Due to numerous possible complications associated with cancer care, the National Coalition for Cancer Survivorship (NCCS) – which advocates for quality treatment for all affected Americans – recently announced its support for these rules.

The new regulations clarify for physicians and hospitals how to be meaningful users of certified EHRs, which is expected to streamline the delivery and quality of cancer care.

"We are hopeful that this regulation will be the first of many enhancements to the healthcare system, and we look forward to continued work with the CMS and the ONC on improving quality, efficiency and safety for patients," said Thomas P. Sellers, NCCS president and CEO.

EHRs have the potential to help cancer patients, since they allow for coordination among multiple specialists.

More efficient exchange of communication and healthcare information through EHRs may also increase a patient’s involvement in their care and result in a more safe and effective delivery of treatment.

Released by the Centers for Medicare and Medicaid Services (CMS), the report showed that Medicaid health plan enrollment increased by nearly 2.4 million individuals in 2009, and the program currently covers more than 23 million Americans.

Moreover, the study found that while the ranks of Medicaid recipients expanded by 7 percent between June 2008 and June 2009, Medicaid programs saw more than 11 percent growth during that same time, regardless of their size, ownership or financial status.

This means that nearly half (47 percent) of all Medicaid beneficiaries are enrolled in a health plan, and some 72 percent participate in some form of managed care.

The report also estimates that starting in 2014, when most of the provisions of the healthcare reform bill will come into effect, Medicaid ranks will grow by between 16 and 24 million.

In response to these results, Medicaid Health Plans of America (MHPA) – a nonprofit trade association that provides advocacy, research and forums that support policy to promote and enhance the delivery of quality care, has said that the industry is prepared to absorb most of the new members.

"States are increasingly turning to Medicaid health plans to manage benefits in their Medicaid programs," said MHPA president and CEO Thomas L. Johnson.

He added that it is because "they understand the benefits of health plans in coordinating care and improving quality, which allows for the provision of Medicaid benefits at a lower, more predictable cost than fee-for-service traditional Medicaid."

Medicaid is a social safety program designed to provide access to medical care to eligible individuals and families from low-income backgrounds as well as veterans and children covered by the Children’s Health Insurance Program.

By 2014, states will begin to expand eligibility for Medicaid to include non-pregnant adults under 65 years of age as well as individuals under 65 who are not eligible for Medicare, and whose income is the same or less than 133 percent of the poverty level. Moreover, the application process for Medicaid will be simplified and electronic.

All of these trends should be of great interest to healthcare providers and facilities that serve these populations. They also serve to emphasize the importance of switching to properly certified electronic health records (EHRs) and applying them in such a way that they meet the ‘meaningful use criteria.’ In turn, this will make the providers eligible for incentive payments from the CMS, as stipulated in last year’s American Recovery and Reinvestment Act.

The report also comes shortly after President Obama appointed Dr Donald Berwick – a Harvard graduate, pediatrician and CEO of the Institute for Healthcare Improvement – as the head of the CMS.

Berwick, who was appointed through the controversial process as Congress was on recess, has a reputation for supporting government intervention in the healthcare sectors. However, industry groups such as The American Hospital Association and the Federation of American Hospitals have praised Obama’s choice, saying Berwick "will bring a wealth of knowledge and practical experience to CMS from his perspective as a physician, teacher and passionate advocate for high-quality care," according to media reports.

Medicaid was established on July 30, 1965, through Title XIX of the Social Security Act. The original act, which was passed in 1935, also set up Medicare, which provides government-run healthcare plan for aged and disabled individuals.

Since July 1, providers of this type of technology have been able to submit applications to the Office of the National Coordinator for Health IT (ONC) to have their products certified by approved organizations.

This process is designed to provide healthcare practitioners and facilities with assurance that the technology they purchase and install will perform as expected to allow them to improve the quality of care and become eligible for incentive payments under the Medicare and Medicaid incentive programs contained in the HITECH Act.

"It paves the way for developers of electronic health records to get their products and services approved and it gets [closer] to meaningful use," said Steve Posnack, director of ONC’s Federal Policy Division, quoted by Federal News Radio.

"The certification instills confidence and assurance that the technology capabilities a healthcare provider is looking to use will be there," he added.

Carol Bean, ONC’s division director for certification and testing, told the news provider that once products become certified, the agency will make their details available to healthcare providers to help them research and choose the most suitable system for their practice or facility.

In making the announcement, Sebelius was joined by Surgeon General Dr Regina Benjamin, Dr David Blumenthal, the National Coordinator for Health IT, and Dr Donald Berwick, new administrator of The Centers for Medicare & Medicaid Services (CMS).

The HITECH Act stipulates that eligible physicians and healthcare facilities will qualify for Medicare and Medicaid incentive payments if they adopt certified EHR technology and use it properly to achieve objectives such as improvements in care. Today’s announcement focuses on "meaningful use" of the technology as it relates to these payments. It also specifies the technical capabilities that are necessary for EHR technology to be certified.

The CMS rule, which was originally proposed in January, expands the definition of eligible professionals. There are also two companion regulations: the first – issued by the CMS – delineates the minimum requirements providers must meet through the use of certified technology, including creation of a medical record and entering basic data on patients’ vital signs, demographics, medications, allergies, diagnoses and smoking status.

Meanwhile, the second rule – issued by the Office of the National Coordinator for Health Information Technology (ONC) – codifies the standards and certification criteria for this technology. It aims to help doctors and hospitals easily ascertain that the system they are planning to adopt will perform the necessary functions.

Sebelius said that the move marks a significant step on the way towards the adoption of EHRs throughout the healthcare system in order to improve quality of care and deliver cost savings.

Blumenthal called it "a turning point for electronic health records in America," adding that "in delivering on the goals that Congress called for, we have sought to provide the leadership and coordination that are essential for a large, technology-based enterprise."

He also stressed that the government agencies that cooperated on the project have received extensive input from the healthcare community, as some 2,000 stakeholders weighed in after the DHHS published its proposal for "meaningful use" on January 16.

"We have drawn on their experience and wisdom to produce objectives that are both ambitious and achievable," the National Coordinator for Health IT said.

The release of the final rules was welcomed by many industry organizations, including the American Health Information Management Association (AHIMA).

In congratulating the relevant government agencies on their achievement, Rita K. Bowen, president of the AHIMA board of directors, said that her organization is well aware of the failure of paper records to meet the demands of the modern healthcare system.

"With this last hurdle behind us, the health information management profession can move forward with final preparations for implementation," Bowen said.

Today’s rules apply to the first two years (2011 and 2012) of the incentive program under HITECH Act. Later phases will be governed by rules that will be announced in the coming months.

For this reason, the Department of Health and Human Services’ Office for Civil Rights (OCR) has unveiled a proposal that would strengthen the regulations included in the Health Insurance Portability and Accountability Act (HIPAA) to further protect and preserve confidentiality of individuals’ health information.

Among the proposed rules, the OCR seeks to define uses and disclosures of protected health information for which individual authorization is required as well as strengthen patients’ rights to obtain their EHRs, according to HealthDataManagement.com, an industry website.

The proposals have garnered praise from American Health Information Management Association (AHIMA), which is an organization of more than 57,000 health information management professionals.

AHIMA representatives expressed their belief that the new regulations will boost patients’ trust in EHRs and the electronic exchange of health information.

"These rules represent a striking of the balance between improving appropriate health information access and transfer with the necessary confidentiality and security of that same information or data, and the very important inclusion of patients and their guardians in these activities," said Rita K. Bowen, president of AHIMA board of directors.

She added that the organization stood ready to lend its expertise to the ongoing process to ensure EHRs’ confidentially and privacy.

For example, the governor and the health authorities in West Virginia recently created the West Virginia Regional Health Information Technology Extension Center in order to help local healthcare providers implement electronic records systems smoothly and efficiently.

With the help of funds from the American Recovery and Reinvestment Act, the facility will allow participants to access training and technical support resources as their practices are transitioning to EHRs. Providers will also receive advice on the best ways to meet federal guidelines in order to qualify for incentive payments and avoid penalties.

"Electronic health records have the power to transform our healthcare system," said U.S. Senator Jay Rockefeller (D-WV).

"The extension center will make it easier for doctors and medical professionals to learn how to serve our patients better," he added.

Experts say EHRs have multiple benefits, including the potential to increase the flow of information among a patient’s healthcare providers, thus speeding up the treatment cycle. They can also make care safer by helping doctors and pharmacists avoid errors, including those that result from adverse drug interactions.

To that end, on July 1 the U.S. Department of Health and Human Services (HHS) launched a new website, HealthCare.gov, to allow individuals and small businesses to compare health plans, and find more information about the healthcare reform.

The key part of the website is its Insurance Options Finder, a tool that allows visitors to identify private and the public health coverage options in their area. It also offers tips to help individuals, families and communities improve their health and prevent disease.

Important information about consumers’ and patients’ rights with regards to health insurance coverage will also be available through this resource.

A day after the website was unveiled, HHS Secretary Kathleen Sebelius said the page had received some half a million viewers.

"We hope you will come back often. [This space] is designed to be a powerful tool for consumers, and we are going to keep working to make sure it gives you the information you need," she wrote in a commentary on the site.

On the same day that the website was launched, HHS also announced the creation of the Pre-Existing Condition Insurance Plan, which will increase access to medical insurance for adults who have been denied coverage as a result of suffering from a pre-existing illness, including chronic diseases such as diabetes or cancer.

The program will be transitional in nature since by 2014 the reform bill will make it illegal for insurers to discriminate against individuals based on their health history or status.

With the launch of this plan, Americans with pre-existing conditions "join young adults who can now stay on their parents’ plans until age 26, and seniors who now receive assistance for prescription drug bills," said House Speaker Nancy Pelosi.

The healthcare reform legislation, known as the Patient Protection and Affordable Care Act, was signed into law on March 23, 2010. Its provisions – which will be phased in over a period of four years – include expanding Medicaid eligibility, subsidies for insurance premiums for lower-income Americans, tax breaks for businesses that offer health benefits and a ban on denial of coverage for pre-existing illnesses.

In fact, changes brought about by the healthcare reform passed last March will affect all areas of medical care under that plan, including coverage, care administration and system oversight.

In terms of coverage, states will be allowed to expand eligibility to include non-pregnant adults under 65 years of age through an amendment plan. In 2014, the biggest expansion will take place as individuals under 65 who are not eligible for Medicare and whose income is the same or less than 133 percent of the poverty level will become eligible.

By then, the application process for Medicaid will also be simplified, with states establishing electronic systems to do so.

Quality standards are also key in the PPACA, and they include the requirement that plans provide essential coverage, including for mental health issues. The Department of Health and Human Services (HHS) will also be tasked with identifying health quality measures for eligible individuals, and, based on those, set up a Medicaid Quality Measurement Program.

In the future, HHS will also establish a Centers for Medicare and Medicaid Services innovation center to try out novel payment and care delivery methods in order to bring about cost reductions. It will also create systems to share data with the departments of Veterans Affairs, Defense, Social Security and Indian Health in order to identify and prevent fraud and abuse.

The Department will also team up with the Inspector General’s office to establish procedures for the screening of providers and suppliers participating in Medicare, Medicaid and Children’s Health Insurance Program (CHIP), another government-funded plan, the news provider further reported.

Medicaid was established on July 30, 1965, through Title XIX of the Social Security Act. It is administered at the state level and available to certain low-income individuals and families.

The PPACA was signed by President Obama on March 23, 2010, and some estimates suggest that the Medicaid expansion provisions will add as many as 20 million more people to the plan’s rolls. Currently, some 40 million Americans are covered by various Medicaid programs, according to National Resource Center for Human Service Transportation Coordination.