Skip to main content
Sister Publication Links
  • ESG: THE NEW IMPERATIVE
Subscribe
  • Sign Up Free
  • Login
  • Subscribe
  • News
    • Current News
    • COVID-19
    • Providers
    • Insurance
    • Government
    • Finance
    • Technology
    • Safety & Quality
    • Transformation
    • People
    • Regional News
    • Digital Edition (Web Version)
    • Patients
    • Operations
    • Care Delivery
    • Payment
    • Midwest
    • Northeast
    • South
    • West
  • Digital Health
  • Insights
    • ACA 10 Years After
    • Best Practices
    • Special Reports
    • Innovations
  • Opinion
    • Bold Moves
    • Breaking Bias
    • Commentaries
    • Letters
    • Vital Signs Blog
    • From the Editor
  • Events & Awards
    • Awards
    • Conferences
    • Galas
    • Virtual Briefings
    • Webinars
    • Nominate/Eligibility
    • 100 Most Influential People
    • 50 Most Influential Clinical Executives
    • Best Places to Work in Healthcare
    • Excellence in Governance
    • Health Care Hall of Fame
    • Healthcare Marketing Impact Awards
    • Top 25 Emerging Leaders
    • Top 25 Innovators
    • Diversity in Healthcare
      • - Luminaries
      • - Top 25 Diversity Leaders
      • - Leaders to Watch
    • Women in Healthcare
      • - Luminaries
      • - Top 25 Women Leaders
      • - Women to Watch
    • Digital Health Transformation Summit
    • Leadership Symposium
    • Social Determinants of Health Symposium
    • Women Leaders in Healthcare Conference
    • Best Places to Work Awards Gala
    • Health Care Hall of Fame Gala
    • Top 25 Diversity Leaders Gala
    • Top 25 Women Leaders Gala
    • - Hospital of the Future
    • - Value Based Care
    • - Supply Chain
    • - Hospital at Home
    • - Workplace of the Future
    • - Digital Health
    • - Future of Staffing
    • - Hospital of the Future (Fall)
  • Multimedia
    • Podcast - Beyond the Byline
    • Sponsored Podcast - Healthcare Insider
    • Video Series - The Check Up
    • Sponsored Video Series - One on One
  • Data Center
    • Data Center Home
    • Hospital Financials
    • Staffing & Compensation
    • Quality & Safety
    • Mergers & Acquisitions
    • Data Archive
    • Resource Guide: By the Numbers
    • Surveys
    • Data Points
  • MORE +
    • Contact Us
    • Advertise
    • Media Kit
    • Newsletters
    • Jobs
    • People on the Move
    • Reprints & Licensing
MENU
Breadcrumb
  1. Home
  2. Information Technology
June 03, 2014 01:00 AM

ONC's structure gets flatter as its $2B stimulus appropriation ends

Joseph Conn
  • Tweet
  • Share
  • Share
  • Email
  • More
    Reprints Print

    It should have come as little surprise that Dr. Karen DeSalvo, in announcing last week a reorganization of the Office of the National Coordinator for Health Information Technology, said she was aiming for a “flatter” reporting structure.

    One reason for the reorg is obvious. A massive bulge in ONC funding is deflating because most of the $2 billion that was directly appropriated to the ONC by Congress in 2009 for health IT programs under the American Recovery and Reinvestment Act has been spent over the past four years. The appropriation was part of the economic stimulus during the Great Recession.

    DeSalvo, in a recent memo to her staff, noted that the ARRA's “health IT infrastructure and program investments are ending and it is our responsibility to take this opportunity to reshape our agency to be as efficient and effective as possible, never losing sight of our primary accountability—the people of America.” There were no layoffs with the reorganization; the ONC head count remains at 191 full-time equivalents.

    Back in February, in an on-camera interview soon after her appointment to head the ONC, DeSalvo talked about operating with less money than her two immediate predecessors, Drs. David Blumenthal and Farzad Mostashari, both beneficiaries of ARRA funds.

    “Sometimes you can get quite a bit of work done using your opportunity as a convener, using the existing authorities you have in the regulatory space” to drive the market “to work together to get patient information moving in useful ways,” DeSalvo said. “That requires a collective impact approach which I'm comfortable with. I've done it in public health.”

    Most of that stimulus law money went to health IT workforce development programs, the Beacon Community program, state health information exchanges, higher education in health IT and the regional health IT extension center program.

    Fifty-five of the 60 extension centers in the first two rounds of grants have applied for and received permission from the ONC to keep spending remnants of their funds, according to the ONC. Two other RECs in the third round of grants have requests pending for similar spending extensions. But in no case will spending continue after five years from their original grant date, the ONC maintains.

    Grants for the REC program totaled $688 million or a little more than one-third of the ONC's appropriation under the stimulus law.

    DeSalvo, a professed fan of the RECs, has said she'd like to see their work continue.

    The original plan called for the popular RECs to be financially self-sustaining after four years, but a program to extend federal financial support to them has not materialized.

    In March, Mat Kendall, who headed the ONC's REC program since its inception in 2010, stepped down as director of the Office of Provider Adoption Support.

    That office did not make the cut as DeSalvo's reorganization plan pared the ONC structure from 17 offices and suboffices to 10. Those duties now fall under the new Office of Programs.

    According to a survey of executives of 37 RECs published in April and conducted by the Healthcare Information and Management Systems Society, leaders were optimistic they'd achieve sustainability, but only “a handful” indicated their organizations “have already been generating revenue streams to sustain operations going forward.”

    Aside from the anomalous 2009 appropriations bubble, the ONC's budget over the rest of its history has been repeatedly flattened by Congress. In fact, for the agency's first year, fiscal 2005, its budget was zeroed out by legislators.

    Since then, ONC budgets have been remarkably flat, averaging slightly less than $61 million a year, according to the ONC's latest report to Congress.

    For fiscal 2015, HHS' budget request to Congress is $74.7 million, well below the average request over the years at $81.6 million, with the average cut to an ONC budget request running at 22.3%. For the current year, ONC asked for $77.9 million and—after a 22% whacking by Congress—was given $60.4 million.

    The great bulk of the spending on health IT under the ARRA was actually controlled by the CMS, not the ONC, coming from the electronic health-record incentive payment programs under Medicare, Medicaid and Medicare Advantage.

    “I agree with Karen that it is a new chapter in the ONC as the emphasis pivots from the programs whose funding is winding down to a bigger emphasis on supporting the new models of care that the industry is moving towards,” said Dr. Paul Tang, the chief innovation and technology officer at the Palo Alto (Calif.) Medical Foundation. Tang has served as an ONC adviser since 2010 as vice chairman of the federally chartered Health IT Policy Committee. It “seems an appropriate time to refocus and realign ONC's structure,” he said.

    Follow Joseph Conn on Twitter: @MHJConn

    Letter
    to the
    Editor

    Send us a letter

    Have an opinion about this story? Click here to submit a Letter to the Editor, and we may publish it in print.

    Recommended for You
    Judy_Faulkner_Epic_HIMSS17_edit_i.jpg
    Epic outlines what's ahead for patient portal, Cosmos
    Cerner_fullsize_AP_i.jpg
    Cerner to pay $1.8M to resolve racial discrimination allegations
    Most Popular
    1
    More healthcare organizations at risk of credit default, Moody's says
    2
    Centene fills out senior executive team with new president, COO
    3
    SCAN, CareOregon plan to merge into the HealthRight Group
    4
    Blue Cross Blue Shield of Michigan unveils big push that lets physicians take on risk, reap rewards
    5
    Bright Health weighs reverse stock split as delisting looms
    Sponsored Content
    Health IT Strategist (HITS) Newsletter: Sign up for the latest IT and medical technology news delivered 3 days a week (M, W, F).
     
    Get Newsletters

    Sign up for enewsletters and alerts to receive breaking news and in-depth coverage of healthcare events and trends, as they happen, right to your inbox.

    Subscribe Today
    MH Magazine Cover

    MH magazine offers content that sheds light on healthcare leaders’ complex choices and touch points—from strategy, governance, leadership development and finance to operations, clinical care, and marketing.

    Subscribe
    Connect with Us
    • LinkedIn
    • Twitter
    • Facebook
    • RSS

    Our Mission

    Modern Healthcare empowers industry leaders to succeed by providing unbiased reporting of the news, insights, analysis and data.

    Contact Us

    (877) 812-1581

    Email us

     

    Resources
    • Contact Us
    • Advertise with Us
    • Ad Choices Ad Choices
    • Sitemap
    Editorial Dept
    • Submission Guidelines
    • Code of Ethics
    • Awards
    • About Us
    Legal
    • Terms and Conditions
    • Privacy Policy
    • Privacy Request
    Modern Healthcare
    Copyright © 1996-2023. Crain Communications, Inc. All Rights Reserved.
    • News
      • Current News
      • COVID-19
      • Providers
      • Insurance
      • Government
      • Finance
      • Technology
      • Safety & Quality
      • Transformation
        • Patients
        • Operations
        • Care Delivery
        • Payment
      • People
      • Regional News
        • Midwest
        • Northeast
        • South
        • West
      • Digital Edition (Web Version)
    • Digital Health
    • Insights
      • ACA 10 Years After
      • Best Practices
      • Special Reports
      • Innovations
    • Opinion
      • Bold Moves
      • Breaking Bias
      • Commentaries
      • Letters
      • Vital Signs Blog
      • From the Editor
    • Events & Awards
      • Awards
        • Nominate/Eligibility
        • 100 Most Influential People
        • 50 Most Influential Clinical Executives
        • Best Places to Work in Healthcare
        • Excellence in Governance
        • Health Care Hall of Fame
        • Healthcare Marketing Impact Awards
        • Top 25 Emerging Leaders
        • Top 25 Innovators
        • Diversity in Healthcare
          • - Luminaries
          • - Top 25 Diversity Leaders
          • - Leaders to Watch
        • Women in Healthcare
          • - Luminaries
          • - Top 25 Women Leaders
          • - Women to Watch
      • Conferences
        • Digital Health Transformation Summit
        • Leadership Symposium
        • Social Determinants of Health Symposium
        • Women Leaders in Healthcare Conference
      • Galas
        • Best Places to Work Awards Gala
        • Health Care Hall of Fame Gala
        • Top 25 Diversity Leaders Gala
        • Top 25 Women Leaders Gala
      • Virtual Briefings
        • - Hospital of the Future
        • - Value Based Care
        • - Supply Chain
        • - Hospital at Home
        • - Workplace of the Future
        • - Digital Health
        • - Future of Staffing
        • - Hospital of the Future (Fall)
      • Webinars
    • Multimedia
      • Podcast - Beyond the Byline
      • Sponsored Podcast - Healthcare Insider
      • Video Series - The Check Up
      • Sponsored Video Series - One on One
    • Data Center
      • Data Center Home
      • Hospital Financials
      • Staffing & Compensation
      • Quality & Safety
      • Mergers & Acquisitions
      • Data Archive
      • Resource Guide: By the Numbers
      • Surveys
      • Data Points
    • MORE +
      • Contact Us
      • Advertise
      • Media Kit
      • Newsletters
      • Jobs
      • People on the Move
      • Reprints & Licensing