In one of my recent interviews with a healthcare IT consulting company, they revealed some breaking news for those of us in the EHR world. They told me point blank that:
Meaningful Use is Not Covering Costs
Ok, so that’s not really breaking news. Although, it seems that very few people want to actually articulate this point. It almost feels like heresy that someone would “complain” about the fact that the government is spending $36 billion on EHR incentives and that the money isn’t enough to cover the implementation of these EHR systems.
Actually, I should clarify that last point. The EHR incentive money is covering the costs to purchase the systems. It’s not covering the costs of implementing those EHR systems and then poking, prodding and otherwise cajoling end users to show meaningful use of that system (not to be confused with meaningfully using the system).
Let me also be clear that I’m not complaining about the EHR incentive money. I’ve done enough of that previously. What I’m just trying to acknowledge is something that everyone who deals with the EHR budget already realizes, but no one seems to want to say it. Organizations are spending more money on EHR and meaningful use than they’re getting from the government.
I think this is important for a couple reasons. First, many organizations didn’t budget any EHR money beyond what the EHR incentive money. You can certainly argue this was a mistake on their part, but that’s going to leave a bunch of organizations in a lurch. We’re already seeing the fall out of this as news reports keep coming out about hospitals systems in financial trouble due to the costs of their EHR system. Plus, in each of these cases, it seems their costs continue to balloon out of control with no end in sight. It makes me wonder if the compressed meaningful use timeline is partially to blame for a rushed implementation and poor EHR implementation and cost planning.
Second, there is still a swash of providers and organizations that haven’t yet implemented their EHR. If you can’t support the cost of EHR with government money, how does that bode for those who won’t be getting any EHR incentive money? One could make the argument that they’ll actually be in a better position since they won’t have to worry about meaningful use and can just focus on getting value out of their EHR. Hopefully that’s the case, but many of the meaningful use functions are now hardcoded into the EHR systems. Even if an organization isn’t planning on attesting to meaningful use, that doesn’t mean they won’t be forced by their EHR software to do a bunch of things they wouldn’t have done otherwise.
What are you seeing from your perspective? Is the EHR incentive money covering the costs of an EHR implementation? What are the impacts if it doesn’t?
Coming from an organization that is not eligible for MU dollars (non-profit social service with one .5FTE prescriber) we have had to foot the bill to purchase and implement without the benefit of any of the federal funding made available to primary health care. Furthermore many of the quality measures just don’t fit well within our field, so we’re very much trying to implement a system without clear guidance from CMS but knowing that if we don’t, our operations may be impacted by reduced Medicaid/Medicare reimbursement rates. This, coupled with things like the delay in ICD-10 implementation make it extremely challenging to monitor performance and manage project timelines.
I am the manager of a solo ENT practice in a small rural area. Even though our practice is 60% Medicare, it is going to be less expensive for us to take the cut in 2015 than implement Meaningful use. There are so many things the government wants you to report on MU and PQRS and from the seminars I’ve been attending more things are coming. On top of that trying to get my office ready for the ICD-10 change that’s now been delayed has only added to the stress of everything. It’s very time consuming to a practice to try and gather all of this information for the government. Physicians go to medical school to treat patients, and I feel that all of this “information” they require you to report is ridiculous. We have had to purchase two EHR systems within two years, due to unforseen circumstances that were out of our control. What the government does not understand is the time and money it takes to train the staff. I think the amount of money the government has spent on MU and PQRS enforcement is outrageous and could have been spent to allow better coverage for our Medicare patients. They say this is to make healthcare better for patients. How can something that takes away from patient care be good for patients? The only reason physicians are reporting this information is because they are being threatened with a pay cut. As usual our government uses threats to get the american people to do things even if they don’t want to.
Jason,
I thought that if you weren’t eligible for the MU incentive money, then you weren’t subject to the penalties. Is that not the case? Maybe I was just thinking logical and we’re talking about the government.
Kelly S,
Quite the story. I’d love to learn more. Especially about the two EHR in two years. Off the record if you prefer. Have you checked out Medicare non-par. I don’t know the details, but I know some are using that to avoid the penalties.
The only way to not take a pay cut is to be able to be exempt (ie population, no internet access etc). If you see Medicare/Medicaid patients and cannot justify an exemption to not attest you will take the cut. However, I totally agree that in many cases it makes more sense to take the cut and let your physicians practice medicine again.
Brought to you by the same wizards that set up healthcare.gov. Another example of the Emperor’s new clothes.
Thanks for commenting Natalie. I appreciate you sharing your insights.