ARRA and HHS Data Policy Initiatives

Academy Health NAHDO Academy Health NAHDO

All Payer All Claims Data Bases All Payer All Claims Data Bases

James Scanlon, HHSJames Scanlon, HHS

Deputy Assistant Secretary/ASPE Deputy Assistant Secretary/ASPE

Overview

American Reinvestment & Recovery ActAmerican Reinvestment & Recovery Act HITEC ProvisionsHITEC Provisions Prevention and Wellness Fund Prevention and Wellness Fund Comparative Effectiveness Research Comparative Effectiveness Research

ARRA Overview for HHS

$167 billion over ten years$167 billion over ten years $22 billion in discretionary spending $22 billion in discretionary spending Prevention & Wellness Fund $1 billionPrevention & Wellness Fund $1 billion Comparative Effectiveness Research $1.1 billionComparative Effectiveness Research $1.1 billion Health IT $22 billion – $48+ billionHealth IT $22 billion – $48+ billion State fiscal relief, health care safety net, State fiscal relief, health care safety net,

biomedical research, construction and human biomedical research, construction and human services services

Health Information Technology - Economic & Clinical Health Act HITEC Capacity Building $2 billionHITEC Capacity Building $2 billion

Grants to States for HIEGrants to States for HIE National and Regional Extension Centers (70)National and Regional Extension Centers (70) Health IT Workforce GrantsHealth IT Workforce Grants Public health and infrastructurePublic health and infrastructure Standards, policy, process and regulations Standards, policy, process and regulations

Incentives for Medicare & Medicaid providers Incentives for Medicare & Medicaid providers who demonstrate “meaningful use of EHRs who demonstrate “meaningful use of EHRs $19 - $48 billion beginning in 2011$19 - $48 billion beginning in 2011

Prevention and Wellness Fund $1billion Immunization Grant Program - $300 mil to StatesImmunization Grant Program - $300 mil to States Healthcare Associated Infection - $50 mil to States Healthcare Associated Infection - $50 mil to States Communities Putting Prevention to Work - $650 Communities Putting Prevention to Work - $650

mil for evidence based interventions tomil for evidence based interventions to Increase levels of physical activityIncrease levels of physical activity Improve nutritionImprove nutrition Decrease overweight/obesity prevalenceDecrease overweight/obesity prevalence Decrease tobacco use, and exposure to Decrease tobacco use, and exposure to

secondhand smokesecondhand smoke Evaluation and data Evaluation and data

Comparative Effectiveness Research - $1.1 billion Three componentsThree components

NIH $400 millionNIH $400 million AHRQ 300 millionAHRQ 300 million Secretary’s Fund $400 millionSecretary’s Fund $400 million

IOM Report IOM Report Federal Coordinating Council on CERFederal Coordinating Council on CER FCC Report to President and Congress FCC Report to President and Congress HHS Spending Plan due November 1, 2009HHS Spending Plan due November 1, 2009

Comparative Effectiveness Research

IOM Study – Recommend national priorities for IOM Study – Recommend national priorities for CER to be funded by ARRA.CER to be funded by ARRA.

Portfolio Criteria - Research area, population, Portfolio Criteria - Research area, population, interventions, methodology, prevalence, mortality, interventions, methodology, prevalence, mortality, morbidity, cost and variability morbidity, cost and variability

100 CER priority topics, e.g. Reproduction, end of 100 CER priority topics, e.g. Reproduction, end of life care, respiratory, psychiatry, disparities etc. life care, respiratory, psychiatry, disparities etc.

““CER program should help to develop large scale, CER program should help to develop large scale, clinical and administrative data networks to clinical and administrative data networks to facilitate better use of data and efficient ways to facilitate better use of data and efficient ways to collect new data for CER.”collect new data for CER.”

Federal Coordinating Committee for CER Research 15 members from federal government15 members from federal government Public listening sessions Public listening sessions DefinitionDefinition Strategic FrameworkStrategic Framework Report to President and CongressReport to President and Congress Areas of investment and priorities Areas of investment and priorities

FCC CER Report

Four areas of investmentFour areas of investment CE researchCE research Human and scientific manpower for CERHuman and scientific manpower for CER Data infrastructure for CERData infrastructure for CER Dissemination and translation of CERDissemination and translation of CER

Priorities Priorities Priority populationsPriority populations Priority conditions Priority conditions Types of interventions Types of interventions

FCC CRE DefinitionComparative effectiveness research is the conduct and synthesis of Comparative effectiveness research is the conduct and synthesis of

research comparing the benefits and harms of different interventions research comparing the benefits and harms of different interventions and strategies to prevent, diagnose, treat and monitor health conditions and strategies to prevent, diagnose, treat and monitor health conditions in “real world” settings. The purpose of this research is to improve in “real world” settings. The purpose of this research is to improve health by developing and disseminating information to patients, health by developing and disseminating information to patients, providers, and decision-makers, responding to their expressed needs, providers, and decision-makers, responding to their expressed needs, about which interventions are most effective for which patients under about which interventions are most effective for which patients under specific circumstances. To provide this information, comparative specific circumstances. To provide this information, comparative effectiveness research must assess a comprehensive array of health-effectiveness research must assess a comprehensive array of health-related outcomes for diverse patient populations and sub-groups. related outcomes for diverse patient populations and sub-groups. Defined interventions compared may include medications, procedures, Defined interventions compared may include medications, procedures, medical and assistive devices and technologies, diagnostic testing, medical and assistive devices and technologies, diagnostic testing, behavioral change, and delivery system strategies. This research behavioral change, and delivery system strategies. This research necessitates the development, expansion, and use of a variety of data necessitates the development, expansion, and use of a variety of data sources and methods to assess comparative effectiveness and actively sources and methods to assess comparative effectiveness and actively disseminate the results.disseminate the results.

FCC CER Strategic Framework

Human & Scientific Capital

for CER

CE ResearchCER Data Infrastructure

Dissemination and Translation of CER

Priority Populations

Priority Conditions

Types of Interventions

Crosscutting Priority Themes

Primary investment Secondary investments Supporting investment

Legend

Data infrastructure examples

Linked longitudinal claims data Linked longitudinal claims data Expanded Medicare /Medicaid claims data Expanded Medicare /Medicaid claims data Linked distributed clinical data networks Linked distributed clinical data networks EHR data EHR data Registries Registries

Other HHS Data Initiatives

New HHS CTONew HHS CTO Making HHS data mere accessible Making HHS data mere accessible

Data.GovData.Gov HHS portals HHS portals Data to reduce disparities Data to reduce disparities Health data collection investments Health data collection investments

Questions?