The chorus is growing and getting louder. A bipartisan group of 27 U.S. senators are calling on CMS to relax some of the requirements to achieve meaningful use and adopt a more manageable implementation process.
I can appreciate CMS' desire to lay down an aggressive timeline and criteria. The industry needs a thorough, iron-fisted plan. CMS needs to demonstrate its seriousness and transform the government's reputation for being too slow, especially where technology is concerned, but it's time for the middle ground. Think of the ultimate goal. The goal is to drive health IT adoption. It's not so much a technology issue as it is an execution issue: If we don't execute properly and carefully, we all lose.
I agree with the senators that physicians who practice in outpatient centers and clinics that are located in facilities owned by a hospital system should not be excluded from eligibility. In addition, I agree that multi-campus hospitals should not be counted as one entity because they all share one federal provider number. The amount of money that would have to be split among several facilities would not make the effort worthwhile.
Perhaps someone in the community can enlighten me as to why critical access hospitals are excluded from being eligible for incentive payments. The senators certainly have a bone of contention here.
I spoke with the folks at the American Hospital Association, the California Hospital Association and the Texas Hospital Association about the state of hospitals today. With regard to the federal stimulus program, all of them say that their constituents are concerned they will not be able to meet the criteria on time. Those who were voicing these concerns were the large institutions, which do have the IT infrastructure and resources, so imagine where the rural community hospitals and clinics stand on this issue.
Relax and delay. If CMS and HHS agree to those two overarching recommendations, the next step is determining where to relax and delay so that consensus - not just the senators' concerns but other stakeholders - is garnered and the intent of driving health IT adoption is not weakened. As they say, the devil is in the details.
