Content created by Office of Budget (OB)
Fiscal Year 2016
Released February, 2015
Topics on this page: Goal 1. Objective F | Table of Related Performance Measures | Analysis of Results | Plans for the Future | Objective Progress Update Summary
Goal 1. Objective F: Improve health care and population health through the meaningful use of health information technology
At the heart of HHS’s strategy to modernize the healthcare system is the use of data to improve healthcare quality, reduce unnecessary healthcare costs, decrease paperwork, expand access to affordable care, improve population health, and support reformed payment structures. HHS has taken a leading role in realizing health information technology’s (HIT) potential benefits. Within the last few years there has been unprecedented investment in HIT propelled by a range of initiatives, including incentive payments for the adoption and meaningful use of health information technology and standards; and the funding of regional extension centers, state health information exchanges, and Beacon communities. The rapid “wiring” of American health care, will do more than simply digitize paper-based work. It will facilitate a new means of improving the quality and efficiency of care, as well as an enhanced focus on the patient’s needs.
HHS has identified the nationwide adoption and meaningful use of HIT as a top priority for changing the healthcare system and for making health care more accessible, affordable, and safe for all Americans. ONC serves as the Secretary’s principal advisor charged with coordinating nationwide efforts to implement and use the most advanced health information technology and the electronic exchange of health information. ONC is working closely with CMS to implement the Medicare and Medicaid Electronic Health Record (EHR) Incentive Programs, which encourage hospitals and health professionals to move from paper-based records systems to EHRs. In addition to ONC and CMS, many HHS agencies and offices play significant roles in advancing health information technology with the goal to improve healthcare quality and efficiency and reduce costs. These components, including AHRQ, ASPE, CDC, CMS, FDA, HRSA, IHS, NIH, OASH, OCR, ONC, and SAMHSA are contributing to this objective by integrating these principles at the program level. The Office of the Secretary led this Objective’s assessment as a part of the Strategic Review.
Objective 1.F Table of Related Performance Measures
Increase the number of eligible providers (professionals and hospitals) who receive an incentive payment from the CMS Medicare and Medicaid EHR Incentive Programs for the successful adoption or meaningful use of certified EHR technology (Lead Agency - ONC; Measure ID - 1.B.4)
| FY 2011 | FY 2012 | FY 2013 | FY 2014 | FY 2015 | FY 2016 | |
|---|---|---|---|---|---|---|
| Target | N/A | 80,000 eligible professionals and hospitals | 230,000 eligible professionals and hospitals | 375,000 eligible professionals and hospitals | 450,000 eligible professionals and hospitals | 455,000 eligible professionals and hospitals |
| Result | 10,700 eligible professionals and hospitals | 156,758 eligible professionals and hospitals | 325,124 eligible professionals and hospitals | 414,914 eligible professionals and hospitals | Dec 31, 2015 | Dec 31, 2016 |
| Status | Historical Actual | Target Exceeded | Target Exceeded | Target Exceeded | Pending | Pending |
Increase the percent of office-based primary care physicians who have adopted electronic health records (basic). (Lead Agency - ONC; Measure ID - 1.A.2)
| FY 2011 | FY 2012 | FY 2013 | FY 2014 | FY 2015 | FY 2016 | |
|---|---|---|---|---|---|---|
| Target | 35% of office-based primary care physicians | 45% of office-based primary care physicians | 55% of office-based primary care physicians | 65% of office-based primary care physicians | TBD | TBD |
| Result | 39% of office-based primary care physicians | 49% of office-based primary care physicians | 53% of office-based primary care physicians | Mar 31, 2015 | TBD | TBD |
| Status | Target Exceeded | Target Exceeded | Target Not Met but Improved | Pending |
Increase the percentage of public health agencies that can receive production Electronic Laboratory Reporting (ELR) Meaningful Use compliant messages from certified Electronic Health Record (EHR) technology used by eligible hospitals (Lead Agency - CDC; Measure ID - 8.B.1.3a)
| FY 2011 | FY 2012 | FY 2013 | FY 2014 | FY 2015 | FY 2016 | |
|---|---|---|---|---|---|---|
| Target | N/A | Set Baseline | 33 % | 54 % | 54 % | 65 % |
| Result | 9 % | 18 % | 46 % | Mar 31, 2015 | Mar 31, 2016 | Mar 31, 2017 |
| Status | Historical Actual | Baseline | Target Exceeded | Pending | Pending | Pending |
Analysis of Results
To promote the use of health IT, the Medicare and Medicaid EHR Incentive Programs provide incentive payments to eligible professionals, eligible hospitals, and critical access hospitals as they adopt, implement, upgrade, or demonstrate “meaningful use” of certified EHR technology. Because the EHR Incentive Program is seen as key to HHS’s goal to strengthen healthcare, it has been chosen as one of HHS’s five Priority Goals. This increased focus has led to the pursuit of coordinated strategies that have resulted in a dramatic increase in the number of eligible providers who received EHR incentive payments. ONC exceeded its target in FY 2014 of 375,000 providers who receive an incentive payment for successful adoption or meaningful use of certified EHRs. The Recovery Act helped to set the groundwork for the expansion of electronic health care records and HHS used a variety of strategies to increase the number of providers using electronic health care systems by funding Health IT Regional Extension Centers, by working with state Health Information Exchanges and with Beacon Communities. Since 2011 the number of providers who received an incentive payment from CMS for meaningful use of electronic healthcare records increased 40 fold to 414,914 providers.
The wide scale adoption of appropriate HIT will enable providers to communicate with fewer errors to pharmacies, better coordinate care across settings, alert physicians and caregivers of preventive care options that would benefit the patient, and reduce duplicative testing results—among many other potential benefits. HHS measures the percentage of office-based primary care physicians who have adopted electronic health records. A basic EHR system would be expected to include: patient demographics, patient problem lists, medications, clinical notes, prescriptions, ability to view laboratory results, and the ability to view imaging results. By FY 2013, 53 percent of office-based primary care physicians had systems that met the basic EHR standard, falling short of the target.
CDC tracks the contribution of the informatics program and CDC program partners through the Electronic Health Records Meaningful Use (EHR-MU) initiative. CDC works to assess and ensure readiness of three key systems in each state: Electronic Laboratory Reporting, Immunization Information Systems, and Syndromic Surveillance. Public health agencies will assess their capability to receive data in a Meaningful Use-compliant format (i.e., Health Level 7 (HL7) 2.5.1 standard) from eligible hospitals and providers, meaning those with certified EHRs participating in the Centers for Medicare and Medicaid Services' Meaningful Use program. In FY 2014, Meaningful Use stage two required eligible providers to use only the latest format (HL7 version 2.5.1). However, if the public health agency approves, providers currently using the older format (HL7 2.3.1) could be grandfathered in. In FY 2013, CDC demonstrated significant capability gains for Electronic Laboratory Reporting as healthcare and public health agencies strove to meet Meaningful Use stage one and two requirements. Electronic Laboratory Reporting capability more than doubled from the 2012 baseline, exceeding the FY 2013 target by 39 percent.
Plans for the Future
ONC, CMS, CDC, AHRQ and their partners will to promote the meaningful use of technology and the development of health IT standards designed to improve quality and lower health care costs. More specifically, ONC and its partners will continue to analyze EHR Incentive Program registration, attestation, and payment data to evaluate the characteristics of providers at each of the different program milestones. Analysis of the program data will enable states and Health Information Technology for Economic and Clinical Health (HITECH) Act grantees to establish goals and accelerate progress to meaningful use of electronic health records and health IT. Monthly analyses of program participation and related policy-relevant data are available in the following internet locations: CMS EHR Incentive Program data and reports - http://www.cms.gov/Regulations-and-Guidance/Legislation/ EHRIncentivePrograms/DataAndReports.html; Health IT Policy Committee Meeting Archive - http://www.healthit.gov/facas/FACAS/health-it-policy-committee.
Objective Progress Update Summary
HHS demonstrated progress toward this objective as shown by the representative performance measures described in the HHS Annual Performance Plan and Report. Further evidence of progress is described below.
- The Electronic Health Record (EHR) Incentive Programs gained significant momentum in 2014, and as of September 2014, eligible providers received an incentive for adopting, implementing, or upgrading their certified electronic health record technology (CEHRT) or for successfully demonstrating Stage 1 of meaningful use. Also, 4,674 eligible hospitals and critical access hospitals have received an incentive for adopting, implementing, or upgrading their CEHRT or for successfully demonstrating Stage I of Meaningful Use, totaling 414,914 providers. The progress has exceeded the HHS priority goal for FY 2014 that 375,000 providers would receive a payment from either the Medicare or Medicaid programs.
- In 2013, 46 percent of public health agencies received production electronic laboratory reporting (ELR) Meaningful Use compliant messages from certified EHR technology used by eligible hospitals, exceeding the target by 13 percent. An additional 21 public health agencies tested ELR messages from eligible hospitals; therefore, CDC expects significant capability gains in the percentage of public health agencies that receive production messages, as healthcare and public health agencies strive to meet Meaningful Use stage one and two requirements.
The Department is continuing to support and execute the programs contributing to this objective, monitoring progress, performance, and program integrity while adjusting to any budgetary constraints or changes to programmatic demands.