CMS Launches Chronic Condition Dashboard

CMS has launched its new Chronic Conditions Dashboard, an interactive tool that provides quick analyses and reports based on the data CMS houses in its Chronic Conditions Warehouse. The dashboard is housed on a CMS website created to help researchers access federal data on Medicare Fee-For-Service patients. The dashboard focuses on patients with diseases such as heart disease and diabetes.

It offers "new and critical data that can help us develop better patient-centered approaches to improve health outcomes, lower costs and maximize quality of life," says HHS Assistant Secretary Dr. Howard Koh.

Population Health, Value-Based Care Drive Health Information Exchanges

The pursuit of population health and value-based care "may be reviving the business case for organizations to join health information exchanges," according to a HealthLeaders magazine article. Now more than ever, providers need accurate and complete patient data to effectively manage chronic care populations and earn incentives or shared savings; they need their own data as well as that of their affiliates and competitors. Bringing down costs in the health care system as a whole depends on sharing data. Nevertheless, although preliminary results suggest HIEs can help health care organizations save money, some are still reluctant to participate.

An HIE is an organized regional network that enables hospitals, physicians, and other care providers to upload and access patient health information. HIEs connect data for organizations—from affiliates to competitors—to share clinical data that can improve a patient's overall care. The HIE is generally connected through a provider portal, giving easy access to clinical applications that allow caregivers to see all of the patient's clinical information in real time while restricting access to any claims data or other financial information. Early data indicates the HIE can reduce costs for participants. But one of the main barriers to participation may be issues associated with costs; and not just the actual dollar amounts required to make the investment, but who makes the investment and who controls the flow of capital. Whether to participate in HIE is a strategic conversation, but all the participants have to be willing put aside their individual issues and agenda and to work toward a solution that's best for the patient.

Although the American Recovery and Reinvestment Act (ARRA) allotted grants to encourage the establishment of HIEs, participating in an HIE still doesn't come free. Participants must have an EHR in place, and most HIEs ask participants to pay a fee to connect; that price can vary depending on an organization's size and the degree and complexity of the connectivity needed. Employers have a unique role to play as purchasers in the encouragement of HIE establishment because employers all need employees whose health conditions are well-managed. HIE establishment presents a unique opportunity for employers to partner with and work directly with providers.

Utah's All-Payer Claims Database Fails to Deliver

The Salt Lake Tribune reports that simply having an All-Payer Claims Database (APCD), without the support in place to actually use the data, will not provide consumers with useful and actionable information about which doctors, clinics and hospitals deliver the best care for the best price. Utah’s APCD, a repository of all medical and pharmacy insurance claims filed statewide, has failed to deliver this critical information.

Utah’s database was conceived in 2008 by a legislative health reform task force as means to arm consumers with the information they need to take charge of their health. It was intended to expose how much value patients receive from their insurance, how much they pay for tests and surgeries, and help them comparison-shop for coverage and medical care.

But State Department of Health employees charged with building and overseeing the database have moved on to other positions in state government. The New Jersey-based vendor hired to mine the data, Care Advantage, went out of business last month. And promised reports comparing health centers on certain quality measures have yet to materialize.

Many point to the lack of funding as the major reason for the database's failure. Utah’s database was held out as an example of what can be done on the cheap. While most states spent millions to get their versions running, Utah budgeted $800,000. At last count, the database contained more than 65 million insurance claims dating back to Jan. 1, 2007.

But until the health department hires a replacement for Care Advantage, there’s no way to extract data. The department isn’t staffed or equipped to run complicated queries, such as tracking "episodes of care," or patient outcomes from diagnosis through treatment and any follow-up.