| Incentive Programs For EHR Adoption Growing
Momentum is building behind incentives for physicians to
adopt electronic health records (EHRs) in their medical practices,
boosted by the assurance that EHR software approved by the
Certification Commission for Healthcare Information Technology (CCHIT)
can deliver concrete benefits.
In its first search for programs that have sprung up to
subsidize physician adoption of health information technology over the
past two years, the Certification Commission found 90 initiatives in
the public and private sectors. The 90 programs in the CCHIT Incentive
Index catalog represent at least $700 million in potential funding for
EHR software and implementation costs. Of those programs:
- 50 have been launched by hospital organizations in
response to federal "safe harbor" regulationsannounced in 2006. Under
those rules, hospitals can subsidize up to 85 percent of certain costs
for physicians to acquire, implement and maintain EHRs which are CCHIT
certified for their offices.
- 40 incentive programs are being offered by government
agencies, insurance plans, employer coalitions and public-private
partnerships, of which 20 explicitly call for CCHIT-certified
technology.
For the rest, the certification of EHR products constitutes a first step in the selection process.
"As we dug deeper to research the real impacts of
certification, the results surprised us, as we found many more
incentive programs – and more funding – to be available
than we expected at this point," said Dr. Mark Leavitt, commission
chair."Although we started our first certification in ambulatory care
just 2½ years ago, we’re already seeing evidence of a
major redirection of investment toward adoption of EHRs in that
setting."
Bridges to Excellence offers bonuses for use of
CCHIT-certified EHRs. Most recently, Bridges to Excellence has chosen
to use a CCHIT-certified EHR as sufficient qualification to demonstrate
use of electronic information at levels that put physicians in line for
monetary bonuses as a reward for superior management of patients with
chronic ailments.
Two of the Newtown, Conn.-based organization’s
programs reward physicians who systematically organize their practices
to monitor the health of their patients and intervene expeditiously to
prevent or lessen the effects of problems associated with chronic
illnesses. By using a CCHIT-certified EHR, physicians under the
Physician Office Link program can get up to a $50 bonus per year for
each patient whose treatment meets expectations of at least one
clinical improvement program, such as for diabetes, heart or back-pain
care. Alternatively, physicians can get up to $125 per year for each
patient treated under a new program rewarding superior results of care
provided under a comprehensive patient management approach known as the
"medical home" care model.
"Transforming a physician practice into a 21st century
patient-centered care center requires a significant amount of time and
money on the part of the physicians in that practice," said
François de Brantes, CEO of Bridges to Excellence. "Our research
shows that the results in higher quality and lower cost of care are
worth the effort, and we have to make the process of being recognized
for that effort as hassle-free as possible. Leveraging the CCHIT
certification helps us do just that without sacrificing the rigor of
the overall assessment of the practice’s transformation."
The Bridges to Excellence pay-for-performance initiative
is supported by 80 participating purchasers of healthcare for their
employees, including computer giants Cisco, Intel and Oracle;
telecommunication companies AT&T and Verizon; and large employers
General Electric, 3M, UPS and IBM. The participating employers support
rewards and quality recognition through health plans in 16 state or
regional healthcare markets. More than 12,000 physicians have been
recognized through this initiative.
Information from the newly compiled CCHIT Incentive
Index shows that at least 43,000 physicians are being offered subsidies
or participation in state or local initiatives. This is a conservative
estimate; numbers of physicians affected by the programs were either
available or calculable in 41 of the 90 total programs identified, said
John Morrissey, the report’s author and the commission’s
communication manager.
Equally conservative is the finding that incentive
programs are pouring at least $700 million into the healthcare field
for adoption of EHRs and other health IT; that figure is based on 36
programsreporting current and anticipated financial investments and
commitments.
The programs include the federal government’s
biggest initiative to date, the $150 million Medicare demonstration
project that will provide incentive payments to 1,200 physician
practices for using certified EHRs to improve quality of patient care.
The largest known regional commitment to accelerate adoption of
certified interoperable EHRs is in New York, which is distributing $157
million already to regional networks and community alliances of
physician practices representing more than 18,000 physicians and is
poised to announce a new round of funding in November.
"New York is making unprecedented public investment in a
statewide health information infrastructure. Having technical
accountability mechanisms in place like CCHIT certification for
interoperable EHRs, including electronic prescribing, is necessary to
help ensure clinicians and patients are realizing value and the
public’s investment produces the expected quality and efficiency
gains," said Lori M. Evans, deputy commissioner of the New York
Department of Health’s Office of Health Information Technology
Transformation. "The progress of CCHIT is also a key part of the
equation to advance new reimbursement models that require standardized
information from certified EHRs to assess outcomes and performance."
Adoption-incentive activity is especially high in the Northeast, from New York City up through New England. For example:
- New York City’s Primary Care Information
Project has committed $60 million, mainly to physicians who work in
high-poverty areas.
- Vermont has established a health IT fund expected to
raise $32 million over seven years as a stable source of public funding
for EHRs and operation of a statewide health information exchange.
- Massachusetts has passed a law appropriating $25
million to launch a statewide EHR system, in which hospitals and
community health centers must participate by 2015. The same law
requires hospitals to implement CCHIT- certified systems for
computerized provider order entry by 2012.
Many of the programs place special emphasis on providing EHR capabilities to rural and medically underserved areas.
Two examples are: Hawaii, where the state’s Blue
Cross Blue Shield plan has committed $20 million to finance up to half
the cost of an EHR for about 1,000 physicians, capped at $20,000 per
physician.
The Pacific Northwest, where a public-private
partnership granted $1 million in 2007 to 52 clinics, physician
practices and community health IT projects in Washington, Oregon, Idaho
and Alaska.
Address: Certification Commission for Healthcare
Information Technology, 200 S. Wacker Dr., Suite 3100, Chicago, IL
60606; (312) 674-4930, www.cchit.org.
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