May 12, 2008

CMS launches PHR pilot for Medicare beneficiaries

BY Dr. Keith J. Kaplan

By  Richard Pizzi, Associate Editor  05/07/08  Healthcare IT News

The Centers for Medicare & Medicaid Services this week announced a new pilot project that encourages traditional Medicare beneficiaries to use an online Personal Health Record to track their healthcare services and better communicate with their providers.

The CMS pilot – which will take place in South Carolina – gives Medicare beneficiaries the ability to collect and access information about their health or healthcare services, such as medical conditions, hospitalizations, doctor visits and medications.

CMS claims that strict privacy and security safeguards will protect all beneficiary data, and affirmed that the PHRs would be under the control of patients.

"By using a PHR, patients with the pilot will have easy access to personalized medical information that will enable them to be more involved with their healthcare services," said Kerry Weems, CMS Acting Administrator."The steps we are taking today will help CMS understand how to best educate beneficiaries on the use of a PHR so that we can encourage use of these tools in the future."

Medicare beneficiaries participating in the pilot will be given an opportunity to use a PHR populated by their own claims data. Information from hospital and provider medical claims will be automatically entered into the PHR once the individual registers and requests the data. Each beneficiary will control who is able to see the information in the PHR, and can decide whether and with whom the information can be shared.

CMS representatives said prescription drug information, even for individuals who participate with a Part D Drug Plan, would not be automatically entered into the PHR, but individuals could choose to enter their own prescription drug and over-the-counter medications into the PHR.

The pilot project’s PHR also allows individuals to look up information specific to their own personal health status and health conditions. CMS said that the PHR tool provides links to "carefully selected" Web sites with educational material on health topics, which would allow beneficiaries or other authorized users to do research on health issues and better manage their care.

The pilot began on April 4, 2008, and is expected to run for 12 months. CMS plans to use information gathered from the pilot to determine future steps with respect to PHRs.

The PHR tool selected for the South Carolina pilot is offered by HealthTrio, which currently offers PHRs to patients through employer contracts. The Medicare data will be provided through Palmetto GBA, a Medicare contractor serving the region. Gaithersburg, Md. -based firm QSSI is managing the pilot, which has been termed "MyPHRSC" ("SC" standing for South Carolina. ).

The South Carolina PHR pilot follows close on the heels of another initiative launched in June of 2007, where CMS is collaborating with seven health plans to test the use of PHRs for beneficiaries who are enrolled in a Medicare Advantage or Part D Prescription Drug Plan.

Currently, Medicare beneficiaries are able to receive some personalized information about their Medicare benefits and services at the MyMedicare. gov page on www.medicare.gov. However, CMS officials say a PHR can provide additional support for people with Medicare, because the technology provides access to a fuller, more comprehensive view of medical history, along with interactive educational resources.

Participation in the pilot is voluntary, and interested patients can enroll online at www.MyPHRSC.com and at local events in South Carolina.

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