House and Senate committees focused on Medicare issued a number of reports and proposed amendments in final month of 2013.

 

Among the amendments proposed by Senate Finance Committee members are provisions for new integrated mental and behavioral health demonstrations, an increase in medical residency slots, and a mechanism for HHS to set aside funds for a stop-loss program to support hospitals seeing declines from the disproportionate share hospital program.

 

Some House and Senate members also want to revisit the HITECH Act. Sens. John Thune and Mike Enzi, Republicans from South Dakota and Wyoming, proposed amendments in December requiring "interoperability to be achieved by 2017 to be meaningful user under the Electronic Health Record Meaningful Use program," with rules established via federal committee under the direction of the HHS Office of the National Coordinator.

 

Senator John Cornyn, R-Texas, proposed a more specific and different amendment, directing HHS to adopt a common interoperability standard by 2017, as part of the rules for meaningful use Stage 3.

 

Members of the House Energy and Commerce Committee have proposed similar provisions and also issued a report outlining their visions for health information technology, pointing out the connections between interoperability and quality and cost improvements.

 

"While technology has begun to change the way doctors provide care and patients engage in their health, we must recognize that these technologies will be unable to truly transform our health system unless they can easily locate and exchange health information," the members wrote. "For this effort to be successful, however, more must be done to bolster interoperability. The Administration, acting through the Office of the National Coordinator for Health IT, must provide appropriate guidance to providers and to industry on its vision for interoperability and work to engage all stakeholders in adoption of those systems."

 

The committee suggested that HHS adopt interoperability standards that "allow every healthcare provider to access and use longitudinal data on the patients they treat to make evidence-based decisions, coordinate care, and improve health outcomes as quickly as possible."

 

With many payment reforms riding on information exchange, interoperability by 2018 "is reasonable," they said, and "should be the highest priority for ONC in order to enable healthcare providers to measure, report, track, and perform on the quality measures and payment updates required by this legislation."

 

The timelines proposed for meaningful use fit within similar requirements Congress set for VA and DoD military health interoperability in the Defense Authorization Act, which even withholds some project funds until the agencies offer a plan for integrated or interoperable systems.

 

A previous version of this story erroneously reported that the committee amendments had been added to the budget bill signed by the President.