The Wave that Never Breaks: Health IT Implementation and Adoption Initiatives

Transcription

1 The Wave that Never Breaks: Health IT Implementation and Adoption Initiatives Margo Edmunds, Cheryl Austein-Casnoff, Rachel Block, Shirley Girouard, and Patricia MacTaggart AcademyHealth Annual Research Meeting Chicago, IL, June 29, 2009

2 Welcome Meet the panelists Margo Edmunds, Booz Allen and Johns Hopkins University Cheryl Austein-Casnoff, HRSA Office of Health IT Rachel Block, New York ehealth Collaborative (NYeC) Shirley Girouard, San Francisco State University Patricia MacTaggart, The George Washington University 1

3 What Our Panel is About Technology adoption and innovation in the public sector Using IT to promote administrative simplification and reduce errors Based on experiences implementing the State Children s Health Insurance Program (SCHIP, S-CHIP, CHIP, schip) Apply lessons learned to current challenges in technology adoption and health reform 2

4 Highlights of the State Children s Health Insurance Program Congress passed SCHIP as part of Balanced Budget Act of 1997 Largest expansion of healthcare coverage since Medicare and Medicaid in 1965 New opportunities for innovation Consumer-friendly, e.g., PeachCare Streamlined administrative processes, e.g., faxed or Web-based applications instead of face to face More accurate information; improved tracking and electronic reporting of enrollment numbers 3

5 Who Helped to Launch the State Children s Health Insurance Program? FEDERAL Federal Interagency Task Force Dept. of Health & Human Services Office of the Secretary Asst. Secretary for Planning & Evaluation Agency for Healthcare Research & Quality Center for Medicare & Medicaid Services Health Resources & Services Administration National Center for Health Statistics (CDC) Dept. of Commerce, Bureau of Census: Current Population Survey Dept. of Education: School-Based Outreach Dept of Agriculture: Food Stamps Dept of the Interior: Park-Based Outreach STATES Governors EXECUTIVE BRANCH Medicaid Directors/Human Services Agencies Separate State Agencies Insurance Departments Health Departments Office of the First Lady Office of Management & Budget National Organizations of Public Officials American Public Human Services Association Association of State & Territorial Health Officials National Conference of State Legislatures National Governors Association National Association of Insurance Commissioners STATES State Organizations WHITE HOUSE PUBLIC/PRIVATE PARTNERSHIPS Robert Wood Johnson Foundation (RWJF) Covering Kids American Academy of Pediatrics Chapters PRIVATE SECTOR Business & Industry Bell Atlantic Kaiser Permanente Blue Cross-Blue Shield; Caring Programs Foundations RWJF: Covering Kids Packard Foundation (AHRQ grants) Milbank Memorial Fund W. T. Kellogg Foundation National Organizations Private American Academy of Pediatrics Children s Defense Fund Families USA Family Voices March of Dimes National Assn. of Children s Hospitals Research & Policy Organizations Center on Budget & Policy Priorities Institute of Medicine Mathematica National Academy of State Health Policy Urban Institute Universities & Public Service Organizations 4

6 Institute of Medicine, 1998: Recommendations at Program Launch All children should have health insurance Develop national and state performance monitoring systems using technology (IT) Develop systems that produce meaningful information on SCHIP s effects at federal and state levels Develop core set of basic indicators for all types of programs (Medicaid expansions, separate state program, private program) Make information available to the public via Web Source: Edmunds and Coye, America s Children: Health Insurance and Access to Care and Systems of Accountability (IOM, 1998) (RWJF) 5

7 Children s Defense Fund: Progress Report, 2000 States that used technology got more kids enrolled faster Toll-free numbers and call centers TV and radio ads (social marketing) Web-based enrollment Reduced enrollment barriers/access through streamlined application procedures, application assistance, and community-based outreach Positive disruptor in Medicaid: software upgrades, program coordination, interoperability Source: Edmunds et al. All Over the Map: A Progress Report on SCHIP (CDF, 2000) (RWJF, Packard, Kellogg) 6

8 That was Then, This is Now, or Déjà Vu All Over Again IT as a means to an end: goal was getting kids enrolled so they can access health care Medicaid reforms with SCHIP were precursors to IT-focused Medicaid transformation grants Public sector innovation continues through shared services and system integration Focus on consumers : child- and familycentered programs and policies Provider leadership, engagement and advocacy Model for small group market coverage expansions in public sector 7