HIT Policy Committee Accountable Care Workgroup – Kickoff Meeting

1. HIT Policy CommitteeAccountable Care Workgroup – Kickoff Meeting May 17, 2013 1:00 – 2:00 PM Eastern

2. Agenda • Welcome • Themes from Kickoff Call • Review Proposed Initial Task • Presentation on CCHIT Framework for Accountable Care • Next Steps • Public Comment

3. Charge & Scope from WG Charter • Charge: Make recommendations to the Health IT Policy Committee on how HHS policies and programs can advance the evolution of a health IT infrastructure that enables providers to improve care and population health while reducing costs in accountable care models. • Scope of work: Likely areas of focus include: • Supporting the evolution of data aggregation and analytics capabilities that are scalable and accessible across disparate providers for ACO success. • Enabling and encouraging information exchange to support care coordination across providers, including non-core care and wellness providers that have a significant impact on readmissions rates and total cost of care for a patient, including long-term care facilities, home health providers, long term support services providers and other community-based organizations. • Increasing patient activation as a member of a defined care team, engaging patients in assessments of their health, and using technology to deliver care to patients outside of traditional care settings. • Aligning payment policy & health information exchange for sustainable ACO success. • Improving the linkage between functionality and value creation.

4. Charge & Scope from WG Charter • Scope (con’t): Examples of policy issues the WG may engage in include: • Uptake of Meaningful Use and certification of electronic health record systems (EHRs), for instance, recommending inclusion of quality measures critical to ACOs in certification guidance and considering certification of technology components for ACOs; • Standards and interoperability activities, for instance, providing input on work around developing standards for exchanging data with long term care facilities and incorporating data from remote monitoring devices used to manage chronic disease and prevent avoidable readmissions; • Medicare Shared Saving and other payment pilot guidance; and • Coordination opportunities across federal partners such as ONC, CMS, AHRQ, HRSA, and NLM, for instance, reconciling measure requirements between ACO and MU programs.

5. Themes from Kickoff Call • Access to Medicare data is critical, but ACOs still face significant challenges and expense around standardizing claims information they are receiving. Besides addressing current challenges, how will data offerings to ACOs will evolve over time? • Broad interest in thinking about how ACOs can use claims and clinical in a collaborative fashion to drive success. How do we develop a standard, scalable way to aggregate information about care outside the system? • ACOs continue to face challenges with exchanging clinical data, including: technical challenges around aggregating data that aren’t standardized, business concerns around data sharing, and legal and regulatory problems around privacy and PHI. • Current clinical decision support offerings still face challenges, low capacity to consistently deliver appropriate, customized alerts and messages for individual patients. • Standardizing care plans now used across providers such as LTPAC organizations would be a substantial benefit to the ACO market. For mental health providers, legal/consent issues are still a barrier for ACOs.

6. Initial Task • Consider the technology needs for accountable care models to be successful. • Review should include capabilities such as: population analytics, capacity to identify caps in care, integration of clinical and care data, dissemination of clinical guidelines, utilization management, patient engagement, physician analytics and profiling, care management for transitions and episodes of care, referral management, etc. • Consider in the context of accountable care models broadly defined, i.e. ACO public and private initiatives as well as models like the Comprehensive Primary Care Initiative. • Evaluate current and proposed Meaningful Use framework against these functions to understand overlap and gaps. • In light of findings, recommend a set of next steps to the HITPC to advance these functions through the current policy framework, e.g., through a voluntary health IT certification program focused on accountable care.

7. Additional task for consideration • Work in tandem with CMS and other relevant ONC workgroups to inform the transition to a new set of quality measures and reporting systems for accountable care models, e.g., measures that are patient-centered, longitudinal, value-oriented, incorporate data from across care settings, etc. • Offer recommendations around: • How quality measure format and reporting should evolve to meet the needs of accountable care models • What types of new measures are needed for ACOs within the context of MU Stage 3 measure development

8. Framework for IT Infrastructure Needed for Accountable Care • Karen Bell, Chair, CCHIT

9. Public Comment