AMA

The American Medical Association and CDC have partnered to launch a multiyear initiative that leverages online tools to reach individuals with pre-diabetes and to help prevent the onset of Type 2 diabetes, Health Data Management reports (Slabodkin, Health Data Management, 3/16).

Background on Pre-Diabetes, Type 2 Diabetes

According to CDC, 86 million U.S. residents have pre-diabetes, 90% of whom are unaware of it (Reinberg, HealthDay/Philadelphia Inquirer, 3/13).

Ann Albright, director of CDC's Division of Diabetes Translation, said, "Research shows that 15% to 30% of overweight people with pre-diabetes will develop Type 2 diabetes within five years unless they take steps to prevent or delay its onset by making important lifestyle changes."

AMA President Robert Wah said, "More than $245 billion each year in health care spending and reduced productivity is directly linked to diabetes" (Health Data Management, 3/16).

Details of Initiative

The new initiative, called Prevent Diabetes STAT (Screen, Test, Act Today), will focus on "delay[ing] or prevent[ing] the development of Type 2 diabetes," according to Albright (HealthDay/Philadelphia Inquirer, 3/13).

As part of the initiative, AMA and CDC co-developed an online toolkit aimed at helping health care providers to screen patients and refer those at a high risk of developing diabetes to prevention programs.

The groups also created an online screening tool to help patients assess their risk for developing Type 2 diabetes.

Albright said, "Research shows that screening, testing and referring people who are at risk for Type 2 diabetes is critical," adding, "Research also shows that when people know they have pre-diabetes they are more likely to take action" (Health Data Management, 3/16).  

The American Medical Association has sent a letter to CMS urging the agency to align the meaningful use program, the Physician Quality Reporting System and the Value-Based Payment Modifier so that providers can avoid penalties under the initiatives, EHR Intelligence reports.

Under the 2009 federal economic stimulus package, health care providers who demonstrate meaningful use of EHR systems can qualify for Medicaid and Medicare incentive payments.

Details of Letter

In the letter to CMS Administrator Marilyn Tavenner, AMA Executive Vice President and CEO James Madara  wrote that the "programs, with often incomprehensible, conflicting requirements and flawed implementation processes, are all entering their penalty phases and pose a risk to the stability of the Medicare program that many policymakers do not seem to appreciate."

The group noted that because the programs were created through separate legislative processes, policymakers do not understand the "cumulative effect of a set of penalties that, when combined with a 2% payment sequester reduction, would total 11% in 2017 and grow to 13% by the end of the decade."

Further, AMA wrote that the penalties' timings could threaten providers' efforts to comply with ICD-10 standards by Oct. 1, 2015. U.S. health care organizations are working to transition from ICD-9 to ICD-10 code sets to accommodate codes for new diseases and procedures. The switch means that health care providers and insurers will have to change out about 13,000 codes for about 68,000 codes.

In addition to better aligning the programs, AMA called for the reversal of a proposed 10% increase in penalties (Murphy, EHR Intelligence, 10/23).

Overall, AMA President Robert Wah said that if providers "meet the protocol and standards for one quality program, they should be deemed successful for all."

Recommendations

In order to better align the programs, AMA recommended that CMS:

• Stop using an "all-or-nothing approach" to the meaningful use program and instead make standards that challenged providers optional, while also reducing the 2015 reporting period;
• Release 2013 PQRS and VBM aggregate data that will help providers and others to assess the program in a more timely manner and develop a formal appeals process to allow providers more than 30 days to correct inaccurate data; and
• Curb VBM implementation if Congress and the Obama administration seek to impose it on all physicians instead of repealing the measure, and allow providers more time to assess its effect before levying penalties if it is not repealed (AMA release, 10/21).