Q&A: Tom Leary on What the White House's Proposed 2019 Budget Means for Health IT

The budget signals a commitment to expanding cybersecurity and telehealth, but could quell innovation, says the HIMSS vice president of government relations.

The Trump administration's 2019 budget proposal was released earlier this month and its funding plans present a bit of a mixed bag for healthcare IT. The budget proposes deep cuts to the Health and Human Services Department, but at the same time signals a desire to expand other top-line healthcare priorities, such as cybersecurity and telehealth.

To better understand how the proposal could impact the future of health IT innovation, we spoke with the vice president of government relations for the Healthcare Information and Management Systems Society, Tom Leary, who offered his insights into what the budget proposal might mean for providers, payers and patients everywhere if it becomes official.

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HEALTHTECH: Can you begin by speaking generally on what the budget might mean for health IT initiatives?

LEARY: HIMSS is concerned that the president's budget request is inconsistent with the requirements set out by Congress through the 21st Century Cures Act and budget deal from three weeks ago. Congress has been sending the signal since December 2016 that they want the United States to make the necessary investments to keep the U.S. at the forefront of medical and healthcare research and innovation. The proposed budget, with a 21 percent cut in HHS funding, is incongruous with those goals in healthcare delivery, innovation and research.

In particular, we are concerned that the funding in the president's budget request for the Office of the National Coordinator for Health IT at $38 million and the defunding of the Agency for Healthcare Research and Quality and the AHRQ Health IT Portfolio, along with the recommendation to move the agency into the National Institutes of Health, could dramatically impact health IT.

A bright spot is the signal that the president's budget request is making a commitment to health IT solutions for veterans through the first round of funding for the next generation of the Veterans Affairs Department electronic health records, as they move toward the commercial product.

HEALTHTECH: What might this mean for telehealth?

LEARY: Starting in 2019, this proposal expands the ability of Medicare Advantage organizations to deliver medical services via telehealth by eliminating the requirement for MA organizations to provide covered Part B services exclusively through face-to-face encounters.

This is consistent with the direction Congress has provided for telehealth through the support of the Creating High-Quality Results and Outcomes Necessary to Improve Chronic (CHRONIC) Care Act of 2017 that was included in the budget deal on Feb. 8.

HEALTHTECH: The healthcare industry has been hit hard in the last year by ransomware and other cyberattacks. Does this budget offer a way forward when it comes to locking down cybersecurity in healthcare?

LEARY: The president's budget request includes $68 million for critical information and infrastructure protection. The funding also signals a commitment to the Healthcare Cybersecurity and Communications Integration Center (HCCIC), which is in direct alignment with the 2017 HIMSS Congressional Asks to ensure there is greater coordination between the Department of Health and Human Services and the healthcare community.

Additionally, the budget request also includes $2.3 billion for biodefense and cybersecurity needs, to include funding for the Federal Emergency Response Fund.

HEALTHTECH: How do you expect health IT to change in the next few years, shaped by this budget?

LEARY: We would expect a chilling effect on innovation, patient engagement and overall safety initiatives that are currently underway. I encourage Congress to continue focusing on health IT's role in advancing 21st-century medical and healthcare research in the U.S.

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Mar 01 2018