How does the Affordable Care Act impact the healthcare industry? What role does technology play in this controversial piece of legislation? Find out in this brief presentation on the health care transformation happening now in the U.S.

1. The Affordable Care Act and its
Impact on Health IT

2. 3 Health IT Themes in ACA
• Enhance Quality Reporting and
Measurement
• Expand quality reporting (PQRS, ACO
performance measures, etc.)
• Improve quality of care (evidence-based
guidelines, CDS)
• Encourage quality through reimbursement
modeling (CMMI)
• Needed for reimbursement reform

3. 3 Health IT Themes in ACA
• Establish Uniform Operating Rules
and Standards
• Promote Health IT Workforce
Development
Remember: The ACA ruling may impact
certain funding provisions.

4. ACA and Health IT - Data
• §2717 – Establishment of quality reporting for
insurers
o CMS is an insurer (Medicare and Medicaid), extends to
private insurers
o Priority given to:
 Health care outcomes
 Management across episodes of care / transitions of
care
 Use of health IT
 Informed treatment decisions and shared decision-
making

5. ACA and Health IT - Data
o If upheld, “Preference for Clinical Care” must be
defined by HHS
 Use of CDS to guide “preference-sensitive” treatment
choices
 Drives reimbursement
 Controversial for government – “My doctor should
decide, not my government.”

6. ACA and Health IT - Data
• §3004 and 3005 – Submission of quality
measures to HHS
o Affects LTC, Hospitals, Inpatient Rehab, Hospice and
Cancer Hospitals
• §3013 – Grant awards for purposes of developing
Health IT Quality Measures
o Focus on where no measures exist
o Seeks to create standards for measuring population
improvement
o Quality Reporting becomes a broad federal initiative

7. ACA and Health IT - Data
• §4302 – Federal data collection at the smallest
level possible
o HHS/ONC to develop national standards for data
collection, interoperability and security for data
management
o Includes federally conducted/supported health care
programs or surveys

8. ACA and Health IT - Educate
• §6301 → Communication and Knowledge
Transfer (ARHQ)
o RFP issued for preferred vendors for Knowledge
Transfer
o $150M in Grant awards earmarked
• §10332 → Medicare A, B, and D Claims Data
o Probabilistic Matching between unrelated databases
→ Leveraged with ACOs
o Impact Physician Compare rating website
o Patient Privacy issues? → Challenged in other courts
(Patient de-identified, Provider Identity intact)

9. ACA and Health IT - Educate
• §10333 → Grants for Community-based
Collaborative Care Networks
• Example: Tele-health services
• §10109 → HHS to receive input
• Input from NCVHS, HIT Policy Committee, HIT
Standards Committee, Standards Orgs and
Stakeholders will be considered
• §4103 → Annual Wellness Visit for each
Medicare Patient
o Increase Self-Management through use of Health IT

10. ACA and Health IT - Educate
• §5405 → Primary Care Extension Programs
o Education / Technical Assistance in Evidence-
based Practices
o HHS to consults with agencies experienced in health
care / prevention, including ONC
• §934 → Technical Assistance Grants
o Provide education / technical assistance to health
care providers
o Must coordinate with RECs regarding quality
improvement, reform and best practices

11. ACA and Health IT - Educate
• §5604 → Grants to Community Mental Health
Programs
o Includes for provisions of Health IT
• §6701 → Grants for LTC Facilitates for Certified
EHR Technology

12. ACA and Health IT - Measure
• §10305 → Public Reporting of Performance
Data
o Requires alignment with other Health IT efforts
• §1322 → Consumer Operated and Oriented Plan
(CO-OP)
o Non-profit health insurance companies
o CO-OP Organizations Collective Purchasing for items
and services, including HIT

13. ACA and Health IT - Measure
• §1323 → Community Health Insurance, or
Exchanges
o Use Health IT for real-time data for investigation of
fraud/abuse
• §2401 → Home/Community-based services and
support
o To help eligible patients with care such as daily living
o Includes back-up systems for Continuity-of-Care

14. ACA and Health IT - Measure
• §2703 → Chronic Condition Consumers receive
payments
o Provision for home health services
o Includes use of Health IT for care management

15. ACA and Health IT – Pay-for-
Value
• §10410 → Grants to establish National Centers of
Excellence for Depression
o Includes use of EHR and Tele-Health technologies
• §1311 → Reformed Provider Reimbursement –
Ind. & SBA
o Increased pay for best practices, evidence-based
medicine and use of Health IT

16. ACA and Health IT – Pay-for-
Value
• §2706 → Pediatric ACO Demonstration –
Incentives for Quality
• §3002 → PQRS integration with MU CQMs
o Establishes informal review process
• §3021 → CMMI Created ($10B in funding)
o Innovative payment and service delivery models
o Includes ACOs and Health IT enabled networks

17. Learn more!
Our website hosts a wealth of free
resources, including white papers,
case studies, an industry blog, a
newsletter covering current events in
health care, tips and tricks for your
practice, and other informative articles.
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