CMS Launches Pilot To Test Personal Health Records For Medicare Beneficiaries In South Carolina

Main Category: Medicare / Medicaid / SCHIP
Article Date: 08 May 2008 - 4:00 PDT

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The Centers for Medicare & Medicaid Services (CMS) announced a new project that expands its efforts to encourage beneficiaries covered by traditional Medicare to take advantage of Internet-based resources to track their health care services and better communicate with their providers.

The CMS pilot uses an on-line tool called a Personal Health Record (PHR) to give Medicare beneficiaries the ability to collect and then access information about their health or health care services, such as medical conditions, hospitalizations, doctor visits and medications, and collect information about their health. CMS is ensuring that strict privacy and security safeguards are in place to protect all beneficiary data.

The pilot test will take place in South Carolina, where beneficiaries will be given an opportunity to use a PHR populated by their own Medicare claims data. Key information from hospital and provider medical claims will be automatically entered into the PHR once the individual registers and requests the data. Prescription drug information, even for individuals who participate with a Part D Drug Plan, will not be automatically entered into the PHR, but the individual may choose to enter his or her own prescription drug and over-the-counter medications into the PHR.

"By using a PHR, patients with the pilot will have easy access to personalized medical information that will enable them to be more involved with their health care services," said CMS Acting Administrator Kerry Weems. "Furthermore, the steps we are taking today will help CMS understand how to best educate beneficiaries on the use of a PHR so that we can encourage use of these tools in the future."

A PHR is a record of health information that is under the control of the consumer or patient. Sometimes it only contains data entered by the individual or his or her provider, but it can also include information from a health plan - as is the case in this pilot, where Medicare provides information from its claims data base. A PHR is different than an electronic health record (EHR), which is owned by and under the control of the physician.

One feature of this PHR allows individuals to look up information specific to their own personal health status and health conditions. The PHR tool used in this pilot also provides convenient links to carefully selected Web sites with educational material on health topics. This makes it easier for the beneficiary or other authorized users to do research that will help them understand their health issues and better manage their own care.

The beneficiary also will control who is able to see the information in the PHR, and will decide whether and with whom the information can be shared - from health care providers to caregivers and family members.

The pilot, which began on April 4, 2008, is expected to run for 12 months and CMS will use information gathered from the pilot to determine future steps with respect to PHRs.

The PHR tool selected for this pilot is offered by HealthTrio, which currently offers PHRs to thousands of individuals through employer contracts. The Medicare data will be provided through Palmetto GBA, a Medicare contractor serving the region, which includes South Carolina. The pilot is being managed by QSSI, headquartered in Gaithersburg, Maryland, and is called "MyPHRSC," where the "SC" stands for South Carolina. The pilot is accepting enrollment online at http://www.MyPHRSC.com and at local events in South Carolina.

The South Carolina PHR pilot follows another initiative launched in June of 2007, where CMS is collaborating with seven health plans to test the use of PHRs for beneficiaries who are enrolled in a Medicare Advantage or Part D Prescription Drug Plan.

Currently, Medicare beneficiaries are able to receive some personalized information about their Medicare benefits and services at the MyMedicare.govpage on www.medicare.gov. However, a PHR can provide additional information and support for people with Medicare, their providers and caregivers because the PHR provides access to a fuller, more comprehensive view of medical history, along with interactive educational resources.

Participation in the pilot is voluntary, and more information about the project is available at http://www.MyPHRSC.com. Medicare beneficiaries wanting more information about this project should call 1-888-697-4772. Providers will learn more about the pilot through newsletters and efforts of the CMS Region IV office in Atlanta.

Centers for Medicare & Medicaid Services