Skepticism Around Meaningful Use and Government Handouts

Posted on July 16, 2010 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 6000 articles with John having written over 3000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 13 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

There’s a lot of skepticism in the air around the meaningful use requirements and the government handouts that we know as the EMR stimulus. Rightly so. People realize that the government doesn’t just give money out (unless you’re…well I won’t go there). Most government programs come at a cost. The cost of the EMR stimulus money is showing “meaningful use” of a “certified EHR.” Physicians and practice managers around the country are considering whether the cost is worth the benefit.

As an aside, it still upsets me that the conversation has moved to that. A year and a half ago, the conversation around EMR software was, “How and which EMR should I implement?” (A good question considering the 300 plus EMR vendors) Now that’s gone out the window in favor of, “How can I get the stimulus money and is it worth it?”

With every government program there are skeptics. Here’s an excerpt from an article Paul Roemer wrote for HCPLive.

This in turn leaves the healthcare provider in what is best described as a Morton’s Fork scenario. Shall I explain? A Morton’s Fork is a choice between two equally unattractive alternatives—a dilemma. The concept originated in 1487 under the rule of Henry the VII as a result of tax policy to ensure everyone paid taxes. The argument was because the rich had enough money to buy things they must have enough money to pay taxes, and the poor who had bought nothing had saved their money, and thus had money with which to pay taxes. The two prongs of the fork—back then forks only had two prongs. Q. E. D.

The healthcare provider must choose between—as one may not choose among—two alternatives. Attempt to meet Meaningful Use—a Procrustean Solution—and turn their business model inside out to meet the government’s Gossamer standards.

Attempting to meet the standards does not ensure they will in fact meet the standards. Should a practice only meet 99% of the standards, they lose. The Pareto principle does not apply. There is no 80:20 rule. They will not receive any incentive money as Meaningful Use is an all or nothing game.

The second alternative is to not meet Meaningful Use. This choice may be voluntary, or involuntary—trying to meet Meaningful Use and failing. Alternative Two—it is said—will result in reimbursement penalties from Medicaid and Medicare.

I do not think those penalties will be implemented, or at least they will not be implemented in the documented timeframe.

I also do not think there is a Morton’s Fork, because I think Meaningful Use will disappear because it is so arbitrary and capricious—and because the number of large providers who will meet it could all drive to lunch at Morton’s in a Yugo, at which time they could dine with a fork from Morton’s.

I disagree with Paul insofar as Meaningful Use won’t disappear. At least not for the next 5 years. It is what it is and it’s not going anywhere while there’s billions of dollars that hangs on it. However, the question of whether physicians will hop on board the meaningful use train is a better question. If they don’t, then I guess they will have effectively made it disappear.

What I believe is a reality is that physicians are going to implement EMR software. To me it’s just a question of whether the EMR stimulus incentives will be the driving force or whether physicians will learn to generally ignore the government handouts and go back to implementing an EMR because it’s the right thing to do for their business.