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Health Information Technologies and Health Care Transformation

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Title: Health Information Technologies and Health Care Transformation


1
Health Information Technologies and Health Care
Transformation
  • James Golden, PhDDirector, Division of Health
    PolicyMinnesota Department of Health
  • February 7, 2008

2
Overview
  • Opportunities in HIT
  • Clinical HIT
  • Administrative HIT
  • Actions
  • Mandates
  • Support
  • Community Effort
  • Opportunities for Savings

3
Electronic Health Records
  • EHRs
  • Better connect providers
  • Assist providers - Have the right information at
    the right time
  • Improve patient safety
  • Minnesotas private sector has invested hundreds
    of millions of dollars in EHRs and other HIT

4
EHR Actions
  • Minnesota e-Health Initiative Formed 2004
  • Statutory Mandate - that all health care
    providers must implement an interoperable
    electronic health record by January 1, 2015
  • State Appropriated Grants and Interest-Free Loans
    - 14.6 M to support the purchase,
    implementation, and connectivity of EHRs in
    safety net providers

5
EHR Actions
  • Revised Recodified MN Health Records Act to
    eliminate or reduce privacy barriers to
    electronically exchanging health information,
    while maintaining or strengthening patient
    privacy protections.
  • MN HIE - statewide health information exchange
    that will initially exchange medication history
    and formulary information between providers and
    payers

6
EHR Implementation Success
  • Adult Primary Care Clinics June 2007
  • 68 - have implemented or in the process
  • 46 in 2005 ----- 68 in 2007
  • 22 considering implementing - 12-24 months.
  • Acute Care Hospitals Fall 2006
  • 67 - have fully or partially implemented

7
Cost Saving Opportunities
  • Key Assumptions
  • EHRs used to full potential
  • Standardized electronic communication among all
    payers and providers
  • Effective clinical decision support
  • Savings Available
  • 4.3 of projected health care expenditures
  • 2.5 billion per year by 2015

8
Administrative Transaction Simplification
  • Minnesota Health Care Administrative
    Simplification Act
  • Purpose - Savings by implementing electronic data
    interchange using a single set of administrative
    standards and simplified procedures

9
ASA Focus Areas
10
Administrative Costs
  • Administrative Transactions Costs - of total
    spending
  • Health Plans 2
  • Hospitals 1
  • Clinics 3
  • Projected System-Wide Costs
  • SFY 2008 - 742 million
  • SFY 2012 - 970 million

11
2007 Changes to ASA
  • Uniform Electronic Transaction and Implementation
    Guide Standards
  • Requires - Three administrative transactions must
    be exchanged electronically using a single
    standard for content and format starting in 2009
  • Eligibility verification
  • Health care claims
  • Payment and remittance advice

12
Applicability of 62J.536
  • All Health Care Providers
  • Provide health care services in MN for a fee
  • Eligible for reimbursement under Medical
    Assistance
  • All Health Care Payers
  • Health Plans/Insurers
  • Third Party Administrators
  • Workers Compensation

13
Developing the Standards
  • Commissioner of Health uses rulemaking to develop
    companion guides
  • Based on Medicare standards
  • Developed in consultation with Minnesota
    Administrative Uniformity Committee
  • Modifications from Medicare as appropriate
  • Rules developed in 2008, effective in 2009

14
Opportunities for Savings
  • Single Standard - Content and Format
  • Easier to maintain billing software fewer staff
  • Less effort to stay current about payer
    requirements
  • Easier coordination of benefits across payers
  • Electronic Transactions
  • Electronic claims are less expensive than paper
  • Reduced data entry across trading partners
  • Eliminates mailing and telephone costs

15
Implementation Costs
  • Single Standard - Content and Format
  • Programming changes to existing systems
  • Increase in suspended claims during the
    transition
  • Increased customer service costs in transition
  • Electronic Transactions
  • Computer equipment/software or clearinghouse
  • Training of staff on new procedures
  • Development of provider portals

16
Opportunities for Savings
  • Key Assumptions
  • 7 reduction in costs
  • Adoption by all providers and payers
  • Savings Available w/o implementation costs
  • SFY 2008 - 7.4 million
  • SFY 2009 - 23.8 million
  • SFY 2012 - 67.9 million
  • SFY 2008-12 - 215 million

17
Thank You! - Questions
  • Minnesota Department of Health
  • James I. Golden, PhDDirector, Division of
    Health Policy
  • james.golden_at_health.state.mn.us
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