Diana Manos, Senior Editor
Diana Manos is Senior Editor for Healthcare IT News. Located in Washington, D.C., she covers policy and legislation issues surrounding healthcare IT. Follow Diana on Twitter @DManos_IT_News.
Like it or not, MU is underway
May 18, 2012
No matter how you feel about the federal incentive program to drive the adoption of healthcare it, the numbers speak for themselves. The Centers for Medicare & Medicaid Services announced in early May that the federal government had paid out more than $5 billion in meaningful use incentives as of April. This money went to 93,650 physicians–$287 million to Medicare providers and $299 to Medicaid providers.
Robert Anthony from the CMS Office of eHealth Standards and Services reported on May 2 that more than 40 percent (132,000) of all the primary care providers in the country have enrolled in the meaningful use incentive program, with 67,000 of them coming from small practices.
These are striking numbers and an accomplishment many soothsayers did not expect. In the course of my reporting, I still find people who are disheartened by the program, for many reasons. Some do not feel the incentives are a justifiable federal expense. Others, often providers, do not feel the federal pressure to adopt EHRs and the imposition of a new workflow on their private medical practice is appropriate. Still others are just plain speculative about how interoperability will ever come to pass, making all of this progress worthwhile.
Probably one of the more interesting comments I’ve heard lately came from Toby Bond, a practicing internist and president of the Accountable Care Coalition of Greater Athens Georgia, one of the first ACOs named to participate in the Medicare Shared Savings Program. Bond is also a certified professional coder and he owns a hospital.
“I’m a Republican,” he told me. He supports the HITECH bill found in the stimulus package, responsible for paying for the EHR incentive program. “Primary care physicians need more support. Obama gets it,” Bond said. (“Obamacare is a different argument,” he added.) “This is much more thought out than you realize. It’s all building to everybody talking. This is a master plan and it’s actually brilliant. This is a monumental task that we’re about to undertake,” he said, speaking of EHR adoption and the building of ACOs, under the Affordable Care Act.
“Myself, I see patients all day, and it’s a big project for me, but it’s going to be a great project and one we have to do,” Bond said. “I’m very proud of the government for trying to give people resources to do it.”
pjcasey75 say: Too Early to Declare Victory
The high participation in Meaningful Use as a result of the EHR incentives are indeed encouraging, no matter how you look at it. No one, not even the optimists, thought that as many providers would jump into EHRs have already done so by this time.
However, since the Medicaid incentives are so high during the first year of the program, and the requirements so low, it is especially risky to conclude that Medicaid providers are "all in" yet. Many are discovering, often to their surprise, that getting $21,500 last year took much less effort than will be required to get just $8,500 this year. How many Medicaid "AIU" attestors will stay on the road to meaningful use? I guarantee, it won't be 100% of them.
And what is true of the Medicaid EHR incentive program is still true of the incentives for Medicare participants, though not to the same degree. The payments decrease year by year even as the requirements rise. Last year you could achieve MU in just 90 days. In your second year of the program, it will take all year. Come 2014, the bar goes up again, for both providers and vendors. That means the EHR upgrade will cost a provider another fee, and complying will take more effort. How many will decide to still use their EHR, but not the "meaningful use" way? How many will revert to documenting for their own sake, but not for anyone else? How many will fail to sign up for HIE connectivity? I suspect that many, without ongoing assistance and incentives, will do some but not all of what is required to get to the ultimate goal envisioned by this laudable program.
I sincerely hope that we as a country will have whatever it takes, be it public policy, market driven incentives, entreprenuerial energy or sheer genius innovation, to complete the journey we've begun towards a more efficient, transparent and ideally cost effective healthcare system. But I'm not ready to declare victory yet.