Ohio wants its commercial payers to incentivize physicians to adopt EHRs in the same way that CMS is incentivizing physicians through the federal stimulus programs. It makes sense.
To reach full adoption you need all payers - commercial and public - not just part of the market rewarding meaningful use of EHRs.
For physicians whose patient mix is mostly Medicaid or Medicare, the federal program is enough. For others whose patient mix is mostly commercial, the incentive program is not as attractive.
Some have said competition is keeping payers from following the early adopting payers who have EHR systems and are able to automate eligibility verification and enable network providers to file claims remotely. Payers worry about sharing too much data. This shouldn't be a concern in terms of losing market share because of data exposure. In fact, payers would benefit with the increased efficiency, benefitting providers and members. Theoretically that would lead to market share gains.
Payers say it's not a matter of competition. It is - surprise - a financial issue, which means payers have to be incentivized, too. What does that mean? The new healthcare reform law says that the medical loss ratio requires that 80 percent to 85 percent of health premiums must be spent on medical care. Advocates are saying the federal government should allow them to include the cost of EHR adoption efforts in the medical loss ratio.
Is that a fair trade? If you want widespread EHR adoption, the answer is yes. Administering and monitoring a program that oversees how that money is being spent, however, is critical. This should not be a ka-ching moment for payers. Accountability and reporting are key.
EHR adoption cuts down administrative costs, with payers being a major beneficiary. Some would argue that the benefits alone should drive payers to create incentive programs and that medical loss ratio ought not to be tinkered.
Tell us what you think about getting commercial payers involved in an incentive program. It's certainly an interesting concept.
Photo by Southerntabitha via Creative Commons license.
