor in the Health Policy Department at The George Washingtion University and is also a Senior Vice President at the Commonwealth Foundation. Previously Dr. Biles served for seven years as staff director of the House Ways and Means Subcommittee on Health, served later as Biles_brian1[1]Deputy Assistant Secretary for Health at the Department of Health and Human Services in the Clinton Administration and also served as Deputy Secretary for Maryland's Department of Health and Mental Hygiene.  Among other professional activities, Dr. Biles chairs the Medical Administrators Conference and is a Fellow of the New York Academy of Medicine and an Invited Lecturer at the Kennedy School of Government at Harvard University.  Dr. Biles received his Doctor of Medicine and Bachelor of Arts with honors from the University of Kansas and he holds a masters degree in public health from Johns Hopkins University.