By Mary Grealy.  An organization of health industry chief executives today applauded federal regulators for being responsive to the concerns of hospitals and physicians in constructing the final “meaningful use” regulations that will determine the allocation of health information technology (HIT) incentive funds.  But, said the president of the Healthcare Leadership Council (HLC), the newly-released rules leave some critical issues still unaddressed.

HLC president Mary R. Grealy said that, even though her organization was still analyzing the regulations, “it’s clear that federal regulators paid close attention to the more than 2,000 comments they received on the proposed rule, and that they have been responsive to concerns that the initial regulations placed the “meaningful use” bar so unrealistically high that the health technology revolution would have been slowed instead of accelerated.”

The “meaningful use” regulations establish standards that health providers must meet in order to qualify for a share of the more than $27 billion authorized by Congress in last year’s economic stimulus legislation.

The Healthcare Leadership Council is a coalition of chief executives from all sectors of American healthcare.

Ms. Grealy said, “An example of this responsiveness is seen in the fact that the rules no longer require that, in the initial stage of implementation, all of a health provider’s administrative transactions must be included in an electronic health record.  That simply wasn’t realistic.  Those requirements are now in Phase 2 of implementation, which is achievable.”

She said, though, that legitimate concerns remain.  For example, the regulations should consider each campus of a multi-campus hospital system as a separate entity in qualifying for HIT incentive payments.  And, she said, health providers who have built and succeeded with their own information technology systems should be grandfathered into the universe of successful “meaningful use” qualifiers, but that doesn’t appear to be the case based on an initial review of the rules released today.

Nonetheless, Ms. Grealy said, “we’re seeing important progress with these regulations.  Clearly, the administration saw there was a gap between the theoretical standards they initially wanted to apply and the real-world challenges that physicians and hospitals face in achieving HIT advancement.   We all want the benefits that come from information technology – enhanced patient safety, more cost-efficient operations, greater use of evidence-based medicine – but to make strides forward, regulators and providers need to be moving at a coordinated pace.”

Orignially posted on Prognosis: A Healthcare Blog on July 13th

It could not escape notice this week that the Virginia state Senate passed legislation that would make it illegal for any government body to require individuals to purchase health insurance.  The bill is expected to be passed by the state’s House of Delegates and then signed into law by Governor Bob McDonnell.

Virginia is one of the first states to take such action, but it almost certainly won’t be the last.  According to the American Legislative Exchange Council, legislative measures or proposed constitutional amendments have been filed in 35 states to challenge the idea of health insurance mandates.

This is a significant problem for the future of health reform.  One of the most popular components of the health reform bills that have passed both houses of Congress is the provision that removes pre-existing health conditions as a barrier to purchasing health coverage.  Even in our fractious society, there is virtual unanimity around the idea that having an illness shouldn’t leave individuals and families without health insurance and subject to financial ruin.

But we can’t enact that essential reform unless we also take steps to ensure that there is an individual responsibility to have health coverage.  Just as our property insurance system would collapse if individuals could wait until their house is on fire to buy a homeowners’ policy, so would our health insurance system be unsustainable if the healthiest among us could opt out until we became ill and needed an insurance plan to cover their expenses.

Understandably, lawmakers, in a challenging political environment, would love to pass laws making insurance companies issue policies to all comers, but they’re reluctant to impose health insurance mandates on their constituents. This, however, is a case where you genuinely can’t have the dessert without the vegetables.

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Mary R. Grealy is president of the Healthcare Leadership Council, a coalition of chief executives of the nation’s leading health care companies and organizations.  She is also the author of Prognosis:  A Healthcare Blog which explores the nexus at which healthcare policy meets healthcare practice.

If only it were an urban legend that senior citizens in the United States were cutting their physician-prescribed pills in half or ignoring their medications altogether in order to have enough money for food and utilities, but one doesn’t need academic studies to know that this kind of economically-forced non-adherence has too often been the case in our country.

After Congress passed the Medicare Modernization Act (MMA), creating the Part D prescription drug program, the Healthcare Leadership Council – an advocacy group comprised of chief executives of healthcare companies and organizations from all health sectors – literally took its show on the road. Having worked for passage of the MMA, we felt a responsibility to ensure that the new Part D program was implemented successfully and that seniors knew how to take advantage of the new benefit.

In community meetings across the country, I met with scores of elderly men and women who told me heart-wrenching stories of the hard choices they had to make between medications and other necessities, knowing they were putting their health at risk.

Has the Medicare Part D prescription drug program made a difference in drug adherence within this vulnerable population? The results are quite positive but they also show that further improvements remain necessary.

The impact of Part D on drug adherence among the elderly is unquestionable. A survey in April of this year by KRC Research (commissioned by Medicare Today, a coalition of local and national organizations we founded to provide reliable Part D information to seniors) found that three of every 10 Medicare beneficiaries reported that they are now taking medications that they had previously either skipped or rationed.

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