ANN ARBOR, MI – The College of Healthcare Information Management Executives, with more than 1,400 CIO members, is urging the Centers for Medicare & Medicaid Services to rethink the government’s rulemaking proposals on accountable care organizations. At issue is a provision that would give individuals the option to restrict access to data.
CHIME’s view is that the rules, as proposed, “would restrict the flow of information and create significant pressures on accountable care organizations.”
“If beneficiary claims data are withheld, the ACO’s ability to improve individual beneficiary health, as well as achieve the desired shared savings, could be compromised,” CHIME stated in its comments to CMS. “We believe that allowing ACO patients to opt out of data-sharing, while maintaining their ability to see the primary care physician participating in an ACO, contraindicates efforts to provide accountable care.”
CHIME recommends that patients who want to opt out of sharing claims data be required to see a primary care physician not affiliated with an ACO, or that healthcare expenditures for these patients not be included for calculations to determine whether an ACO is eligible for payments for shared savings.
CHIME filed its comments with CMS on May 10 in response to the CMS Notice of Proposed Rulemaking for governing ACOs. The deadline for comments was June 6.
CIOs see data sharing as critical
As CHIME sees it, an optimized approach to information technology is important for ACOs because this new delivery model will have the best chance to succeed if patient and population data can be shared across the continuum of care.
“Technology will no doubt play a prominent role in the success of any ACO,” said William Spooner, senior vice president and CIO at San Diego-based Sharp HealthCare. “The amount of data and information exchange between ACO participants will be enormous. But as the person responsible for lining up those data points, CIOs are really worried about patient data opt-out provisions. We think the simplest answer is to remove patients from ACO participation if they refuse to share their data.”
CHIME also notes that the proposed ACO rule tries to encourage the meaningful use of EHRs, but it takes issue with a requirement that stipulates that 50 percent of an ACO’s primary care physicians (PCPs) meet all MU standards by the beginning of the second year of the ACO’s agreement with CMS.
“From both patient management and business perspectives, CHIME feels it would not be necessary for an ACO’s PCPs to meet all MU requirements. Similarly, CHIME sees no need for CMS to specify some minimum level of EHR MU performance for the hospitals participating in an ACO,” CHIME said.
“Our comments speak to the complex technical implications of CMS’ Shared Savings Program,” said Pam McNutt, senior vice president and CIO of the Methodist Health System in Dallas and chairwoman of CHIME’s Policy Steering Committee. “As hospitals look to participate, they will depend on CIOs to understand how ACOs meet the data collection and reporting requirements. We urged CMS in our comments to avoid prescribing technology, such as requiring meaningful use, instead allowing ACOs to make determinations based off their business needs and patient populations.”
Topics: Electronic Health Record (EHR), Enterprise Content Management, Privacy and Security, Quality and Safety, College of Healthcare Information Management Executives (CHIME), College of Healthcare Information Management Executives, Accountable care organization (ACO), Centers for Medicare & Medicaid Services (CMS), Meaningful use, Health Information Exchange (HIE)