CMS Expands Personal Health Record Pilot In South Carolina To Include Data From Tricare

Main Category: Medicare / Medicaid / SCHIP
Article Date: 24 Sep 2008 - 4:00 PDT

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The Centers for Medicare & Medicaid Services (CMS) announced an expansion of the South Carolina Personal Health Record pilot (MyPHRSC) to include TRICARE health data.

An interagency agreement between CMS and the Department of Defense (DoD) will enable beneficiaries who have original Medicare and also receive TRICARE benefits to be offered the option of adding TRICARE health data to their MyPHRSC personal health records (PHRs). This data has only been available to the beneficiary through the DoD Medical Information Technology systems until this point.

"This exciting pilot expansion will be a major step forward for Medicare and DoD. We believe that collaborations of this sort will provide more complete information and better tools to empower consumers to manage their health," CMS Acting Administrator Kerry Weems said. "We expect this pilot, which brings data together from multiple sources, can be combined successfully to provide the beneficiary with access to more complete personal health records."

PHRs generally are electronic health records that individual patients maintain or control, which can include clinical, laboratory and claims data, among other types of medical data. PHRs are tools that can help consumers manage their health and health care services. Beneficiaries who elect to participate in the South Carolina initiative can also add other personal health information manually if they choose.

MyPHRSC is a pilot program that enables Medicare beneficiaries in South Carolina to collect and then access information about their health and health care services electronically. Having this information available at their fingertips will help them better manage their health care needs and medical care. Currently, beneficiaries can authorize CMS to send their individual Medicare health data to the PHR.

Under this expansion of the pilot, an eligible beneficiary may authorize the DoD to provide TRICARE data from the DoD systems directly to their existing MyPHRSC record. Initially, active medications will be made available. Other data may later be made available for existing MyPHRSC records, as they become available, and upon request by the beneficiary. Additional data may be made available for existing MyPHRSC records and could be requested by the beneficiary.

TRICARE is the DoD's worldwide health care program for uniformed service members and their families.TRICARE beneficiaries, regardless of age, who are entitled to premium-free Medicare Part A and who have Medicare Part B coverage may use TRICARE For Life (TFL). With TFL, Medicare is the beneficiary's primary insurance, and TRICARE acts as secondary payer minimizing out-of-pocket expenses. TRICARE benefits include covering Medicare's coinsurance and deductible.

"The Department of Defense is delighted about the opportunity MyPHRSC will provide to TRICARE beneficiaries," said Dr. S. Ward Casscells, assistant secretary of defense for health affairs. "Since they will now have easy access to and ownership of their own medical information, in a way that allows them to better understand and manage their conditions."

This collaboration with DoD will be the first time additional data from another electronic source other than Medicare will be available in MyPHRSC.

"At CMS, we strive to find innovative ways to better serve our beneficiaries," Weems said. "This pilot is designed to provide additional value for Medicare beneficiaries by giving them better access to information and more tools to help them improve their health and at the same time giving CMS valuable experience with personal health records."

The PHR tool selected for the MyPHRSC was created by HealthTrio, which currently offers PHRs to thousands of individuals through employer contracts. The Medicare data is provided through Palmetto GBA, a Medicare contractor serving the region that includes South Carolina . The pilot is being managed by QSSI, a company that specializes in information technology solution development and headquartered in Gaithersburg , Md. The pilot is accepting enrollment online at http://www.MyPHRSC.com.

http://www.cms.hhs.gov