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Since 2006, the Centers for Medicare & Medicaid Services (CMS) has been engaged in a number of pilot projects to encourage Medicare beneficiaries to take advantage of Personal Health Records (PHRs). These tools, usually available through the internet, can help people track their health care services and better communicate with their providers. The type of Personal Health Records CMS has been testing are populated with health information from Medicare claims data. In the future, these records may be able to get information from a provider's electronic health record system, and some provider's may begin to allow patients to see the information directly from those electronic records. In general, a Personal Health Record (PHR) is controlled by the individual, and can be shared with others, including caregivers, family members and providers. This is different from a provider's electronic health record, which is controlled by the provider just as paper medical records are today. Ideally, a Personal Health Record will have a fairly complete summary of an individual's health and medical history based on data from many sources, including information entered by the individual (allergies, over the counter medications, family history, etc). Today, Personal Health Records are available from a number of sources: by many health plans for their members, by providers for their patients, and by independent vendors who are given permission by the individual to receive and store information from health plans, providers, pharmacies, labs, etc. CMS Personal Health Record Pilots in South Carolina, Arizona, and Utah CMS is currently conducting two pilots. One called MYPHRSC in the state of South Carolina, and one called Medicare PHR Choice, in Arizona and Utah. My Personal Health Record South Carolina (MYPHRSC) is a pilot that provides an on-line PHR to beneficiaries with original (fee-for-service) Medicare in the State of South Carolina. The PHR allows participants to see their medical history, based on the past two years of claims. Additional information can be added manually, and the PHR provides helpful resources to understand diagnoses, conditions, and procedures. This pilot is expected to run through December 31, 2009. If you are a Medicare beneficiary residing in South Carolina go to the link in the "Related Links Outside CMS" section below for more information. Medicare PHR Choice is a pilot program for people with original Medicare residing in Utah and Arizona. People with Medicare in those states may choose one of the participating PHRs and authorize Medicare to populate it with their Medicare claims data. The Medicare PHR Choice pilot will continue through December 31, 2009. For more information go to the "Related Links Inside CMS" section below. Personal Health Record pilot with Medicare Advantage and Part D Plans In June 2007, CMS launched a pilot project to encourage Medicare beneficiaries to take advantage of Personal Health Records offered by their Medicare Advantage or Part D Drug Plans. The pilot ended in December 2008, but the health plans continue to offer the PHRs to their Medicare members. The plans are: BCBS of Arkansas, BCBS of Louisiana, HIP USA, Humana, Kaiser Permanente, and the University of Pittsburgh Medical Center (UPMC). Medicare beneficiaries who are members of those plans may link to those PHRs directly from the health plan's website or through the Medicare website, at www. Mymedicare.gov. Feasibility Test of Using Claims Data to populate Personal Health Records In July 2006, CMS awarded contracts to two organizations to test the feasibility of using Medicare claims data to populate Personal Health Records. One of the goals of the test was to determine if Medicare claims history information could be successfully imported into an Internet-based tool. The contracts were awarded to ViPS, using the WebMD tool, and Capstone Government Solutions, using the SharedHealth tool. The pilot was a success, proving that it was feasible to use Medicare claims data to populate PHRs. Those contracts formed the foundation for the pilots that began in 2007 and 2008. For more information, see the link in the "Related Links Inside CMS" section below. CMS Request for Information (RFI) regarding Personal Health Records (PHR) In 2005, CMS requested information from the industry, regarding the role for CMS with Personal Health Records. CMS received over fifty responses and prepared a report summarizing the feedback. The information has been used to assist us in developing our strategy for fostering the development of PHRs for Medicare and Medicaid beneficiaries. To view this summary, see the link in the Downloads section below. For industry resources on PHR, please see the links in the "Related Links Outside CMS" section below.
Page Last Modified: 03/12/2009 9:02:00 AM
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