HHS briefs funding hopefuls on extension center competition

More than 1,200 funding hopefuls jammed phone lines and server connections of the Office of the National Coordinator yesterday to listen for clues at a briefing on how the Office plans to distribute about $600 million in grants set-side to build a nationwide network of health IT technical training centers.

In a 90-minute Web conference, ONC senior advisor Dr. Farzad Mostashari laid out the parameters of the grant program, designed to lend providers technical assistance on using health IT in ways that will not only make their businesses more efficient but will lift healthcare quality nationwide.

In doing so, he first identified the target of the federally subsidized services, called for in the HITECH health IT stimulus legislation: Small primary care providers and group practices with 10 or fewer physicians are where ONC wants to focus its efforts, he said.

“This is a strategic policy decision to make sure that as soon as possible we get the primary care providers in this country to help reach the goal of every American having electronic health records,” said Mostashari, who is also assistant commissioner of  the New York City Department of Health.

Public hospitals and primary care providers who practice in community health centers, rural health clinics and others that serve un-insured populations will round out the market for the services, he said.

There are a total of about 240,000 primary care providers in the United States, Mostashari said. ONC wants the program to help establish 100,o00 of them as “meaningful users” of health IT during the brief window the funds will be available between 2011 and 2013.

To accomplish that, ONC envisions funding about 70 centers that will each  train about 1,500 primary care providers over the course of the program. The centers will provide education and outreach as well as disseminate best practices.

Mostashari emphasized the importance of cooperation among grantees. “We’re on a mission and we really have to help each other,” he said. “Certain groups are going to do a great job on aspects of this and that knowledge needs to be shared as quickly as possible with other extension centers.”

He also pledged that “transparency” would be a hallmark of the program, in order to combat what he called the “increasing asymmetry between providers and vendors.”

“One concern that we have is that these extension centers not become proxies for a particular vendor,” Mostashari said. “We hope extension centers will provide greater transparency and support for leveling the playing field, as it were.”

On the other hand, he said, “vendors are an absolutely essential partners in this – but a relationship of equals is what we’re looking for. Our stance is for the extension centers to be on the side of the providers.”

ONC will limit awards to non-profit organizations, about which more guidance is forthcoming, Mostashari said. ONC wants to place one extension center in each designated geographic area. Those could be portions of an individual state, a Metropolitan Statistical Area that crosses state boundaries, or an entire state in some cases.

The average size the grant will be between $8.5 million to $9 million, Mostashari said. Most of the funding is going to be tied to direct support practices, including those that have already stood up EHRs but not at a level of meaningful use and those that have not adopted EHRs.

ONC has designed the program to be available to practices in  2011 and 2013, before direct Medicare and Medicaid incentives to providers kick-in. “The extension center should have a head start and an ability to show the are adding value to the provider community -- that the assistance you are offering to practice is worth something to them,” Mostashari said.

“That’s the expectation,” he said. “We could end up being wrong about that. I’m sure we’re going to be wrong about many things we can’t see the future. But that is the assumption that underlines this model here.”