The concept of linking payment to higher quality, more efficient healthcare may finally be turning the corner. The success of this payment model requires buy-in from payers and the application of the model across all providers.
As the biggest payer in the country, the Centers for Medicare & Medicaid Services (CMS) carries a lot of influence in terms of moving the market in a certain direction. It usually begins with a demonstration project and awards.
The Dept. of Health and Human Services awarded its latest contract to George Washington University to study healthcare reimbursement incentive approaches. The agency is hoping it can bring these approaches to safety-net providers - federally qualified health centers, rural clinics and free clinics - who are unable to participate in quality incentive programs because their payment method and forms aren’t aligned with program requirements, such as the collection of certain data elements.
Through ARRA and the HITECH Act, the federal government established healthcare IT adoption programs with financial backing. One of the necessary conditions for the success of true healthcare IT adoption, however, is payers reimbursing providers for the use of healthcare IT to improve quality of care and clinical outcomes. It also requires equality so that all providers, especially those who serve medically underserved communities, can participate in these programs.
The other part of the contract will enable George Washington University to study the impact of EHRs and how to drive greater adoption of EHRs in communities that have a greater degree of health disparities. These communities typically have a lower socio-economic population and are being served by safety-net providers. So the two parts of the contract are intertwined.
Let’s hope George Washington University can come up with some viable reimbursement solutions that can bring safety-net providers into the fold. It's not only good for the providers, but it will truly drive quality healthcare in communities that need it the most.
