Webinar presented by GE Healthcare

1. GE Healthcare
Top 10 for 2010
How can your practice prepare for the changes ahead?
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GE Top 10 in 2010 /
12/10/2009

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©2009 General Electric Company – All rights reserved.
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GE Top 10 in 2010 /
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3. Today’s speakers
Don McDaniel
President and CEO, Sage Growth Partners
Faculty, Healthcare Economics and Competitive Strategy,
The Johns Hopkins University
Mark J. Segal, PhD
Director, Government and Industry Affairs, GE Healthcare
Chris Freer, MBA, CPHIMS
General Manager, GE Healthcare
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GE Top 10 in 2010 /
12/10/2009

4. Top 10 for 2010
1. The push for HCIT – Stimulus 101
2. EMR arrives in earnest
3. Key bodies shaping future directions
4. Health reform
5. Cost containment and reimbursement pressures mount
6. Will pay for performance take shape?
7. Consolidation all around
8. Physician enterprise challenges continue
9. Workforce and skills
10. The age tsunami
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GE Top 10 in 2010 /
12/10/2009

5. 1 The Push for HCIT: Stimulus 101

6. The push for HCIT – Stimulus 101
• $36.6B Investment (CMS: $45B for incentives)
• Objective: Increase EHR Adoption
– Goal: All in U.S. by 2014
– Projection: 90% Physicians and 70% Hospitals by 2019
• Incentives and Penalties
– Medicare major factor for most physicians (Medicaid for some)
– Physicians (non-hospital-based): $44K maximum for 2011-12 start
– There is no fixed pot for incentives: based in a statutory formula
– Physician penalties start 2015: 1-3% of allowed charges at risk
• Terms: Qualified EHR, Certified EHR , Meaningful Use
• State HIE Infrastructure
• New Privacy and Security Rules
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GE Top 10 in 2010 /
12/10/2009

7. 2 EMR Arrives in Earnest

8. EMR arrives in earnest
• Key Regulations: December 2009/Spring 2010
• Certification: What is in the EMR
– Shift from current approach: driven by meaningful use, interop, security
– “ARRA” Certification, modular/site, multiple certifiers
– Criteria (“final”) and process (proposed) in ONC December rules
• Meaningful Use: What you do with the EMR/HIT
– Step up in rigor every two years from “light(er)” 2011-12
– Structured data, quality reporting, HIE, CPOE, CDSS, patient-centric
– CMS December NPRM rule: Refinement of Policy Committee proposal
– RECs
• Payment Policies: Medicare and Medicaid
– How payments flow and how do I prove certification and meaningful use
– “When do I have to be a meaningful user?”
– In CMS December NPRM rule
Change (management) the only constant 8/
GE Top 10 in 2010 /
12/10/2009

9. 3 Key Bodies Shaping Future Directions

10. Key bodies shaping future directions
SDOs
?
HIT ONC & CMS Certification Vendors
HIT Policy HHS Secretary
Standards
Committee Federal Gov. Providers
Committee
GE is focused on
monitoring and
influencing key
decision points
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GE /
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GE Top 10 in 2010 /
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11. 4 Health Reform

12. Health reform
• Insurance Market Reform
• Covering the Uninsured
• Delivery Reform and “Bending the Curve”
– Bundling
– Pay for Performance
– Care Coordination
– Accountable Care Organizations
– Medical Homes
• Quality Measurement and Reporting
• HIT as an Enabler
• Funding Reform: Taxes and Medicare Cuts
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GE Top 10 in 2010 /
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13. 5 Cost Containment & Reimbursement Pressure

14. Cost containment and
reimbursement pressures mount
• Reform may further constrain public sector reimbursement
• Fee for Service under assault
– Poorly aligned incentives
– Recovery Audit Contractors
– Bundled and Global payment “Demonstrations”
– P4P
– Denials for mistakes?
• Higher deductibles with patient due balances
• New codes and documentation procedures for PQRI, ARRA,
and eRX incentives
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GE Top 10 in 2010 /
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15. 6 Will Pay for Performance Take Shape?

16. Will pay for performance take shape?
• Consensus Shifting from Pay for Volume
• Healthcare Reform Will be a Major Driver
• But Private Payer use Continues to Rise
• Focus on “Efficiency” and Episodes of Care
• Increased Funding for Quality Measures
• Quality Reporting from EMRs: ARRA/PQRI are Drivers
• PQRI: Shift to Penalties from Incentives
• Medicare P4P
– Hospitals by 2013 (Senate HCR)
– Physicians by 2015 (Senate HCR)
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GE Top 10 in 2010 /
12/10/2009

17. 7 Consolidation All Around

18. Consolidation all around
• Physicians
– Lifestyle – Health IT deployment needs
– Employment – Skills
– Cottage – industry
• Hospitals – expect more IDN formation given environment
– Regulatory – Access to capital challenged
– Reimbursement – Investment portfolio returns down
– Public payor reimbursement
• Health IT Vendors
– Certification regimen – Commitment to industry
– Balance sheet – Above and beyond: “the health
– R&D care cloud”
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GE Top 10 in 2010 /
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19. 8 Physician Enterprise Challenges Abound

20. Physician enterprise challenges
abound
• Scale dis-economies still the order of the day
– 50% of US physicians operate in groups of less than 5 physicians*
• Reimbursement environment tough—inflation +/- for
foreseeable future
• Health reform on back of medicine cuts
• Tremendous pressure on operating expenses in many places
despite economic downturn
– Labor and related (health insurance)
– Rent
– Medical malpractice
• Inability to fund “productivity enhancing” technologies
*Source: 20 /
http://www.hschange.org/CONTENT/1078/?words=Practice+Size#fig1 GE Top 10 in 2010 /
12/10/2009

21. 9 Workforce and Skills

22. Workforce and skills
• Physician shortages here and anticipated, especially
in the primary care arena
• Aging of nursing workforce continues, “calamity”
stalled by economy, structural issues remain
• Big push to deploy technology – both to enhance
productivity and improve quality of care and patient
safety
• Informatics capacity will be challenged to reach
90% EHR physician organization user adoption by
2019
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GE Top 10 in 2010 /
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23. 10 The Age Tsunami

24. The age tsunami
• Population over 65 will grow from 13% to 20% by
2050
• Includes substantial growth in racial and ethnic
minorities
• Complexity intensifies!
– One-quarter of all Medicare recipients
– Have five or more chronic conditions*
– See, on average, 13 physicians per year
– Secure 50 prescriptions per year
– Over 13,000 different drugs being sold in the U.S. in
2007 – 16x what was available 50 years ago
*Source: New England Journal of Medicine: 353;3, July 21, 24 /
2005: “Medicare and Chronic Conditions”, Gerard F Anderson, GE Top 10 in 2010 /
12/10/2009
PHD

25. For more information
• General questions
– EMR@ge.com
• Stimulus Simplicity and the ARRA HITECH Act
– www.gehealthcare.com/HITECHtoday
– HITECH@ge.com
– 1-800-535-7921
• EMR Value Calculator
– www.gehealthcare.com/EMRValueCalculator
Thank you!
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GE Top 10 in 2010 /
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