The Centers for Medicare and Medicaid Services (CMS) recently 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 healthcare services and better communicate with their providers. The CMS pilot test uses an online tool called a Personal Health Record (PHR) to give Medicare beneficiaries the ability to collect and then access information about their health or healthcare services, such as medical conditions, hospitalizations, doctor visits, and medications, and to collect information about their health.
A PHR is a record of health information under the control of the consumer or patient. Sometimes it contains only data entered by the individual or by his or her provider, but it also can include information from a health plan, as is the case in this pilot test, for which Medicare provides information from its claims database. A PHR is different from an electronic health record, which is owned by and under the control of the physician.
A 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 test 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 healthcare providers to caregivers and family members. The CMS is ensuring that strict privacy and security safeguards are in place to protect all beneficiary data.
The pilot test, which began April 4, 2008, is expected to run for 12 months, with CMS using the information gathered from the pilot test 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 test will take place in South Carolina, allowing beneficiaries an opportunity to use a PHR populated by their own Medicare claims data. Key information from hospital and provider medical claims will be entered automatically into the PHR once the individual registers and requests the data. Prescription drug information will not be automatically entered into the PHR, even for individuals who participate with a part D drug plan. However, 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 healthcare services," says 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."
The pilot test is being managed by QSSI, headquartered in Gaithersburg, Maryland, and is called MyPHRSC, in which the SC stands for South Carolina. The pilot test is accepting enrollment online at http://www.MyPHRSC.com and at local events in South Carolina.
The South Carolina PHR pilot test follows another initiative launched in June 2007, in which CMS is collaborating with 7 health plans to test the use of PHRs for beneficiaries 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 http://MyMedicare.gov page on http://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, together with interactive educational resources.
Participation in the pilot test is voluntary, and more information about the project is available at http://www.myphrsc.com. Medicare beneficiaries wanting more information about this project may call 1-888-697-4772. Providers will learn more about the pilot test through newsletters and efforts of the CMS Region IV office in Atlanta.