ARRA and HHS Data Policy Initiatives Academy Health NAHDO All Payer All Claims Data Bases James Scanlon, HHS Deputy Assistant Secretary/ASPE

Overview American Reinvestment & Recovery Act American Reinvestment & Recovery Act HITEC Provisions HITEC Provisions Prevention and Wellness Fund Prevention and Wellness Fund Comparative Effectiveness Research Comparative Effectiveness Research

ARRA Overview for HHS $167 billion over ten years $167 billion over ten years $22 billion in discretionary spending $22 billion in discretionary spending Prevention & Wellness Fund $1 billion Prevention & Wellness Fund $1 billion Comparative Effectiveness Research $1.1 billion Comparative Effectiveness Research $1.1 billion Health IT $22 billion – $48+ billion Health IT $22 billion – $48+ billion State fiscal relief, health care safety net, biomedical research, construction and human services State fiscal relief, health care safety net, biomedical research, construction and human services

Health Information Technology - Economic & Clinical Health Act HITEC Capacity Building $2 billion HITEC Capacity Building $2 billion  Grants to States for HIE  National and Regional Extension Centers (70)  Health IT Workforce Grants  Public health and infrastructure  Standards, policy, process and regulations Incentives for Medicare & Medicaid providers who demonstrate “meaningful use of EHRs $19 - $48 billion beginning in 2011 Incentives for Medicare & Medicaid providers who demonstrate “meaningful use of EHRs $19 - $48 billion beginning in 2011

Prevention and Wellness Fund $1billion Immunization Grant Program - $300 mil to States Immunization Grant Program - $300 mil to States Healthcare Associated Infection - $50 mil to States Healthcare Associated Infection - $50 mil to States Communities Putting Prevention to Work - $650 mil for evidence based interventions to Communities Putting Prevention to Work - $650 mil for evidence based interventions to  Increase levels of physical activity  Improve nutrition  Decrease overweight/obesity prevalence  Decrease tobacco use, and exposure to secondhand smoke  Evaluation and data

Comparative Effectiveness Research - $1.1 billion Three components Three components  NIH $400 million  AHRQ 300 million  Secretary’s Fund $400 million IOM Report IOM Report Federal Coordinating Council on CER Federal Coordinating Council on CER FCC Report to President and Congress FCC Report to President and Congress HHS Spending Plan due November 1, 2009 HHS Spending Plan due November 1, 2009

Comparative Effectiveness Research IOM Study – Recommend national priorities for CER to be funded by ARRA. IOM Study – Recommend national priorities for CER to be funded by ARRA. Portfolio Criteria - Research area, population, interventions, methodology, prevalence, mortality, morbidity, cost and variability Portfolio Criteria - Research area, population, interventions, methodology, prevalence, mortality, morbidity, cost and variability 100 CER priority topics, e.g. Reproduction, end of life care, respiratory, psychiatry, disparities etc. 100 CER priority topics, e.g. Reproduction, end of life care, respiratory, psychiatry, disparities etc. “CER program should help to develop large scale, clinical and administrative data networks to facilitate better use of data and efficient ways to collect new data for CER.” “CER program should help to develop large scale, clinical and administrative data networks to facilitate better use of data and efficient ways to collect new data for CER.”

Federal Coordinating Committee for CER Research 15 members from federal government 15 members from federal government Public listening sessions Public listening sessions Definition Definition Strategic Framework Strategic Framework Report to President and Congress Report to President and Congress Areas of investment and priorities Areas of investment and priorities

FCC CER Report Four areas of investment Four areas of investment  CE research  Human and scientific manpower for CER  Data infrastructure for CER  Dissemination and translation of CER Priorities Priorities  Priority populations  Priority conditions  Types of interventions

FCC CRE Definition Comparative effectiveness research is the conduct and synthesis of research comparing the benefits and harms of different interventions and strategies to prevent, diagnose, treat and monitor health conditions in “real world” settings. The purpose of this research is to improve health by developing and disseminating information to patients, providers, and decision-makers, responding to their expressed needs, about which interventions are most effective for which patients under specific circumstances. To provide this information, comparative effectiveness research must assess a comprehensive array of health- related outcomes for diverse patient populations and sub-groups. Defined interventions compared may include medications, procedures, medical and assistive devices and technologies, diagnostic testing, behavioral change, and delivery system strategies. This research necessitates the development, expansion, and use of a variety of data sources and methods to assess comparative effectiveness and actively disseminate the results.

FCC CER Strategic Framework Human & Scientific Capital for CER CE Research CER Data Infrastructure Dissemination and Translation of CER Priority Populations Priority Conditions Types of Interventions Crosscutting Priority Themes Primary investment Secondary investmentsSupporting investment Legend

Data infrastructure examples Linked longitudinal claims data Linked longitudinal claims data Expanded Medicare /Medicaid claims data Expanded Medicare /Medicaid claims data Linked distributed clinical data networks Linked distributed clinical data networks EHR data EHR data Registries Registries

Other HHS Data Initiatives New HHS CTO New HHS CTO Making HHS data mere accessible Making HHS data mere accessible  Data.Gov  HHS portals  Data to reduce disparities  Health data collection investments

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