Policy Roundtable Abstracts - AcademyHealth

experiences of adopters, measure progress towards
HITECH program goals, and develop policies for the
second stage of meaningful use criteria effective in
2013. Susan Dentzer is the Editor-in-Chief of Health
Affairs, the nation's leading journal of health policy, and
an on-air analyst on health issues with The NewsHour
with Jim Lehrer on the Public Broadcasting Service
(PBS). Ms. Dentzer will round out the panel by
discussing the key questions she hears about electronic
health records from policymakers, providers, and other
stakeholders and the role that she sees digitalized health
information playing in a reformed health delivery system.
The panel will be chaired by Melinda Beeuwkes Buntin
PhD, Director of the Office of Economic Analysis and
Modeling within the Office of the National Coordinator for
Health Information Technology (ONC) at HHS. She will
introduce the panelists, give them each 10 minutes to
deliver introductory remarks, and then ask them a series
of questions including: • What is the biggest challenge
providers face when deciding whether or not to adopt an
EHR What additional policies might help them address
that challenge • If you could go back and add one
provision to the HITECH Act what would it be and why
What might it cost • Research on health information
technology is expanding rapidly. What is the most useful
finding you’ve seen from the research community this
year What would you like to know more about
Geographic Equity in Medicare Payment Policy:
Geographic Adjustment Factors and Value-Based
Health Care
Organizer/Moderator: Margo Edmunds
Tuesday, June 14 * 8:00 a.m.–9:30 a.m.
Panelists: Jon Christianson, Ph.D., University of
Minnesota School of Public Health; Stuart Guterman,
M.A., The Commonwealth Fund; Carlos Jaen, M.D.,
Ph.D., University of Texas Health Science Center at San
Antonio; Marilyn Moon, Ph.D., American Institutes for
Research; Thomas Ricketts, Ph.D., University of North
Carolina, Chapel Hill
Roundtable Summary: Medicare payments to
physicians and hospitals are adjusted by geographic
location, recognizing that some costs beyond the
providers’ control vary in urban and rural areas and
different parts of the country. Geographic adjustment is
intended and designed to create a fee structure that
compensates providers at the same real rate across the
country. Before the Patient Protection and Affordable
Care Act was passed, several members of Congress,
policy experts, and clinical practitioners actively debated
the need for an adjustment and the equity of the
geographic adjustments for urban and rural areas and
the data and methods used to calculate them.
By Medicare statute, geographic adjustments
must be budget-neutral, which forces a zero-sum game
in which any adjustment upward for one provider or
group of providers must be paid for by a downward
adjustment to one or more other providers. Because
there is no consensus in the provider community or
among policy-makers on how to best adjust payments
based on geographic location, The Secretary of Health
and Human Services (HHS) and Congress sought
advice from the Institute of Medicine (IOM) on how best
to address stakeholders’ concerns as the new health
care reform legislation is being implemented.
The IOM study was commissioned to evaluate
the accuracy of the adjustment factors and the
methodology used to determine them, including the
timeliness and accuracy of the sources of data used and
their representativeness of operational costs of
providers. The IOM was also asked to assess the effect
of the adjustment factors on the level and distribution of
the healthcare workforce and providers’ ability to provide
high-value care, and the resulting impact on Medicare
beneficiaries’ access to care.
The participants in this policy roundtable will
discuss the technical approach, findings, and
recommendations of the IOM study’s first report to
Congress and the Secretary of HHS, which will be
released in May 2011. The participants include the
study director and five members of the expert committee
convened by the IOM to conduct the study. Their areas
of expertise include health economics, health policy
analysis, primary care, rural healthcare, geographic
variation, healthcare workforce, and policy development
and implementation.
The study director, Margo Edmunds, PhD, will
serve as moderator. Dr. Edmunds is a health policy
analyst with a clinical background in disease
management. She will provide a brief background on
the scope and methods of the study and will introduce
the IOM committee members who will serve as
panelists.
Marilyn Moon, PhD, is a health economist,
Senior Vice President and Director, Health at the
American Institutes for Research, and former Trustee for
the Medicare trust fund. Dr. Moon will provide
background on the Medicare payment structure for
physicians and hospitals and describe the committee’s
approach to evaluating data accuracy for the Hospital
Wage Index.
Stuart Guterman, MA, is Vice President,
Payment and System Reform, and Executive Director for
the Commission on a High Performance Health System
at The Commonwealth Fund, and is a health economist
with extensive experience in health care financing and
payment systems. He will describe the committee’s
recommendations about geographic payment localities
and labor markets and their implications for urban and
rural payment equity.
Jon Christianson, PhD, Professor and James A.
Hamilton Chair in Health Policy and Management at the
University of Minnesota School of Public Health, is a
health economist with expertise in health insurance,
healthcare markets, and tracking change in healthcare
markets. Dr. Christianson will describe the committee’s
approach to impact analysis and the study’s implications
for value-based healthcare delivery.
Carlos Jaen, MD, PhD, is Professor of
Epidemiology and Biostatistics, Co-Director of the