Electronic Medical Records Contracts Awarded

A press release from Social Security:

Michael J. Astrue, Commissioner of Social Security, today announced that 15 healthcare providers and networks have received $17.4 million in contract awards to provide electronic medical records to the agency. These electronic medical records, which will be sent through the Nationwide Health Information Network (NHIN), will significantly shorten the time it takes to make a disability decision and will improve the speed, accuracy, and efficiency of the disability program.

“Using health information technology will improve our disability programs and provide better service to the public,” Commissioner Astrue said. “We’ve seen a significant increase in disability applications. To process them, the agency sends more than 15 million requests annually for medical records to healthcare providers. This largely paper-bound workload is generally the most time-consuming part of the disability decision process. The use of health IT will dramatically improve the speed, accuracy, and efficiency of this process, reducing the cost of making a disability decision for both the medical community and the American taxpayer.”

The contract awards are funded through the American Recovery and Reinvestment Act. They will require awardees, with a patient’s authorization, to send Social Security electronic medical records through the NHIN. The NHIN, a safe and secure method for receiving access to electronic medical records over the Internet, is an initiative of the Department of Health and Human Services supported by multiple government agencies and private sector entities.

For the last year, Social Security has been successfully testing health IT to obtain electronic medical records. Disability applications processed with electronic medical records from the test sites in Massachusetts and Virginia have significantly reduced processing times. Some decisions are now made in days, instead of weeks or months. Social Security expects to receive more than 3.3 million applications in fiscal year (FY) 2010, a 27 percent increase over FY 2008.

Contracts were awarded to the following organizations:

1. Cal RHIO, San Francisco, CA - $1,625,000
2. CareSpark, Kingsport, TN - $1,363,000
3. Center for Healthy Communities, Wright State University, Healthlink, Dayton, OH - $999,000
4. Central Virginia Health Network/MedVirginia, Richmond, VA - $1,139,000
5. Community Health Information Collaborative (CHIC), Duluth, MN - $977,000
6. Douglas County Individual Practice Association, Roseburg, OR - $502,000
7. EHR Doctors Inc., Pompano Beach, FL - $1,000,000
8. HealthBridge, Cincinnati, OH - $1,400,000
9. Lovelace Clinic Foundation (LCF), Albuquerque, NM - $1,083,000
10. Marshfield Clinic Research Foundation, Marshfield, WI - $998,000
11. Memorial Hospital Foundation & Memorial Hospital of Gulfport Foundation, Inc., Gulfport, MS - $1,100,000
12. Oregon Community Health Information Network (OCHIN), Portland, OR - $284,000
13. Regenstrief Institute, Inc, Indianapolis, IN - $350,000
14. Science Applications International Corporation (SAIC), Reston, VA - $1,587,000
15. Southeastern Michigan Health Association, Detroit, MI - $2,988,000

President Recommends 8% Budget Increase For Social Security

From the White House:

• $12.5 billion for SSA [Social Security Administration], an increase of $930 million, or 8 percent, above the 2010 enacted level.
  • Includes resources to increase staffing in 2011 and allow SSA to provide services faster with a focus on key service delivery areas, such as processing initial retirement and disability claims, and disability appeals.
  • Funds targeted to lower the initial disability claims backlog below 1 million by processing more than 3 million claims and lower the appeals hearing backlog.

Significantly Increase Program Integrity Efforts

• $796 million for SSA program integrity, including a 9 percent increase in the level of medical Continuing Disability Reviews over the prior year. SSA’s program integrity efforts are part of a strong framework for making sure the government is spending tax dollars efficiently and that benefits are paid only to those beneficiaries who are eligible and are paid in correct amounts. ...

Highlights of this department’s goals are:

• By 2012, SSA will achieve an online filing rate of 50 percent for retirement applications.
• SSA will work towards achieving the agency’s long-term outcomes of lowering the disability backlogs and accurately processing claims. In 2011, SSA’s will process 3.317 million out of a universe of 4.316 million initial disability claims and 799,000 out of a universe of 1.456 million hearing requests.
• SSA will improve program integrity efforts by minimizing improper payments and strengthening the agency’s efforts to protect program dollars from waste, fraud, and abuse. In 2011, SSA’s will process 359,800 out of a total of approximately 2 million medical continuing disability reviews, an increase of 9.4 percent over 2010.

Why Social Security's Budget Shouldn't Be Frozen

The President's recommended budget for the next fiscal year is due out this morning. Here are a couple of charts from an Urban Institute Fact Sheet showing why a budget freeze for Social Security would be devastating. The first is for men and the second for women. Click on each to see full size.

Informal Remand Instructions Released

Social Security has released an emergency message with updated instructions on informal remands, also known as "re-recon." These are cases where a disability benefits claimant has been denied at the reconsideration stage, files a request for a hearing before an Administrative Law Judge, but has his or her case sent back for a new review at the reconsideration level while awaiting a hearing. A not insignificant percent of these cases are approved on re-recon.

ALJ Removed

The Merit Systems Protection Board has affirmed the removal from office of Danvers Long, who had been an Administrative Law Judge (ALJ) for Social Security, after he was arrested in Coral Springs, FL for domestic violence battery and culpable negligence.

Clear That Backlog!

Beth Bates, a Jackson, TN attorney, has a nice op ed piece in the Jackson Sun dealing with the human costs of Social Security's hearing backlog. While there has been some progress on this backlog in the past year, a budget freeze could start moving things in the opposite direction.

Budget Situation Perilous

President Obama's recommended budget for fiscal year (FY) 2011, which begins on October 1, 2010, is due out on Monday, February 1. The President has stated that he intends to recommend a freeze for almost all domestic agencies. for the next three years. The Center for American Progress has posted an analysis of what this could mean, which includes this paragraph:

Based on extensive analysis, the IRS Oversight Board has concluded that for each dollar spent at the IRS, four dollars in taxes owed to the Treasury are collected. Studies by the Social Security Administration and Centers for Medicare and Medicaid Services show similar ratios between staffing resources and savings to the U.S. Treasury from identification of fraudulent claims, overpayments, and incorrect billings. These three agencies have a combined annual budget of $27 billion over the next 10 years. The federal government will spend approximately $337 billion on salaries, contracts, and other expenses if we maintain the same level of effort as we have today.

A Contrast

The Department of Veterans Affairs (VA) has its own severe backlog problem. To help deal with the onslaught of claims, VA is proposing some changes to its computer systems. The response from veterans advocacy groups:

• "This is old news"
• "Verbiage in proposal is obtuse to the max ... many in attendance did not understand the Gov.speak gobbledygook."
• "This proposal is Dead on Arrival."

I cannot help but contrast this to past introductions of somewhat similar plans at Social Security. I do not know whether this is good or bad but I have to say that Social Security advocacy groups have been much more restrained in their comments on similar proposals at Social Security even when their private thought might have been the same as what the veterans advocacy groups are saying.