They say as the Centers for Medicare & Medicaid Services goes, so goes the rest of the payer industry. CMS is close to releasing the final meaningful use criteria. There are rumblings out in the marketplace that commercial payers are putting meaningful use criteria in their physician contracts.
Trying to get physicians to adopt EMRs has been attempted before. The most visible effort is the Massachusetts healthcare reform legislation of 2008. Lawmakers are requiring all physicians in the commonwealth to use EMRs by 2015. According to the president of the Massachusetts Medical Society, general fear and the belief that EMRs didn't fit their workflow were the main barriers to adoption.
In the case of commercial payers, the push for EHR adoption was presented as a requirement for their pay-for-performance (P4) programs. While I don't know the aggregate results of having such a criterion for P4P, the incentives likely were not big enough to justify the cost.
In a few short years, however, things have changed dramatically. In fact, two things have made a significant difference in the industry: The federal stimulus funds that will be administered by CMS and the aggressive move to develop industry standards for EMRs. While the $44,000 amount may be pennies for some of the larger healthcare organizations, it's much larger than previous incentives.
America's Health Insurance Plans (AHIP) says it's not aware of the movement for commercial payers to include an EMR requirement in their physician contracts. Maybe it's not a movement now, but it sounds like there are some that are running with it. Have any physician groups or healthcare systems seen the requirement in their contracts?
Is it a good idea for commercial payers to make it a requirement? If you believe health IT can improve the quality of care and patient safety, and make healthcare delivery more efficient, then yes, it makes sense for all payers to make it a requirement. CMS has a big chunk of the payer market, but it can't successfully move the industry to health IT adoption by itself.
Photo by joostj.bakkerIJMuiden obtained via Creative Commons license.
