New mandates for adopting "operating rules" to tighten the HIPAA transactions, as well as adoption of new transactions and a unique health plan identifier, dominate the information technology provisions of the new health reform law (see story). But there are numerous other ways that I.T. will support the goals of reform.

For instance, Sec. 520K of the law calls for the Department of Health and Human Services to offer grants and "cooperative agreements" for demonstration programs to coordinate care to special populations "through the co-location of primary and specialty care services in community-based mental health and behavioral health settings," according to the law. Up to 15 percent of funding can be used to implement information technology to accommodate the needs of primary and specialty care professionals. The section authorizes $50 million for these demonstration programs in 2010 with undetermined sums for 2011 through 2014.

Sec. 6114 of the reform law requires HHS to conduct a three-year demonstration project for development of best practices for using I.T. to improve residential care in nursing homes. The project would start within the next year. The same section also authorizes a single demonstration project for development of best practices to undertake culture change in nursing homes. Both projects would be appropriated "such sums as may be necessary to carry out this section," according to the law.

In Sec. 2703, states may provide programs to assist in coordinating home health care with other care settings. The section authorizes $25 million for state planning grants. States shall include in their plans a proposal to use I.T., including wireless technology, in providing home health services and improving coordination across the care continuum.

Under Sec. 1103 and Sec. 1311, HHS shall assist states in establishing Internet portals to serve consumers seeking insurance through Health Benefit Exchanges. The portals will use a standardized format for presentation of information relating to the coverage options. They also will provide data to assess the quality and value of health plans offered through the exchanges, as well as results from enrollee satisfaction surveys. HHS shall make available to states "a model template for an Internet portal that may be used to direct qualified individuals and qualified employers to qualified health plans, to assist such individuals and employers in determining whether they are eligible to participate in an Exchange or eligible for a premium tax credit or cost-sharing reduction, and to present standardized information (including quality ratings) regarding qualified health plans offered through an Exchange to assist consumers in making easy health insurance choices."

The reform bill is available at congress.gov. Under Search Bill Summary & Status, click on Bill Number and enter HR 3590 in the search box. Then select version 7, the enrolled bill sent to President Obama.

--Joseph Goedert

 

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