HIMSS Federal Affairs Update

HIMSS Federal Affairs Update

The U.S. Department of Health and Human Services (HHS) provided the health IT community with a 30-day extension on the public comment period for the Centers for Medicare & Medicaid Services (CMS) Interoperability Regulation and the Office of the National Coordinator for Health IT (ONC) Proposed Regulation on Interoperability, Information Blocking and the ONC Health IT Certification Program. Public comments are now due June 3. In addition, HHS recently released more information on two initiatives that help facilitate more health data exchange and support the proliferation of value-based care delivery models.

On Friday, April 19, ONC published its second draft of the Trusted Exchange Framework and Common Agreement (TEFCA) and opened it for public comment, with a deadline to respond of Monday, June 17. This second draft of TEFCA follows the initial iteration that was released in January 2018. HIMSS, along with many other stakeholder organizations, proposed significant revisions to the original TEFCA – our February 2018 public comment letter is available online.

ONC has focused its TEFCA development on three high-level goals: provide a single “on-ramp” to nationwide connectivity; enable electronic health information (EHI) to securely follow the patient when and where it is needed; and, support nationwide scalability.

This new draft makes clear that the Trusted Exchange Framework (TEF) and the Common Agreement (CA) will be distinct components that together aim to create technical and legal requirements for sharing EHI at a nationwide scale across disparate health information networks (HINs).

In addition, on April 22, CMS announced the latest set of primary care transformation models to come from the CMS Innovation Center, entitled the Primary Cares Initiative. The major driver of this model is to reward value and quality by way of offering innovative payment model structures to support delivery of advanced primary care.

This initiative will provide primary care practices and other providers with five new payment model options under two paths: Primary Care First (PCF) and Direct Contracting (DC).

To stress the importance and central nature of primary care, CMS recognizes the urgent need to preserve and strengthen this practice modality, as well as the need to support complex, chronic and serious illness care services for Medicare beneficiaries. PCF attempts to create a seamless continuum of care across many provider organizations with multiple stages of readiness to assume accountability for patient outcomes. Moreover, DC creates opportunities for a broad range of organizations to participate in risk-sharing arrangements that promote value and high quality care, while supporting the shift away from the fee-for-service paradigm.

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