1.Short title; table of
contents
(a)This Act may be cited
as the Blueprint for Health Act of
2009
.
(b)The table of contents of this Act is as follows:
Sec. 1. Short title; table of contents.
Sec. 2. Purpose.
Sec. 3. Establishment of a Blueprint for Health for disease
prevention, health promotion, and education about and better management of
chronic conditions.
Sec. 4. Strategic plan.
Sec. 5. Chronic care management programs.
Sec. 6. Incentives for prevention of chronic
disease.
Sec. 7. Health information technology.
Sec. 8. Recommendations to Congress; annual report.
2.It is the purpose of this Act to establish a
Blueprint for Health which is designed—
(1)to create a national integrated medical
home model of care that enhances primary care, encourages multidisciplinary
coordination, and promotes disease prevention, health promotion, and education
about and better management of chronic conditions;
(2)to increase Americans’ access to
affordable, appropriate, high quality care through the use of the integrated
medical home model; and
(3)to
reduce costs to the United States health care system through the application of
such model.
3.Establishment of
a Blueprint for Health for disease prevention, health promotion, and education
about and better management of chronic conditions
(a)The Secretary of
Health and Human Services (in this Act referred to as the
Secretary
) shall create consistent with this Act a program (in
this Act referred to as the Blueprint for Health
) that provides
a national infrastructure for disease prevention, health promotion, and
education about and better management of chronic conditions through the use of
a nationwide integrated medical home model of care (in this Act referred to as
the integrated medical home model of care
) in a manner that is
designed to initiate, coordinate, and evaluate measures for promoting health
and preventing disease in the United States.
(b)The Blueprint for Health shall include the following
elements:
(1)A strategic plan described in section 4 for designing the
integrated medical home model of care.
(2)Chronic care
management programsChronic care management programs described in
section 5.
(3)Incentives for the prevention of chronic disease
described in section 6.
(4)Assessment of
HIT initiativesA plan
described in section 7 for the assessment of current health information
technology initiatives.
(c)
(1)The Secretary shall convene an executive committee to
advise the Secretary on the creation and implementation of the Blueprint for
Health.
(2)The
executive committee shall include representation from national and State
medical, hospital, and pharmaceutical associations, consumer and patient
advocacy groups, labor groups, employer and other purchasing groups, and the
health insurance industry.
4.The Blueprint for Health
shall include a strategic plan for designing the integrated medical home model
of care that includes the following:
(1)Recommended
elements of an integrated coordinated chronic care management model that
incorporates the following:
(A)Medical practices
acting as medical homes in being primary caregivers in close coordination with
other elements. The elements for such homes may be based on guidelines
developed for such homes by the National Committee for Quality Assurance.
(B)Early disease
detection and risk stratification.
(C)Community care
teams that provide care support for medical homes and assist in coordinating
care among medical homes, hospitals, prevention programs, multidisciplinary
specialists, and others.
(2)A plan for the formation of such community
care teams that may include panel managers, public health prevention
specialists, nurse coordinators, social workers, dieticians, community health
workers, care coordinators, behavioral health specialists, and other patient
support personnel.
(3)Incentives for
patient self management, community-based initiatives, and system and
information technology reforms, intended for use by all providers and health
plans, including Medicare, Medicaid, the Federal employees health benefits
program, and other Federal programs.
(4)A description of recommended prevention
programs and a strategy for integrating them into the integrated medical home
model of care.
(5)A plan to ensure that chronically ill
patients have a low level of cost sharing under the integrated medical home
model of care.
(6)Alignment of
health care information technology initiatives with information technology
needs.
(7)Development and use
of outcome and reporting measures designed to track the progress of patients
meeting clinically recommended treatment goals.
(8)A
strategy for ensuring the broad support of the integrated medical home model of
care by health insurers, hospitals, and health care professionals, including
specialists and other physicians.
(9)Recommendations for better integrating
specialty care services into primary care practices to ensure care coordination
and the use of best practices.
(10)Recommendations
for the consultation of providers experienced with the development and
implementation of an integrated medical home model of care as this Act’s care
coordination model is developed.
(11)A strategy for
standardizing outcome and financial measures to ensure consistency among all
health plans, including Medicare, Medicaid, the Federal employees health
benefits program, and other Federal programs.
5.Chronic care
management programsThe
Secretary shall include in the Blueprint for Health chronic care management
programs which provide for at least the following:
(1)Methods for
identifying and enrolling chronically ill patients and for encouraging primary
care physicians, specialists, hospitals, and others to participate in such
programs.
(2)Development of
health risk appraisal or assessment for individuals enrolled under Medicare,
Medicaid, or the Federal employees health benefits program.
(3)A process for coordinating care among
health professionals including multidisciplinary care teams and specialty care
providers.
(4)Methods for increasing communication among
health care professionals and patients, including patient education,
self-management, and follow up plans.
(5)Process and
outcome measures to provide performance feedback for health care professionals
and information on the quality of care.
(6)Payment methodologies to create financial
incentives for patient participation and to allow primary care physicians to
meet specific standards of a medical home program. Such financial incentives
shall include—
(A)enhanced payment
to medical practices, such as a per member per month fee, based on standards
for a medical home, such as the National Committee for Quality Assurance
standards for a patient centered medical home;
(B)payment for care
support services, such as community care teams or other applicable approaches,
across all insurers, including multi-payer private plans and Medicare,
Medicaid, and other public plans; and
(C)the support of a
community based savings sharing and reinvestment model, such as an accountable
care organization, which incorporates a balanced set of financial and quality
incentives, such as the Institute for Healthcare Improvement’s Triple Aims.
6.Incentives for
prevention of chronic disease
(a)The Secretary shall
include in the Blueprint for Health a plan to provide incentives to prevent
chronic diseases, including investments in healthy and sustainable local and
regional food systems as well as the broader use of lifestyle changes, such as
through diet, exercise, and smoking cessation in the schools, communities, and
workplace.
(b)Compilation of
effective practicesBased on recommendations set forth by the
United States Preventive Services Task Force, the Secretary shall compile a
list of effective practices that would serve as a basis for establishing
programs to prevent chronic disease and that could be included in the Blueprint
for Health.
(c)The
plan under subsection (a) may include the following:
(1)Grant opportunities
and Federal tax credits for localities to conduct community assessment,
intervention, and activation plans in which public health data are collected
and analyzed to identify areas in greatest need of prevention and wellness
programs.
(2)Federal tax credits and incentive grants to
local education agencies, businesses, local departments of public health,
communities, hospitals, health care providers, and other entities so that they
may adopt effective models of wellness shown to lower costs and improve
health.
(3)Incentives for individuals to take
proactive preventative measures, including weight management and smoking
cessation.
(4)Federal tax credits and incentive grants
to local education agencies, businesses, local departments of public health,
communities, hospitals, health care providers and other entities to promote the
development of healthy and sustainable local and regional food systems.
7.Health
information technology
(a)The Blueprint for
Health shall promote the effective, efficient, national use of health care
information technology initiatives.
(b)As
part of the Blueprint for Health, the Secretary shall commission an assessment
to be presented to Congress not later than two years after the date of the
enactment of this Act that examines the implementation of the health
information technology provisions enacted as part of the American Recovery and
Reinvestment Act of 2009 (Public Law 111–5). This assessment shall evaluate the
implementation of such provisions as they apply to chronic care management, and
determine if further action is needed to ensure that the funding provided in
such Act under such provisions is used effectively and efficiently to help
ensure the effective management of chronic disease.
8.Recommendations
to Congress; annual report
(a)Not later than 1 year
after the date of the enactment of this Act, the Secretary shall present to
Congress recommendations for legislation to implement the Blueprint for Health,
including the establishment of programs designed to enhance primary care,
promote multidisciplinary care coordination, prevent disease, improve quality,
contain costs, more effectively manage chronic illness, and promote good health
and prevention initiatives.
(b)The Secretary shall submit an annual report to Congress on
the status of the implementation of the Blueprint for Health.