The growing use of health information technology, such as electronic health records, is starting to provide critical data needed to track new payment models.

That is the contention of Ezekiel Emanuel, M.D., chair of the Department of Medical Ethics and Health Policy at the University of Pennsylvania’s Perelman School of Medicine, who spoke Feb. 24 at a Federal Trade Commission/Department of Justice public workshop on healthcare competition in Washington.

When it comes to EHRs and EHR usage, Emanuel believes “we’re not fully there” with “digitization across the spectrum of care” and there’s “lots of uncertainty” in the marketplace. However, Emanuel predicts that the healthcare industry will “pass the tipping point on the payment side” as well as the “ability to share data and mine data” by the end of the decade.

“As we look forward, we need to assess whether these health systems are really doing the things that are necessary to operate in the value-based, risk-based payment system,” he told the audience. According to Emanuel, among the critical questions that must be addressed by these healthcare organizations are: “How are they working on digitization? Do they have data warehouses that they actually use, not just for financials, but to manage care?”  

The two-day FTC/DOJ workshop, continuing today, focuses on payment issues. The Affordable Care Act created a number of new payment models, including Accountable Care Organizations (ACOs), primary care medical homes, and new models of bundling payments for episodes of care, and holding providers accountable for the quality and cost of the care they deliver to patients.

Last month, the Department of Health and Human Services announced a goal of tying 30 percent of traditional, or fee-for-service, Medicare payments to quality or value through alternative payment models, such as ACOs or bundled payment arrangements by the end of 2016, and tying 50 percent of payments to these models by the end of 2018.

In addition, HHS also set a goal of tying 85 percent of all traditional Medicare payments to quality or value by 2016 and 90 percent by 2018 through programs such as the Hospital Value Based Purchasing and the Hospital Readmissions Reduction Programs.

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