Healthcare Revenue Cycle Management, ICD-10, Claims Reimbursement, Medicare, Medicaid

Policy & Regulation News

Congress Debates Economic Benefits of EHR Incentive Programs

By Jacqueline DiChiara

- The Electronic Health Record (EHR) Incentive Programs are failing to prove economically beneficial and impose unreasonable mandates on providers according to members of the Senate Health, Education, Labor and Pensions Committee hearing on Health IT earlier this week.

In a hearing on EHR adoption and meaningful use earlier this week, the committee examined why the latter program’s objectives have yet to be attained and discussed overcoming various barriers to successfully achieve interoperability.

The EHR Incentive Programs, which began as a result of the American Recovery and Reinvestment Act of 2009 and subsequent Health Information Technology for Economic and Clinical Health of 2010, makes Medicare and Medicaid incentive payments to hospitals and physician using certified EHR systems. Its ultimate goal is to promote the seamless movement of data to improve care.

Taking away Medicare payments will not enable and encourage their adaptation by physicians and hospitals, said Committee Chair Senator Lamar Alexander (R-Tenn.).

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  • “Evidence suggests” while the meaningful use program spent $30 billion, it has yet to effectively “improve care, improve coordination and reduce costs,” Alexander argued.

    Half of physicians face penalties for failing to meet the meaningful use program requirements, Alexander explains. Physicians are struggling to implement pricey systems and pay annual licensing fees for hardware and associated services and expedited penalties are complicating the process, he continued.

    As additional chairman’s remarks explained, it was initially hoped the program would reduce costs, among other objectives.

    “The evidence suggests these goals haven’t been reached,” claimed Alexander.

    Those doctors and hospitals not adopting such record systems lose 1 percent of their Medicare payments this year. This loss amount will increase to five percent.

    Almost three quarters of physicians said their EHR systems were not worth the cost.

    For instance, Tennessee-based Wellmont Health System, spent $125 million for a complete EHR system conversion and were guaranteed they would meet meaningful use requirements.

    But Wellmont expects to only receive $38 million in meaningful use dollars.

    Another Tennessee-based center foresees a $100,000 penalty after spending $731,000 attempting to comply with Meaningful Use requirements after not meeting only one measure.

    A movement for change was emphasized. Senator Sheldon Whitehouse (D-R.I.) stated, “I would love to work with my colleagues with rebooting meaningful use.”

    Whitehouse also expressed concern about the high cost of building interfaces so doctors and hospitals can collectively share data. Doctors can choose systems that allow data to be cost-effective if vendors state their connecting fees within their pitch, he explained.

    Peter DeVault, Director of Interoperability at Epic Systems said his EHR system involved an upfront cost and a licensing cost, the latter involving a per-patient-per-year cost of $2.35. According to DeVault, the total costs “could vary widely.”

    Physicians in capitated or accountable care organization financing arrangements would share data more readily, continued DeVault. Such providers would do so to save money, he explained.

    There was a wide variety of opinion, however, regarding such statements.

    Robert Wergin, President of the American Academy of Family Physicians, recommended the EHR incentive payment program adjust its documentation requirements to save physicians valuable time and remove noncompliance penalties.

    It was suggested ongoing meetings be held to further address meaningful use and EHR improvements.



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