Failure to comply with the Health Insurance Portability and Accountability Act (HIPAA) makes hospitals and health-care providers quake with fear of delayed payments from Medicare and Medicaid.
Right now, health-care providers, including hospitals and physician practices, are not even 60 percent HIPAA-compliant in terms of the forms and processes they have in place.
Click here for more on the struggle toward HIPAA compliance.
Yet the organization responsible for these fears, the Centers for Medicare and Medicaid Services (CMS), has also seen nearly 90 percent of hospitals sign up for its voluntary program to share data about heart attack, heart failure, pneumonia, surgical infection and other means of assessing quality.
That doesn't mean that all of the hospitals are reporting data yet. But what is really encouraging about this news is the level of cooperation with private groups.
The American Hospital Association (AHA), the Federation of American Hospitals (FAH) and the Association of American Medical Colleges are all working very closely with CMS on the Quality Initiative Effort.
The project was launched only in December 2002, and for organizations with as many moving parts as hospitals—in terms of personnel, equipment and paperwork—this level of participation seems laudable.
Of course, CMS, which provides more than half of many hospitals' revenues and one-third of national health expenditures, has some powerful tools for encouragement.
Hospitals that don't report on the 10 performance measures described in the Quality Initiative won't receive a full "inflation update" of their Medicare payments in fiscal year 2005, and they must register by June 1 this year to qualify.
According to the CMS Web site, the project was launched because CMS lacked a comprehensive, clinical data set from hospitals that could be used to develop standard, robust measures of quality.
The most public part of the project will be the launch of a new Medicare Web site for consumers in 2005.
In addition to objective measures reported by health-care workers, the site will include information from surveys of patients about their experience in the hospital. Patients will be able to use this information to choose where they receive care.
According to the AHA, more than 1,000 of 3,900 eligible U.S. hospitals are already reporting data for all 10 measures, a fact that clearly makes the association proud, as it does for the FAH.
"Hospitals are leading the charge toward developing national standardized performance measures," said Chip Kahn, president of the Federation of American Hospitals.
"Members of the federation have been proud to take part in this important initiative since the get-go, well before the new Medicare law pegged payment to participation."
But the initiative has a long way to go. (Click here for a progress report from CMS.)
Nonetheless, the level of cooperation should carry over to issues of HIPAA compliance—after all, many of the same entities are involved—and eventually to implementing the use of electronic health records.
To read more about health-care vendors and providers asking for help with HIPAA compliance, click here.
The good thing is that progress made on one goal will make figuring out how to accomplish the others easier.
An aside:
In my last column, about the Health Level 7 (HL7) draft standards that promise to provide a common language for electronic health records, I noted that a common language only worked if people actually used it and referred to the invented language Esperanto. Two people e-mailed me noting that Esperanto was indeed being used, at least to some extent.
The more polite of the two, a delegate of the World Esperanto Association, told me, "People do use Esperanto, every day, particularly in small countries where the predominant language is very exotic and of very limited value outside of that country."
He referred me to an article in the Slovak Spectator in which an expert suggests that a non-national language might be a good option for the European Parliament.
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