Thursday, May 20, 2010

The CMS / CGI Partnership

The contract that most sports enthusiasts are pondering this summer is that of Lebron James. However, if you are interested in the healthcare / web development equivalent of this question you need not wait any longer.

This week, the Centers for Medicare and Medicaid Services (CMS) announced that it has awarded CGI Federal, Inc. a five-year, $73.2 million contract to redevelop three of their websites that enable Medicare beneficiaries to find information about their healthcare programs.
















The three sites - www.medicare.gov, www.cms.hhs.gov and www.Mymedicare.gov - provides information for 44 million beneficiaries and receives a total of 500 million views a year. The sites are primarily focused on allowing consumers to view health claims information, compare health and drug plans based on quality measures and estimated costs, and create a report listing information that they can share with their healthcare providers. As an example of the importance HHS puts on the ability to navigate the site, the following video was released involving Secretary Sebelius walking viewers through the Medicare.gov:



The execution of this contract will be an extremely interesting task. It has been well documented that a large chunk of the healthcare reform package will be enacted and implemented over this period of time, and as new regulations are developed on items such as the role of social media, these three websites will have to be well managed.

CGI and CMS have had a long standing and successful collaboration, including projects like the Hospital Compare and Nursing Home Compare tools, which combine geographical data from Google Maps with healthcare provider quality-of-care information to help users locate and assess nearby healthcare facilities. Additionally, CGI was awarded the Enterprise System Development (ESD) contract, which covers systems development and integration, system and application engineering and technical support to improve the automated systems and agency-wide applications of the Health and Human Services Department.

However, this project will involve developing tools for the public at large, not a subset of experts in the industry. It is a different mode of thinking, but the potential is there for a new evolution of internet communication.


Friday, May 7, 2010

The 411 on Form 990

February is the perfect time to make predictions for the year, but trying to make predictions on the healthcare industry, even month-to-month, for 2010 is best defined as difficult. However, that didn’t stop people from trying.

McDermott Will & Emery’s Stephen Bernstein was one of many that took a stab with his “
Top 10 health law issues for 2010” article, outlining his thoughts on what the buzz-topics of the year would be. Among many of the obvious subjects, he mentioned a very specific administrative function, which is Schedule H for Form 990 and how it relates to hospitals. He explained it this way:

Tax-exempt hospitals must, for the first time, fully complete Schedule H to Form 990 when filing their 2009 tax returns. Schedule H requests disclosure of each hospital’s community building activities, bad debt expenses, Medicare-shortfall and debt-collection practices, arrangements with management companies, participation in joint ventures, and level of charity care and other community benefits. In addition to these data, Schedule H also requests supplemental information in narrative form, including descriptions of how the hospital assesses the needs of its community, informs patients of their eligibility for charity care, and uses community building activities to promote the health of its service area. While many hospitals used last year’s filings as “practice” for Schedule H’s data portions, few prepared sample responses to its narrative portions.

In addition to learning about the ins-and-outs of Schedule H, tax-exempt hospitals must also fully complete Form 990's Schedule K. Schedule K, which requests additional information on tax-exempt bonds, including disclosure of private business use.

All of this information compiled by Schedule H and Schedule K, because of the way it is being filed, will eventually be subject to public disclosure and the media. While there will be a lag of about a year in being made public, hospitals should be consulting now with outside organizations on how to properly compile this information for the federal government.

While this issue isn’t as heart-pounding as others in healthcare, what can’t be denied is that an economy that is in the midst of recovery, combined with a large-scale healthcare reform, creates a scenario in which every ounce of efficiency has to be identified, and while we are still in the beginning stages of this new process, there is potential to learn a great deal from the information that will now be shared via these new mechanisms. The immediate reaction is to assume that this will be used as source material for negative investigations, but through this process, we may also be able to create an upgraded business model and examples of best practices for hospital administration.