President’s Obama’s FY 2010 HHS budget request for $879 billion was highlighted at an agency media briefing held on May 7th. “This budget sends a clear message that we can’t afford to wait any longer if we want to get healthcare costs under control and improve our fiscal outlook,” said HHS Secretary Kathleen Sebelius. The 2010 budget establishes a healthcare reserve fund of $635 billion over 10 years to finance health reform to bring down costs and improve and ensure access to quality care.
The country has been very concerned about the H1N1 flu but it now seems that we are dealing with a much milder version of the flu reports the Secretary. The Secretary said she visited CDC and saw firsthand that CDC has the resources to handle flu epidemics. On April 30, 2009, the President requested a FY 2009 supplemental of $1.5 billion to provide immediate support to address the 2009 HINI influenza outbreak. These funds, in addition to the FY 2010 budget request of $584 million and the remaining balances of pandemic flu preparedness funds, will enable HHS to handle the public health surveillance and response efforts needed to handle the situation effectively.
The CDC budget request for Health Information and Services includes $292 million for Health Statistics, Health Marketing, and Public Health Informatics capabilities. Specifically, the Public Health Informatics budget request includes $71 million to determine the need for public health information systems and to develop standards for the systems to work together.
The budget request for the Office of the National Coordinator for Health Information Technology is $61 million, $0.1 million above FY 2009. This proposed funding is in conjunction with the $2 billion appropriated to ONC under the Recovery Act. The funding will enable HHS to implement the HITECH Act.
In addition, the budget request also includes funding for health IT in other divisions within HHS:
- AHRQ’s budget requests $45 million for health IT to enhance patient safety
- The CMS request includes resources to conduct the second year of a demonstration to encourage small physician practices to adopt electronic health records. The Recovery Act also includes $45 billion to accelerate the adoption of electronic health records through incentives to Medicare and Medicaid providers starting in 2011
- The Substance Abuse and Mental Health Services Administration request includes $2 million to support State-administered controlled substance monitoring programs to enable the early identification of patients at risk for addition
- The Indian Health Services budget request is for $5 billion an increase of $454 million over FY 2009 and includes $16 million to support the IHS health IT program. Specifically, the Resource and Patient Management System and the IHS electronic health record will receive funds to be used in conjunction with the $85 million for Health IT provided in the Recovery Act
- In FY 2009 and 2010, the Office for Civil Rights will develop the regulations and guidance required under the HITECH Act to strengthen the privacy protections of HIPAA
ONC funding will address standards development, privacy, security issues, and expand health information exchange network capabilities across additional markets and communities.ONC will update the Federal Health IT Strategic Plan in FY 2009 and will fund surveys on the adoption rates for electronic health records among physicians and hospitals.
Also included in the request is $50 million in funding for comparative effectiveness research through AHRQ’s Effective Health Care Program. Comparative effectiveness research provides patients and physicians with state-of-the-science information to determine the best medical treatments that will work best for a given clinical condition.
NIH’s budget request includes $31 billion with an increase of $443 million over the FY 2009 level. The budget request will build on the $10.4 billion provided by the Recovery Act has $8.2 billion for to use for biomedical research, $1.3 billion for infrastructure, $0.5 billion for NIH owned facility construction and repairs, and $0.4 billion for comparative effectiveness research.
The budget requests more than $6 billion to be used to support cancer research across NIH. As part of the $211 million HHS wide initiative, $1 billion would be invested over the next eight years for autism-related activities, $3.1 billion for HIV/AIDS research, and $467 million to fund the Clinical and Translational Science Award program and the General Clinical Research Centers.
HRSA has put improving the quality of rural healthcare high on the agenda. The budget includes $73 million for a new “Improve Rural Health Care” initiative. This will mean that there will be increased funding of $55 million for Rural Health Care Services Outreach, Network, and Quality Improvement grants and $9 million to go to the State Offices of Rural Health.
The request would fund Telehealth grants with $8 million to expand the use of telecommunications technologies within rural areas. Funding is also requested for HRSA to improve chronic disease management options for patients in rural areas who suffer with cardiovascular diseases and diabetes.
The budget request includes over $1 billion for the healthcare workforce. The funding would be used to expand loan repayment and scholarship programs for physicians, nurses, and dentists who will practice in medically underserved areas.
The budget request for CMS is $758.9 billion, a net increase of $56.3 billion over the FY 2009 level. The Medicare budget would provide incentives to improve quality by paying hospitals incentive payments based on the quality of care provided, reduce hospital readmissions, enable physicians to form voluntary groups to coordinate care for Medicare beneficiaries.
Other incentives to promote efficiency and accountability include competitive bidding for Medicare Advantage Plans, bundle payments for inpatient hospital services and post-acute care within 20 days of discharge beginning in 2013, and improve payment accuracy by helping contractors with resources to update their claims processing systems to better screen for payment errors.
Secretary Sebelius estimates that for every $1 spent to stop fraud in the system, $1.55 would be saved. The President’s budget lays out funding for anti-fraud efforts over five years that could save $2.7 billion by improving overall oversight of fraud and abuse in the Medicare Advantage and Medicare prescription drug programs.
Some of the other funding areas included in the budget request would provide FDA $3.2 billion with an additional $511 million over FY 2009. $259 million of the increase is to use to devote to food safety issues.
The HHS budget request calls for $354 million to combat health disparities and improve the health of racial and ethnic minorities and low income and disadvantaged populations. $116 million would be allotted for the Health Professions and Nursing Training Diversity Programs, the Office of Minority Health, and $40 million for the CDC Reach program.
The budget calls for $10 million to be used for a new Emergency Care System program to improve the quality of emergency rooms at regional hospitals and to set national standards. The funding would support a demonstration program to support the quality of operations and outcomes at regional emergency medical systems.