 |
Tribal Technical Advisory Groupto the Centers for Medicare & Medicaid Services |
 |
IntroductionThe Tribal Technical Advisory Group (TTAG) is a group of elected tribal leaders, or an appointed representative from their Area, who are nominated from the twelve areas of the Indian Health Service (IHS) delivery System. The TTAG serves as an advisory committee to the Centers for Medicare & Medicaid Services (CMS) on important health care matters associated with the Medicare, Medicaid, and State Children Health Insurance Programs (SCHIP). There is a Principal Member and an Alternate from each of the twelve service areas. These areas are: Alaska, Aberdeen, Albuquerque, Bemidji, Billings, California, Nashville, Navajo, Oklahoma, Phoenix, Portland, and Tucson. In addition to these twelve areas, there is representation from the four Washington, DC based advocacy organizations: Tribal Self Governance Advisory Committee (TSGAC), National Indian Health Board (NIHB), National Congress of American Indians (NCAI) and National Council of Urban Indian Health (NCUIH). The TTAG is divided into TTAG Smaller Subcommittees (Adobe Acrobat PDF) to analyze major Medicare and Medicaid topics effecting AI/ANs in greater detail. Individual TTAG and MMPC members along with employees from the CMS and IHS are subcommittee members. These subcommittees include, but are not limited to: Across State Borders, Long Term Care, Data, Outreach & Education, Affordable Care Act Policy and Behavioral Health. For more information about the TTAG and the MMPC Technical Advisors, please refer to the document Tribal Technical Advisory Group Membership (PDF). growth in u.s. health spending remains slow in 2010Health spending growth at historic lows for second consecutive year U.S. health care spending experienced historically low rates of growth in 2009 and 2010 according to the annual report of national health expenditures (NHE) published in the January issue of the journal Health Affairs. Analysts at the Centers for Medicare & Medicaid Services (CMS) report in the article that the increase in spending for 2009 represents the lowest rate of increase in the entire 51 year history of the NHE. The low rate of growth, the data show, reflects lower utilization in health care than in previous years. The report notes that U.S. health care spending grew only 3.9 percent in 2010, reaching $2.6 trillion or $8,402 per person, just 0.1 percentage point faster than in 2009. In 2010, as health spending growth remained low, growth in U.S. economy as reflected in gross domestic product (GDP) (4.2 percent) rebounded. As such in 2010, the health spending share of the overall economy was unchanged at 17.9 percent. In the past, this share has increased, rising over time from 5.2 percent in 1960. The NHE report, prepared annually by the Centers for Medicare & Medicaid Services’ (CMS) Office of the Actuary, summarizes recent trends in health care spending based on the most current data sources. Available historically since 1960, the NHE represents the official estimates of total health care spending in the United States and measures annual health spending by the types of goods and services delivered (hospital care, physician services, retail prescription drugs, etc.), by the programs and payers that pay for that care (private health insurance, Medicare, Medicaid, etc.), and by the sponsors who are ultimately responsible for financing that care (private business, households, and governments). Information in this report can be accessed at the following web location:
http://www.cms.gov/NationalHealthExpendData/
To read the entire CMS Press Release issued today (1/9/12) and other key findings click here: http://www.cms.gov/apps/media/press/ qualified Entity program on line application opens January 9Qualified Entity Program On Line Application Opens January 9 Affordable Care Act Section 10332 – Availability of Medicare Data for Performance Measurement – amended Section 1874(e) of the Social Security Act to enable the creation of the Qualified Entity Program. The provisions of this section of the Act were recently announced in the Final Rule published December 7, 2011 [76 Fed Reg 76542-76571] and codified in 42 CFR 401G. Organizations interested in applying to the Qualified Entity Certification Program for Medicare Data are encouraged to visit www.QEMedicareData.org. Applications will be accepted beginning January 9. There is no deadline for submitting applications for certification as a Qualified Entity. Applications will be accepted on a rolling basis. To be eligible to participate in the program, an applicant (either itself or through contracts with other entities) will need to have experience in a variety of tasks related to the calculation and reporting of performance measures, including combining claims data from different payers, designing performance reports, sharing performance reports with the public, working with providers and suppliers regarding requests for error correction, and ensuring the privacy and security of data. Applicants will also need to have access to claims data from other sources to combine with the Medicare data in the evaluation of providers and suppliers. They will also need strong systems to ensure the data is secure and protected. Qualified entities are only permitted to use the data to generate performance reports for providers of services and suppliers on measures of quality, efficiency, effectiveness, and resource use. Qualified entities are required to make the performance reports available publicly after providers and suppliers are given an opportunity to review and correct the data. Uses of Medicare data other than for the generation of performance reports is strictly prohibited by the statute.
Additional information is available at affordable care act provision cuts red tape, save up to $4.5 billionStreamlining electronic funds transfers in health care will bring total savings to more than $16 billion over 10 years New standards for electronic funds transfers in health care, required by the Affordable Care Act, will reduce up to $4.5 billion off administrative costs for doctors and hospitals, private health plans, states, and other government health plans, over the next ten years, according to estimates included in new rules published today by the U.S. Department of Health and Human Services (HHS). The standards build upon regulations published earlier this year that set industry-wide standards for how health providers use electronic systems to quickly and easily determine a patient’s eligibility for health coverage and check on the status of a health claim. Together, the two regulations implementing the Administrative Simplification provisions of the Affordable Care Act and the Health Insurance Portability and Accountability Act (HIPAA) are projected to save the health care industry more than $16 billion over the next 10 years. These savings come from the adoption of electronic standards that will help eliminate inefficient manual processes and reduce costs. “Thanks to the Affordable Care Act, health care professionals will spend less time filling out paperwork and more time focusing on delivering the best care for patients,” said HHS Secretary Kathleen Sebelius. An April 2010 study in the journal Health Affairs found that physicians spend nearly 12 percent of every dollar they receive from patients to cover the costs of filling out forms and performing other excessively complex administrative tasks. The study found that simplifying these systems could save four hours per week of professional time per physician and five hours of support staff time every week – time that could be better spent on patient care. “As a nurse, I know the importance of giving health care professionals time to focus on patient care,” said CMS Acting Administrator Marilyn Tavenner. “The less time a physician has to spend on paperwork is that much more time that can be devoted to patient care. Having standardized procedures across the health care industry can only lead to lower costs and greater efficiencies all around.” Today’s rule—the Adoption of Standards for Health Care Electronic Funds Transfers and Remittance Advice — adopts streamlined standards for the format and data content of the transmission a health plan sends to its bank when it wants to pay a claim to a provider electronically (through an electronic funds transfer) and to issue a Remittance Advice notice. Remittance Advice is a notice of payment sent to providers that may or may not accompany the payment the provider receives. For example, currently when a provider submits a claim electronically for payment, a health plan often sends a Remittance Advice separately from the Electronic Funds Transfers payment. The disconnect between the two makes it difficult or sometimes impossible for the provider to match up the bill and the corresponding payment. Today’s rule addresses this by requiring the use of a trace number that automatically matches the two. The new tracking system will allow health care providers to eliminate costly manual reconciliation that must currently be done. Future administrative simplification rules will address adoption of:
The regulation is effective January 1, 2012. All health plans covered under HIPAA must comply by January 1, 2014. To view the Interim Final Regulation with comment period, go to: http://www.regulations.gov For more information on the June 2011 HIPAA Administrative regulation: Adoption of Operating Rules for Eligibility for a Health Plan and Health Care Claim Status, visit: http://www.hhs.gov/news/press/2011pres/06/20110630a.html healthcare professionals selected for the new innovation advisors program to improve care for patientsThe Centers for Medicare and Medicaid Services (CMS) today announced that it has selected 73 individuals from 27 States and the District of Columbia for its Innovation Advisors program.
A list of Innovation Advisors can be found at http://www.cms.gov/apps/media/press/factsheet.asp The initiative, launched by the CMS Innovation Center in October 2011, will help health professionals deepen skills that will drive improvements to patient care and reduce costs. After an initial orientation phase, Innovation Advisors will work with the CMS Innovation Center to test new models of care delivery in their own organizations and communities. They will also create partnerships to find new ideas that work and share them regionally and across the United States. Funding for this initiative was made possible by the Affordable Care Act. “There has been an incredible groundswell of interest in becoming an Innovation Advisor. It’s clear that doctors, hospitals and health care providers are enthusiastic about implementing the Affordable Care Act and strengthening our health care system,” said CMS Acting Administrator Marilyn Tavenner. The 73 individuals were selected from 920 applications through a competitive process, and include clinicians, allied health professionals, health administrators and others. By attending in-person meetings as well as remote sessions to expand their skills and applying what they learn, the Advisors will be able to deepen their knowledge in health care economics and finance, population health, systems analysis, and operations research. “We’re looking to these Innovation Advisors to be our partners—we want them to discover and generate new ideas that will work and help us bring them to every corner of the United States,” said CMS Innovation Center Director Rick Gilfillan, M.D. Among other duties, the Advisors will be expected to support the Innovation Center in testing new models of care delivery, to form partnerships with local organizations to drive delivery system reform, and to improve their own health systems so their communities will have better health and better care at a lower cost. Each Innovation Advisor’s home organization will receive a stipend of up to $20,000. The stipend will support an individual’s activities while serving as an Innovation Advisor. More information about the Innovation Advisors Program, including a fact sheet and list of participants and their home organization, can be found at: http://innovations.cms.gov/initiatives/innovation- |
UPCOMING MEETINGS AND CONFERENCE CALLS
Announcements |