Particularly over the next few months, with the presidential election looming and the aftermath underway, I doubt we’ll see any changes to the Meaningful Use program. But it’s worth asking nonetheless, given the recent request by some Congressmen that HHS halt the MU program, what would happen if MU incentive payments suddenly came to a halt.
Here’s a few observations based on what we know or can easily guess right now:
1. The effects would be very widespread.
As HIMSS notes in its press release opposing the cut:
“Recently-released CMS data show that over 2,700 Eligible Hospitals and 73,000 Eligible Professionals have attested to Meaningful Use Stage 1 requirements since the incentive program began in 2011.”
I don’t know what percentage of EPs that represents, but that’s approaching roughly half of all U.S. hospitals, depending on which ones you count. Pulling back incentives would slam the other half.
2. Efforts to bring rural/critical access hospitals on board would stall.
ONC is just kicking off a program to have all 1,000 critical access/small rural hospitals meaningfully using health IT by 2014. (More to follow on this on our sister site HospitalEMRandEHR.com.) While big hospitals might move ahead on their efforts for other reasons, these smaller hospitals probably wouldn’t have the means to do so.
According to HIMSS data, such hospitals are already way behind when it comes to health IT adoption. A halt in incentive payments could only make this worse.
3. Future incentives would be viewed with suspicion.
I don’t know about you, but if I was promised incentives for taking on a very, very expensive and rigorous process, had them pulled back, then had them restored, I’d lose trust in the Meaningful Use program. ‘Nuff said.
4. EMR adoption would lose momentum.
Hospitals and eligible providers have taken on big expenses and risks to bring on EMRs and supporting health IT, but if they don’t see the promised incentives as being completely predictable, they might slow or stop their efforts. How much so would depend on how committed they already were, of course, but the EMR adoption process would lose momentum.
Incentives are giving many hospitals and EPs an excuse to move forward, and without that many might sit on their hands for a while.
What other effects do you think it would have if the incentive payments stopped flowing for a while?
A couple of points:
1. The program will not stop. There is little support for the incentive program to stop. Rather than setting off a demand for halting, the letter has shown the buy in from a variety of sources.
2. The letter is contradictory. It cites as a harm of EHRs the Times article about upgrading, as if that were dispositive of the issue. It then asks for higher standards of compliance. Reminds me of the old line about school food, “it’s terrible and the portions are too small.”
3. The good members missed an opportunity for a good discussion on MU’s standards. Their call for higher standards of compliance without calling for a halt could have been helpful. After all, it’s not every day that Republicans ask for more not less stringent government standards. They might have even garnered some Democratic cosigners, which would have raised the discussion out of the partisan area.
Active government incentives rarely work well in the long term. Attempts to rush any technology most often ends up being wasteful (think green energy). And of course government incentives also mean the government gets to set the terms.
EMRs will eventually be adopted simply because there is a cost saving to doing so over paper records. The free market will always provide better long-term value.
‘Attempts to rush any technology most often ends up being wasteful (think green energy).”
Like the Manhattan Project, the Apollo Project, GPS Systems, the Salk Vaccine, the Transcontinental Railroad, the Panama Canal, etc., etc?
IF this happened it would slow things down – but any vendors who raised their fees because of MU money might back off a bit. In the meantime, that this program is limited to CMS (Medicaid and Medicare) means that doctors with few such patients have no financial incentive worth noting to adopt EHRs.
Any technology for EMR without testing proof positive would be wasteful don’t you think? My thought is with the baby boomers on the rise, the MU incentive between Medicaid and Medicare may be the best prototype. It would also help to have more stringent government standards to work through this process.