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ARRA and HHS Data Policy Initiatives. Academy Health NAHDO All Payer All Claims Data Bases James Scanlon, HHS Deputy Assistant Secretary/ASPE. Overview. American Reinvestment & Recovery Act HITEC Provisions Prevention and Wellness Fund Comparative Effectiveness Research.
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ARRA and HHS Data Policy Initiatives Academy Health NAHDO All Payer All Claims Data Bases James Scanlon, HHS Deputy Assistant Secretary/ASPE
Overview • American Reinvestment & Recovery Act • HITEC Provisions • Prevention and Wellness Fund • Comparative Effectiveness Research
ARRA Overview for HHS • $167 billion over ten years • $22 billion in discretionary spending • Prevention & Wellness Fund $1 billion • Comparative Effectiveness Research $1.1 billion • Health IT $22 billion – $48+ billion • State fiscal relief, health care safety net, biomedical research, construction and human services
Health Information Technology - Economic & Clinical Health Act • HITEC Capacity Building $2 billion • Grants to States for HIE • National and Regional Extension Centers (70) • Health IT Workforce Grants • Public health and infrastructure • Standards, policy, process and regulations • Incentives for Medicare & Medicaid providers who demonstrate “meaningful use of EHRs $19 - $48 billion beginning in 2011
Prevention and Wellness Fund $1billion • Immunization Grant Program - $300 mil to States • Healthcare Associated Infection - $50 mil to States • Communities Putting Prevention to Work - $650 mil for evidence based interventions to • Increase levels of physical activity • Improve nutrition • Decrease overweight/obesity prevalence • Decrease tobacco use, and exposure to secondhand smoke • Evaluation and data
Comparative Effectiveness Research - $1.1 billion • Three components • NIH $400 million • AHRQ 300 million • Secretary’s Fund $400 million • IOM Report • Federal Coordinating Council on CER • FCC Report to President and Congress • HHS Spending Plan due November 1, 2009
Comparative Effectiveness Research • IOM Study – Recommend national priorities for CER to be funded by ARRA. • Portfolio Criteria - Research area, population, interventions, methodology, prevalence, mortality, morbidity, cost and variability • 100 CER priority topics, e.g. Reproduction, end of life care, respiratory, psychiatry, disparities etc. • “CER program should help to develop large scale, clinical and administrative data networks to facilitate better use of data and efficient ways to collect new data for CER.”
Federal Coordinating Committee for CER Research • 15 members from federal government • Public listening sessions • Definition • Strategic Framework • Report to President and Congress • Areas of investment and priorities
FCC CER Report • Four areas of investment • CE research • Human and scientific manpower for CER • Data infrastructure for CER • Dissemination and translation of CER • Priorities • Priority populations • Priority conditions • Types of interventions
FCC CRE Definition Comparative effectiveness research is the conduct and synthesis of research comparing the benefits and harms of different interventions and strategies to prevent, diagnose, treat and monitor health conditions in “real world” settings. The purpose of this research is to improve health by developing and disseminating information to patients, providers, and decision-makers, responding to their expressed needs, about which interventions are most effective for which patients under specific circumstances. To provide this information, comparative effectiveness research must assess a comprehensive array of health-related outcomes for diverse patient populations and sub-groups. Defined interventions compared may include medications, procedures, medical and assistive devices and technologies, diagnostic testing, behavioral change, and delivery system strategies. This research necessitates the development, expansion, and use of a variety of data sources and methods to assess comparative effectiveness and actively disseminate the results.
Human & Scientific Capital for CER Dissemination and Translation of CER Priority Populations Priority Conditions Types of Interventions FCC CER Strategic Framework CE Research CER Data Infrastructure Crosscutting Priority Themes Legend Secondary investments Supporting investment Primary investment
Data infrastructure examples • Linked longitudinal claims data • Expanded Medicare /Medicaid claims data • Linked distributed clinical data networks • EHR data • Registries
Other HHS Data Initiatives • New HHS CTO • Making HHS data mere accessible • Data.Gov • HHS portals • Data to reduce disparities • Health data collection investments