Each Patient Counts: Massachusetts Medical Society Weblog

Congratulations to Howard Koh

We received word last night that Dr. Howard Koh, former public health commissioner for Massachusetts and past chair of the Massachusetts Medical Society's Committee on Public Health, has been named assistant secretary for health in the Obama administration. He will be responsible for establishing the nation's public health agenda.

Dr. Koh's tenure as state public health commissioner may best best remembered for his aggressive and innovative anti-tobacco campaign. He led the initiative to raise the state tobacco tax in 1992, which funded the state's renowned tobacco control program.

In recent years, Dr. Koh has been serving as associate dean of the Harvard School of Public Health.

This has been an exciting week for the Koh family. A few days earlier, Dr. Koh's brother Harold, dean of Yale Law School, was named the top-ranking legal advisor at the U.S. State Department.

Payment Reform Commission Meets; Still Weighing Principles

The state Payment Reform Commission met for the fifth time today to listen to several presentations on global budgets, another alternative payment model.

At the start of the meeting, commission consultant Michael Bailit said he is preparing another amended version of commission operating principles, based on further comments from stakeholder groups. He did not provide a new draft, and he did not provide any hints on how they will change from the latest version. He said the newest version will be posted on the commission’s website in the near future.

The commission heard two presentations on global budgeting models. Two senior leaders of Blue Cross Blue Shield of Massachusetts discussed the insurer’s new Alternative Quality Contract, while Ann Robinow of a Minnesota employer health care purchasing coalition discussed “Patient Choice,” a global payment model that uses market forces to force providers to compete for patients. (More details on these presentations will be provided on the MMS blog by March 16.)

This meeting concluded the education phase of the commission's work. Co-chair Sarah Iselin said the next meetings, starting April 3, will focus on bringing everything together and starting to develop recommendations for the State Legislature.

IOM Looking for Feedback on Comparative Effectiveness Research

The Institute of Medicine is soliciting comments from physicians on the priorities it establish for the new comparative effectiveness research program established by last month's federal stimulus bill. The bill requires the IOM to submit a consensus report and recommendation to Congress by June 30.

The IOM has posted an online questionnaire that will be available until March 27.

It is also holding a public hearing on March 20 in Washington. Fill out this online registration form if you would like to attend or make a presentation.

For more on the comparative effectiveness research provisions in the stimulus bill, read the AMA's analysis. (.pdf)

"Health Affairs" Tackles Health IT and Spotlights the Mass. eHealth Collaborative

The new edition of Health Affairs, published today, is called "Stimulating Health IT." It is devoted almost entirely to the challenge of implementing comprehensive health IT systems throughout the country.

It relies heavily on case studies of EHR pilot projects. In two articles of local interest, Massachusetts eHealth Collaborative Executive Director Micky Tripathi co-authors articles about the results of his nationally renowned program.

• In one article, Tripathi and the director of the Primary Care Information project in New York City, describe how they led successful efforts in their respective communities to implement broad-scale EHR adoption. The approaches contrast in many ways, but they share four broad lessons.
• The second article, written Tripathi and three associates at the eHealth Collaborative, outlines how they were able to persuade 90% of patients in their communities to voluntarily allow their personal health information to be added to the community's health information exchange, while being very upfront and forthcoming with the patients about the difficult issues of privacy and consent.

This entire issue of Health Affairs is worthy of careful reading. A subscription is needed to read the full text of most articles.

The Health IT Money: What’s Coming to Massachusetts?

The Massachusetts Medical Society has published an overview of how the new federal health IT funds could affect the Massachusetts health care system over the next five years. The complete picture will take many months to develop, but we can pass along some preliminary details.

The funding will come in two pools:

• A relatively small pool of loans and grants, directed mostly to states, colleges and state-designated agencies. It's believed that most of these loans and grants will be used to help develop regional health information exchanges, but other IT projects are eligible. A lot of this money will be available within the next year.
• A much larger pool of Medicare bonuses paid directly to qualifying physicians and hospitals after they install EHRs , starting in 2011 for up to five years.

The full analysis is available here, along with links to supporting documentation and other background information.

State Announces Proposal to Boost Some Physician License Fees

The Board of Registration in Medicine has announced plans to raise some licensing fees. This plan is part of a broad effort to raise revenues by the Executive Office of Administration and Finance.

Initial medical licenses will remain at $600, but renewals will go from $400 to $600 per two year period. Lapsed license fees, generated by failure to complete the renewal process by one's birthday in the renewal year, will go from $600 to $700.

A public hearing will be held at the Board’s Wakefield office on March 25.  Written testimony may be sent to Board of Registration in Medicine, 200 Harvard Mill Square, Suite 330, Wakefield, MA 01880.

The complete proposed schedule is available here on the board's website. (.pdf)

Under a 2002 law, passed with the support of the MMS, all future fee increases were 100% dedicated to the board’s work. Generally licensing fees go directly to the state with a small percentage reverting to the Boards and agencies assigned oversight of  a particular profession. Physicians are unique in Massachusetts in the dedication of their licensing fees.

Board sources indicate that the fee increases will allow the Board to continue its work towards online license renewals and its other activities without otherwise significant staff reductions. The MMS is in the process of developing testimony on this issue. Bill Ryder of our Government Relations Department is coordinating the testimony on this issue and may be reached at wryder@mms.org.