Tuesday, February 14, 2012

HHS Budget News

According to the FY 2013 HHS budget request document released February 13th, there is a reduction in discretionary funding for ongoing activities and legislative proposals that would save an estimated $350.2 billion over 10 years. The budget request totals $940.9 billion in outlays and proposes $76.7 billion in discretionary budget authority.

The FY 2013 budget request for the HHS Office of the National Coordinator for Health Information Technology (ONC) is $66 million which is $5 million above FY 2012. The budget includes $7.8 million, an increase of $2 million to allow ONC to work with healthcare and community organizations so that best practices can be shared and to encourage the adoption and meaningful use of health IT. In addition, the funding will continue the support of Regional Extension Centers and other HHS priority programs such as the National Quality Strategy.

The FY 2013 budget request includes $12 million for work on standards and interoperability. ONC supports developing standards and specifications for health IT, implementing standards, developing and maintaining certification criteria and the process, and works to coordinate efforts involving health information exchanges.

The budget request includes $5 million to assure that policies and practices are in place to keep health information private and secure. Key efforts include the evaluation and policy development of privacy and security protections for electronic health information in the evolving nationwide network.

CMS and ONC are working to expand access to care through increased adoption and meaningful use of EHRs. HHS aims to increase the number of eligible providers who receive an incentive payment from the Medicare and Medicaid EHR Incentive Programs for the successful adoption or meaningful use of EHR technology from 80,000 in FY 2012 to 140,000 by the end of FY 2013. As of January 2012, nearly 60,000 REC-assisted providers had implemented EHRs with e-prescribing and quality reporting capabilities and over 5,000 of these providers have achieved meaningful use.

The FY 2013 budget request includes $26 million, the same as FY 2012 for the AHRQ health IT research portfolio. This investment includes $19 million to support approximately 56 research grants to generate evidence that demonstrates the most effective and efficient use of health IT.

In addition, AHRQ would receive $7 million to support contract activities related to synthesizing and disseminating evidence on the meaningful use of health IT. Funds will also be used to develop the tools and resources for various stakeholders to be able to implement best practices.

HRSA’s FY 2013 budget request includes $8.4 billion which is a net increase of $228 million above FY 2012. The FY 2013 includes $122 million for targeted rural health programs. This investment includes $56 million to continue collaborative models to improve healthcare access and quality. The budget request provides $26 million to continue funding for all continuing rural Hospital Flexibility grants, $20 million for research, technical assistance, and policy development. Also included is $12 million to expand access to quality care through telecommunications which is the same amount as in FY 2012.

The Center for Medicare and Medicaid Innovation is addressing patient safety, coordination of care among multiple providers, and enhanced primary care. The Affordable Care Act appropriated $10 billion to support the Center’s activities from FY 2011 to FY 2019.

Through the HHS Health Care Innovation Challenge, the Innovation Center will award up to $1 billion in grants to providers, payers, local governments, and other partners. Recipients will be selected based on their proposals to implement or expand compelling new models to improve care and reduce costs. CMS anticipates making awards in the spring or 2012.

The “Partnership for Patients” program is a collaborative effort by CMS with more than 7,000 stakeholders including over 3,000 hospitals to help improve patient safety. The Partnership has set a target for reducing hospital-acquired conditions by 40 percent by 2013 and to reduce hospital readmissions by 20 percent over the same time period. In December 2011, the Innovation Center awarded $218 million to 26 regional hospital engagement networks to help support the Partnership’s goals.

The Innovation Center has partnered with the Medicare-Medicaid Coordination Office. Specifically, the Medicare-Medicaid Coordination Office awarded contracts up to $1 million to 15 states to design person-centered approaches to coordinating care across primary, acute, and behavioral health and long term services for Medicare-Medicaid enrollees.

The Medicare-Medicaid Coordination Office will have demonstrations to focus on reducing preventable inpatient hospitalizations among long-term residents of nursing facilities that are often eligible for both Medicare and Medicaid. CMS will begin accepting applications for this demonstration in 2012.

Health.gov links to health insurance plans and puts the information in one place to make it easier for consumers and small businesses to learn about and compare insurance options. Of the approximately 6.6 million visitors to the web site in its first year, about 2 million used the Insurance finder tool.

The budget requests $864 million to establish state-based insurance marketplaces called Exchanges. In 2011, 28 states and the District of Columbia received over $438 million in Establishment Grants to begin building their exchanges. Additional grants will be awarded in FY 2012 and may be renewed through January 1, 2015. After their initial establishment, exchanges will be self-funded through user fees or otherwise generate funding to support their operations.

The CDC FY 2013 budget request includes $197 million for Health Surveillance and Statistics, an increase of $23 million over FY 2012. In FY 2013, CDC will use the resources to obtain and use statistics to understand health problems, identify risk factors, support state electronic birth and death records implementation, guide programs and policy, and monitor the impact of health reform. Policy makers, researchers, and the public rely on data from these surveys to support decision making and research on health.

The NIH FY 2013 budget requests $30.9 billion which is the same level as in FY 2012. In FY 2013, NIH estimates that it will support a total of 35,888 research project grants, including 9,415 new and competing awards.

NIH is accelerating discovery by using technology. Investigators are better able to benefit from basic research discoveries by using advanced technologies such as DNA sequencing, microarray technology, nanotechnology, new imaging modalities, and computational biology. In FY 2013, NIH plans to support further development and application of these advanced technologies.

In FY 2013, NIH will continue to implement the National Center for Advancing Translational Sciences (NCATS) to re-engineer the process of translating scientific discoveries into new medical products. A total of $639 million is proposed for NCATS in FY 2013, including $50 million for the Cures Acceleration Network.