The question of whether or not Congress will repeal the HITECH Act has reemerged. Such talk likely has the effect of slowing EHR adoption and undermining the progress that has already been made through the promise of incentives.
I would like to reiterate the conclusion to which I came in a blog post a few weeks ago: EHR incentives are highly unlikely to disappear. As I previously discussed, EHR incentives are not part of Health Care Reform, they are part of the stimulus package intended to jumpstart the American economy and bring it out of recession. Further, there is strong bipartisan support for EHR adoption. In fact, encouraging EHR adoption was an integral part of the McCain/Palin platform in the 2008 presidential election. There is also strong public support for EHR adoption and use.
That all being said, individuals are weary of government programs that have big promises. The EHR incentives program is particularly worrisome given it requires providers to make major investments in HIT that may carry a capital cost that is greater than the EHR incentive. The government is asking providers to share risk rather than absorbing it entirely. If the government doesn’t deliver on its promises, then the burden of risk shifts completely to providers.
Provider reaction to risk varies, but most providers (like most people in general) are risk adverse. There are two options to minimize risk for those who are risk-adverse:
- Delay adoption
- Lessen financial vulnerability
Delay adoption
Providers might feel comfortable delaying EHR adoption. This may give them the chance to better understand the government’s likelihood of issuing incentive payments and whether or not the incentives will be repealed. This is an understandable, yet dangerous means to reduce risk.
If EHR incentives were repealed, this would likely not occur until 2012. This means that providers could still qualify for and receive 2011 benefits (up to $18k for the Medicare program). As well, the program requirements become more difficult as time goes on. For example, providers only need to demonstrate Meaningful Use for 90 days in 2011 to qualify for incentives, but must demonstrate Meaningful Use for 365 days in 2012 to receive the same benefit. It is easier to achieve Meaningful Use in 2011 than it will be in 2012 despite the criteria remaining the same.
Lessen Financial Vulnerability
Simply put, providers can adopt a lower cost EHR. Rather than spend $40k in a single year, providers can opt for a nontraditional payment plan that minimizes risk to the provider. A physician may opt for a plan with a monthly subscription fee of $500-$1000 per provider. Assuming equal features, the ideal scenario is to reduce the monthly and annual costs to $0.
No risk with a significant benefit
Practice Fusion offers functionality that is either on par with or better than legacy EHR systems, but at no cost to providers. This translates into the perfect solution for those who are risk adverse. It ensures exceptional functionality, enables early adoption, and removes all financial vulnerability for providers.
In all likelihood, EHR incentives are here to stay. For those providers who worry that the government may not be able to deliver on their promise, Practice Fusion offers the best solution to not just minimize, but to erase risk while simultaneously maximizing payout.
Thomas McMennamin
Health Policy Manager
Practice Fusion EHR
