Health care reform bill targets technology to improve medical services

Funding included for development of primary care models that integrate decision support tools and remote diagnostics for both doctors and patients.

The health care reform bill President Obama signed on Tuesday calls for technology to reduce costs, improve medical care, and set up a Center for Medicare and Medicaid Innovation to test payment and service models.

The bill provides $5 million for the center in 2010 and $10 million per year from 2011 to 2019.

The innovation center, which will be part of the Centers for Medicare and Medicaid Services, should work to promote "broad payment and practice reform" in primary medical care, according to language in the bill.

The mission includes transitioning payments to clinicians from a fee-for-service model to a contract-based structure and developing treatment models based on the home practice concept the American Academy of Family Physicians and six other medical associations developed in 2002.

The medical home care model calls for each patient to have a primary care doctor who consults with patients to coordinate their care across a wide range of specialties and institutions, including hospitals, home health care agencies and nursing homes.

The bill calls for the innovation center to extend the model to chronically ill patients. Using health information technology, coordination of care for seriously ill patients would be managed through a provider network linked to a chronic disease registry and in-home telehealth services.

About 20 million Americans suffer from diabetes, for example, and home telehealth technology allows patients to automatically relay blood sugar levels to their doctors through remote glucose meters.

The legislation also includes $5 million per year from 2011 to 2015 to develop an Independence at Home Medical Practice Demonstration Program, which would integrate home visits by clinicians, remote patient monitoring and mobile diagnostic technology.

The key tenets of the medical home care model are to inform and involve patients in their health care. The bill directs the Health and Human Services Department to develop decision support tools for patients and their doctors.

HHS, the Centers for Disease Control and Prevention, and the National Institutes of Health would award grants or contracts to develop, update and produce decision aids for health care providers in educating patients and their caregivers on the relative costs and efficacy of specific treatments.