White House budget’s winners and losers

With help from Arthur Allen (@athurallen202) and Darius Tahir (@DariusTahir)

WHITE HOUSE BUDGET’S WINNERS AND LOSERS: The White House’s budget proposal released yesterday cuts resources for several programs critical to health IT, but increases funding for the Veterans Affairs Department.

Slashed staffs and reduced budgets: The proposal would pare the Office of the National Coordinator of Health IT’s staff from 185 to 162, and shrink its budget by more than a third to $38 million. The Office for Civil Rights would lose five out of 152 staffers — its budget would fall from $39 million to $31 million. More for Pros here.

AHRQ could roll into NIH: The budget also proposes folding the Agency for Healthcare Research and Quality, the National Institute for Occupational Safety and Health and the National Institute on Disability, Independent Living, and Rehabilitation Research into the National Institutes of Health. AHRQ funds research into health care and health IT. Under the proposal, it would be rebranded as the National Institute for Research on Safety and Quality with a $256 million budget, down from its current $322 million. NIOSH, now within the Centers for Disease Control and Prevention, would see its budget fall from $338 million to $200 million. The administration would allow the three offices to exist as separate institutes at NIH initially but they would eventually be dissolved into existing institutes and centers, the budget document says. More for Pros here.

HCFAC could see discretionary funding boost: The Health Care Fraud and Abuse Control program, which helps CMS identify improper payments, has seen a return on investment of $5 for every $1 spent between 2014 and 2016, the budget proposal notes. It would raise

HCFAC discretionary funding to $770 million in 2019, $45 million more than the 2017 enacted level (Congress still hasn’t finalized spending for the current fiscal year).

Veterans Affairs Department see an 11.7 percent increase: The Trump administration’s proposed increase for the Department of Veterans Affairs outlines $1.2 billion for the first year of its Cerner EHR implementation, on top of the agency’s $4.2 billion IT budget.

As we’ve reported, the VA’s contract with Cerner is on hold since Secretary David Shulkin put a freeze on the agreement in December. He’s seeking more assurances from Cerner that it could meet the VA’s need for sharing records among health care providers in and outside the agency. Congressional sources expect it to be signed within a month or so.

Overall, the administration is seeking $83.1 billion for the VA, an $8.7 billion jump from the 2017 enacted level. The $4.2 billion proposed for the Office of Information and Technology represents $300 million less than fiscal year 2018. Within the total budget, $204 million would support modernizing VistA and other VA legacy IT systems. Another $1.2 billion would go to a separate budget account to acquire a new EHR system, “a substantive investment for this critical initiative, which would help facilitate a seamless transition for service members as they leave the Armed Forces,” the budget documents say. The total includes a $675 million down payment on the contract, $120 million for project management and $412 million in infrastructure improvements. More for Pros here.

VA OFFICIALS FINALIZING CERNER EHR CONTRACT: In the meantime, VA officials appear to be finalizing details on the massive VistA EHR replacement. John Windom, the VA’s EHR project acquisition director, flew to Cerner’s Kansas City headquarters Monday to review requests his agency made in response to the MITRE report on Cerner’s capacity to provide a state-of-the-art interoperability solution, according to the VA’s chief technology officer John Short. “Everything’s on track to be finished up by the end of the month, pending the secretary’s final decision,” he said at a briefing on the VA’s fiscal year 2019 budget. Sec. Shulkin asked for the MITRE assessment after putting the contract on hold. The department would immediately pay Cerner $370 million once a contract is signed, officials said. More for Pros here.

eHealth Tweet of the day: Steven Posnack @HealthIT_Policy A-side 2018 #healthpolicyvalentines mixtape: 1) un-blockchain my heart 2) how CPT is your love? 3) Crazy little thing called Medicare 4) (Everything I do) I pre-authorize for you 5) I just called to say RVU

Welcome to Tuesday at Morning eHealth where we’re simultaneously fascinated and horrified by this video of a quadruped robot courteously opening a door for its friend. Send your favorite harbingers of the robot apocalypse to [email protected]. Tweet them to @ravindranize, @athurallen202, @DariusTahir, @POLITICOPro, @Morning_eHealth.

TRUMP SAYS ‘RURAL FOLKS’ WANT BROADBAND: Yesterday the president said that some of the $50 billion his infrastructure plan allocates to rural areas should be used for broadband access but didn’t say if any of those funds would specifically be earmarked. The $50 billion is for rural areas that have “really been left out, the rural folks have been left out, including broadband access which they don’t have and they want it and the farmers want it,” Trump said at the White House.

Rural lawmakers have repeatedly called for some infrastructure funds to be specifically dedicated to broadband deployment, our colleague Steven Overly reports. They have argued that without a set-aside, higher-profile projects like roads and bridges will gobble up all the funding. More for Pros here.

ONC NAMES HITAC CO-CHAIRS: Former AMA President Robert Wah and Carolyn Petersen, a patient advocate and senior editor of the Mayo Clinic’s health information website, will co-chair ONC’s Health IT Advisory Committee, the office announced Monday. The 25-member HITAC is responsible for advising ONC on health IT, and will initially focus on the Trusted Exchange Framework, which is designed to improve the health information exchange network. HITAC, which replaced the former ONC Policy and Standards committees, held its inaugural meeting in January and will meet again Feb. 21. More for Pros here.

ATHLETIC TRACKERS GET FUZZIER WHEN WORKING TOGETHER: Researchers examining commercial wearable fitness tracking devices have concluded that the devices are most accurate when working alone. Athletic trackers used by sports scientists, trainers, and athletes themselves could help monitor the effectiveness of certain exercises, analyzing movement and progress in real-time. Since there isn’t a single standards body overseeing these devices, researchers investigated their validity and reliability in a study, they wrote. They recommended that devices be calibrated regularly, and concluded that they are most reliable if “the same device is used for each athlete over the time course of interest.” Interdevice use — combining data on the same athlete from different devices — was “highly variable” and “of diminished reliability and utility. “

WHAT WE’RE CLICKING ON:

— Scott Gottlieb’s FDA strategy

— CSC paying Maryland $81 million for Medicaid claims processing snarl

— Why trackingmedical records is essential to health

— Why we should remain cautious on machine learning