PHRs will automatically contain Medicare data in CMS pilot program

The Centers for Medicare and Medicaid Services is undertaking a third pilot program to test the use of online personal health records by Medicare beneficiaries. In the new pilot, CMS will populate commercial PHRs with Medicare claims data.

The agency plans to select as many as four commercial PHR vendors and give users a choice. As in the other tests, CMS will be examining what works and what doesn’t as it tries to encourage Medicare beneficiaries to use PHRs.

The one-year pilot, which begins Jan. 2, will include Medicare recipients in only Utah and Arizona. The PHR vendors will partner with Noridian Administrative Services, the CMS contractor that processes claims data for those two states.

Nordian will be populating the PHRs with as much as two years’ worth of claims data.

Noridian issued a request for proposals today. Would-be suppliers of PHRs for the project must notify Noridian by Aug. 18, and the winning vendors will be announced Oct. 20, according to a schedule in the RFP.

CMS does not intend to pay the vendors for participating, according to the RFP, and the vendors will not be under contract to CMS.

The RFP calls for vendors to provide a wide array of features and services, such as populating the PHR with prescriptions and lab results during the pilot, importing data from devices such as blood pressure monitors and scales, enabling users to view the data in multiple ways, and allowing them to order prescription refills.

The features are not mandatory, but CMS will select vendors that offer more features than their competitors do, the RFP states. It requires compliance with health IT standards adopted by the Health and Human Services Department and assurances of privacy and security protections.

“This pilot is designed to evaluate how well PHRs meet the needs of our beneficiaries and whether PHRs can improve health outcomes and lower costs,” CMS Acting Administrator Kerry Weems said in a statement.

About the Author

Nancy Ferris is senior editor of Government Health IT.

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