Long Term Care

CMS to Test PHRs for Medicare Beneficiaries in South Carolina

The Centers for Medicare & Medicaid Services (CMS) is expanding 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 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 collect information about their health. CMS is ensuring that strict privacy and security safeguards are in place to protect all beneficiary data.

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 database. 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 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 pilot test will take place in South Carolina, where beneficiaries can 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. The pilot is expected to run for 12 months and CMS will use information gathered from the pilot to determine future steps with respect to PHRs.

Currently, Medicare beneficiaries are able to receive some personalized information about their Medicare benefits and services at the 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, along with interactive educational resources.

Source: Centers for Medicare & Medicaid Services, May 7, 2008

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