Category Archives: media
March 09, 2015 | FAH Hospital Policy Blog Team
Last week, the Federation of American Hospitals held its Annual Public Policy Conference in Washington, DC. This year’s event included many high profile speakers and discussions of timely health care issues. Among this year’s speakers were: House Majority Leader Kevin McCarthy (R-CA); House Ways and Means Committee Chairman Paul Ryan (R-CA); Reps. Xavier Becerra (D-CA) and Pat Tiberi (R-OH); Senators Debbie Stabenow (D-MI) and John Barrasso, M.D., (R-WY); and HHS Secretary Sylvia M. Burwell.
October 20, 2014 | FAH Hospital Policy Blog
FAH President and CEO Charles N. Kahn III assesses the status of the HITECH Act and the state of electronic health record (EHR) implementation and health information exchange more than 5 years since the legislation’s passing in a comprehensive commentary published in this week’s Modern Healthcare magazine.
The adoption and implementation of EHRs have been a major priority for the health care community since the passage of the HITECH Act, and President Obama’s 5-year computerization pledge in 2009. While the HITECH Act, through the EHR Incentive Programs, has been extremely successful in driving uptake of EHRs, other national priorities addressed and funded in the law, including interoperability, have lagged. As Kahn explains:
“The law envisioned building a nationwide interoperable information superhighway, ensuring patient information gets to the right place at the right time to enable better decisionmaking at the point of care.”
In the past five and a half years, hundreds of millions of dollars have been spent attempting to build health information exchange infrastructure and capabilities across the country. Despite this significant financial investment, Kahn points to a glaring lack of macro-interoperability between health care providers as a missed opportunity by both the public and private sectors. Kahn explains:
“The problem is the failure to achieve “macro” interoperability – the movement of patient information outside the walls of a facility. Macro-interoperability is happening in pockets of the country, but certainly not on the scale Congress envisioned when it passed the HITECH.
The law’s initial vision was dependent on three factors: technology, aligned incentives and a culture that enables information to flow. Yet instead of enabling these factors to flourish, we allowed them to atrophy, due largely to what ultimately is a cultural problem – a fundamental distrust of external information among providers and clinicians – that supersedes any policy lever the law created.”
Another missed opportunity, Kahn says, is the lack of focus on the “micro” interoperability problem occurring within health care facilities; this prevents EHRs from working efficiently with other technologies that collect important patient data and departments from communicating with one another effectively.
“Further, meaningful use’s myopic focus on EHRs means that national-level discussions about interoperability effectively ignore the multitude of medical technologies within a facility that generate critical patient data, including devices, modules and other digital instruments. When you ask hospital chief information officers what matters to them, they talk about these technologies and their lack of plug-and-play connectivity with EHRs, even though this problem of “micro-interoperability” continues to be omitted from the growing number of frameworks and roadmaps focusing on how to achieve a connected healthcare system.”
“It is sobering to realize that hundreds of millions of dollars were spent experimenting on how to get patient X’s information from Ohio to Florida, yet we cannot convey data from a digital blood pressure cuff into an EHR three feet away without some type of work-around.”
Kahn concludes his retrospective analysis of the national health IT efforts with a look ahead for health care providers.
“HITECH’s stated goals in 2009 of reducing errors, bringing down costs, ensuring privacy, and saving lives are still the right goals for patients, providers and the healthcare system as a whole. Yet, absent interoperability, macro or micro, their prospects seem shaky at best.
As we look to the future – to Stage 3 meaningful use and eventually a post-HITECH world, it is critically important to continue striving to realize the law’s larger vision for health information technology. At the same time, one “lesson learned” should be never to underestimate the value of taking a concrete step, such as moving information from a digital blood pressure cuff into an EHR a few feet away.”
The FAH has long supported the goals of the HITECH Act. Investments in health IT are one of the pillars of structural changes that are key in the transformation of the American health care system. Hospitals will continue our efforts to achieve improved interoperability on all levels necessary to realize the full potential of health IT to improve the quality, safety and efficiency of health care for patients.
September 17, 2014 | FAH Hospital Policy Blog
Recognized as a key leader in the health care industry and as one of the nation’s leading experts on health policy and health information technology, FAH President & CEO Chip Kahn was honored to participate earlier this month in the annual Digital Health Israel conference in Jerusalem. The conference served as an opportunity for a substantive conversation about changes in health care policy and for exploring the impact of health information technology (HIT) on the healthcare industry.
In an interview for The Jerusalem Post, Chip discussed the current landscape of the health care sector and his expectations for the future.
Among other key issues, Chip addressed a couple of the biggest changes facing health care providers—value-based payment system initiatives which are being implemented, and the healthcare industry’s focus on outcomes of care. The article explains:
“The health reform law (the Affordable Care Act) directly links payment with patient outcomes and efficiency of service. FAH estimates that by 2017, 8% of base DRG payments may be at risk as hospitals are expected to implement the following:
Electronic Health Records (EHRs)
Quality & Value Improvement
In the wide-ranging conversation, Chip also offered key insights into the role of hospitals and the growth of Health IT investment and use of EHRs:
“Treatment will be incredibly enhanced with an immense body of information available to the caregiver. There will be greater decision support to better inform physicians. Some of this will depend on technologies that enable the seamless free-flow of information and interoperability among different caregiver groups.”
“With so many more people accessing coverage and preventive services, there will be a material health effect on the population,” he added. “Over time, management of care across the continuum will improve. However, there may still be about 8% of Americans without health coverage in 3-5 years. This, combined with higher out-of-pocket costs for many Americans, will cause significant social impact.”
Chip concluded on a broader note regarding the expansion of the digital health care infrastructure. “The use of Big Data will enhance our knowledge about what care actually works and what factors demonstrate the need for different kinds of care. I see tremendous possibilities for the future.”
The FAH is honored to have been a part of the Digital Health Israel conference, and to assess with the international press the state of our transforming health care system and how it impacts leading health innovative nations worldwide.
May 30, 2014 | FAH Hospital Policy Blog
Category: Media, Transparency
The FAH has been very active in the past few weeks, as current FAH Chairman David T. Vandewater (President and CEO of Ardent Health Systems) and FAH Chair-Elect Keith B. Pitts (Vice Chairman of Tenet Healthcare Corporation) participated individually in separate panel discussions. Both of these panels were based primarily upon critical policy journal articles addressing hospital realignment and market competition and authored by several academicians also participating as panelists.
Additionally, FAH President and CEO Chip Kahn recently was interviewed for a Q&A feature article by reporter Nathaniel Weixel of Bloomberg BNA. The Q&A, published today, covers a broad number of pertinent topics in health care including SGR reform, mounting cuts to hospitals and transparency.
When asked about his biggest concern for the coming year, Kahn emphasized “enough is enough” when it comes to hospital cuts:
“We support SGR reform. We think it would be good policy. . . All that being said, enough is enough from a hospital standpoint. Since [the Affordable Care Act was passed] it’s now up to almost $122 billion that’s been taken from hospitals over 10 years. We gave at the office…In terms of pay-fors, they need to look elsewhere. We believe that further cuts to hospitals would be completely counterproductive and not in the interest of access to services of Medicare beneficiaries at this point”
In response to a question about paying for SGR reform, Kahn continued to highlight that cutting hospital payments to pay for SGR reform is bad policy that punishes hospitals for a problem they did not create:
“Personally, I think the notion of robbing Peter to pay Paul to fund programs is a problem and not good public policy. . . This problem of (the) SGR wasn’t created by hospitals, home health or [Medicare] Part D. It was created by Congress.
Finally, when asked about transparency and hospital charges, Kahn supported transparency but cautioned that releasing information that is not useful to the consumer is counter-productive to the goal of transparency, a distinction that the FAH reiterated recently in a letter to the Federal Trade Commission.
“Transparency is a good thing. I think transparency needs to be designed in a way that’s actually useful for patients to make decisions or for their caregivers. I think you need information that can be digested, and releasing [hospital] chargemaster data, or even releasing physician data, I don’t know how helpful that is for any particular consumer.”
The FAH is grateful for having multiple opportunities to publicly present the perspective of the investor-owned hospital community when it comes to health care policy, and we are hopeful that these perspectives will contribute to a more comprehensive understanding of the landscape in which hospitals must operate.