The HITECH Act: One Size May Not Fit All

By: Jerry L. Stone

The Health Information Technology for Economic and Clinical Health Act (HITECH) is designed to accelerate the adoption of electronic health records and other health information technology. Physician practices, hospitals, and other health care providers are targeted to receive nearly $25 billion for the establishment of a national exchange of electronic health information. It looks like the first $5 billion will go to the National Coordinator for Health Information Technology (ONCHIT), within the Department of Health and Human Services, to set government standards and get things started. An additional $20 billion has been set aside as incentives to healthcare providers.

As incentives, the HITECH act states, in part, “…physicians will be eligible for $40,000 to $65,000 for showing that they are meaningfully using health information technology, such as through the reporting of quality measures.”

Below are the major areas as excerpted from the HITECH act:

 

“This bill accomplishes four major goals that advance the use of health information technology (Health IT), such as electronic health records by:

  • Requiring the government to take a leadership role to develop standards by 2010 that allow for the nationwide electronic exchange and use of health information to improve quality and coordination of care.

  • Investing $20 billion in health information technology infrastructure and Medicare and Medicaid incentives to encourage doctors and hospitals to use HIT to electronically exchange patients’ health information.

  • Saving the government $10 billion, and generating additional savings throughout the health sector, through improvements in quality of care and care coordination, and reductions in medical errors and duplicative care.

  • Strengthening Federal privacy and security law to protect identifiable health information from misuse as the health care sector increases use of Health IT.”

(Click Here to Download HITECH PDF)

For more than a decade MedicalGPS principals have worked with physicians in all sizes of groups and organizations. While neither I -- nor I’d guess anyone else for that matter -- can know exactly how the HITECH incentive money will be distributed, what does seem clear to me is; healthcare organizations with existing Healthcare IT will benefit first.

What’s likely to happen? Healthcare organizations that have previously implemented the use of an EMR or similar technology, and can demonstrate the “meaningful” use of that technology, may be eligible to receive HITECH incentive money for doing little or nothing different than what they are already doing. It seems to me that many, if not most large physician groups have long ago made capital investments in health information technology. If that is indeed the case – congratulations to all the early EMR adopters!! Imagine, a 250 physician group receiving, let’s say, $40,000 per physician. Do the math; that’s $10,000,000 going to just one group. It will be the large groups that quickly position themselves to receive their share of the HITECH incentive money.

Another section of the HITECH act reads:

 

“Incentive payments for both physicians and hospitals continue for several years, but are phased out over time. Eventually, Medicare payments are reduced for physicians and hospitals that do not use a certified electronic health records that allow them to electronically communicate with others.”


What happens to the small, one or two physician practice? Wait too long to implement a certified electronic health record and instead of receiving an incentive, a small physician group may face even deeper cuts in reimbursement as Medicare payments are reduced.

I also understand that for a nominal fee a government sponsored EMR will be made available to providers. Here’s the excerpt I’m referring to:

 

“After standards are adopted in 2009, the National Coordinator shall make available at a nominal fee an electronic health record, unless the Secretary determines that the needs and demands of providers are being substantially and adequately met by the marketplace. ”


If the fee is going to be “nominal”, then why does the act also include federal money going to State governments to make low interest loans and grants available to providers?

Another excerpt:

 

“The legislation also provides additional funds to States for low-interest loans to help providers finance health information technology and grants to regional health information exchanges to unite local providers. Grants are also offered for the development and adoption of electronic health records for providers other than physicians and hospitals. ”


As a Healthcare Information Technology company, MedicalGPS, LLC specializes in providing efficient, cost effective information technology solutions to healthcare providers. Please understand, we look forward to the HITECH ‘stimulus’ money coming into the healthcare sector -- we hope it benefits provider groups of all sizes, both large and small. Our desire is your desire; improved delivery of healthcare to patients.

Here’s what we do know: When good technology is laid on-top of inefficient, broken processes, the technology has little or no impact. We believe one patient being in a meaningful relationship with one provider, functioning from within an efficient overall process aided by good technology, will ultimately prove to be the successful solution.

As you and your healthcare organization begin to sort-out what the HITECH Act may mean for you, MedicalGPS stands ready to assist as needed. Please give us a call at 615-467-6338 or Contact One of Our Principals – we’d love to work with you!

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