Doctors soon to be awash in penalty tsunami
Anyone under the impression that doctors don’t like technology in general might be mistaken. Rather, what many share distaste for is meaningful use.
That’s according to Mari Savickis, assistant director of federal affairs at the American Medical Association, who claimed that most physicians, at least among AMA’s membership, are actually embracing technology.
Indeed, a RAND study commissioned by AMA elicited some surprises. Originally meant to determine factors that contribute to physician job satisfaction, the research instead revealed just how disturbed many are by meaningful use.
“We ended up having to retool the survey,” Savickis said at the Government Health IT Conference and Exhibition last week, “because EHRs kept coming up.”
Right now, a scant majority (59 percent) of eligible providers who are registered for the federal EHR incentive program have actually achieved meaningful use, according to Savackis. And 50 percent of Medicare doctors are at risk for penalties next year under the program.
“That’s tough. That’s really tough,” Savackis said. “It’s pretty obvious physicians are struggling with Stage 1.”
AMA found the biggest challenges to be patient portals, VDT (view, download and transmit), quality measures and risk assessment.
[See also: Congressman offers 3 ways to fix meaningful use.]
The all-or-nothing aspect of the meaningful use program isn’t fair, Savackis said. “You could miss something by a hair and do everything else right and not get paid.” What’s more, the way a doctor practices medicine, the patient mix and specialty factors all combine to make each provider organizationally and operationally different.
According to Savackis, there are 126 requirements in meaningful use Stage 2. She counted them personally, because “some of them are hidden in there.” With doctors still down in the weeds on Stage 1, it’s no wonder why AMA is calling for changes to Stages 2 and 3.
To add insult to injury, meaningful use isn’t the only place doctors face upcoming penalties. There is also the Value Based Payment Modifier, mandated under the Affordable Care Act, which will begin enacting penalties in 2015, and this is tied to the Physician Quality Reporting System. And, doctors who hope to avoid penalties by participating in an accountable care organization won’t find relief, she warns. That won’t “inoculate” a doctor from penalties.
“You can’t turn the Titanic on a dime,” she said of the current healthcare system. And penalizing doctors is only going to make things worse. “The less money doctors have, you take away their opportunity to move forward with the technology or staffing that could help them cross the chasm to payment reform.”