The American Recovery and Reinvestment Act of 2009 (“ARRA”) provided over $2 Billion Dollars in financial incentives to motivate hospitals and physicians (“Providers”) to adopt the Electronic Health Records (“EHR”). The incentive money was designed to encourage Providers to purchase, adopt and more importantly implement the EHR to improve the overall quality of care, reduce medical errors and improve the clinical care coordination between Providers. In order to ensure that Providers are using an EHR system to achieve these goals, the Providers are required to report on specific measures.
The measures focus on (1) improving quality, safety, efficiencies and reducing health disparities, (2) engaging the patients, (3) improving care coordination among providers, (4) improving public health; and (5) ensuring privacy and security protections of patient information. Upon achieving these measures, the Provider can attest to the government that they are a “meaningful user” and obtain financial incentives.
In order to achieve the measures, the Providers behavior must change. As with all change, adopting and implementing EHR impacts the way that providers act, schedule and treat their patients. The greatest impact of meaningful use is the change in how healthcare is documented, exchanged and how patients and other providers are engaged in the overall delivery of care to a patient. Many providers have complained that the EHR requires so much data entry that physicians are slower and therefore see less patients per day (i.e. less revenue generation). Many Providers have questioned whether it is worth the financial incentives to implement an EHR if it slows them down and introduces change and additional complexities to their practice.
However, Providers should focus on the fact that these financial dollars are in stark contrast to other public policy initiatives that reduce reimbursement and this the first step to being viable in the future. Specifically, the meaningful use policy priorities dovetail into other governmental programs that will impact Provider reimbursement.
For example, the Patient Protection and Affordable Care Act of 2010 (“Healthcare Reform Act”) created multiple payment reform models. One such model is the Accountable Care Organization (“ACO”) which is designed to share savings with Providers that can be achieved by a group of Providers coordinating the care and reducing the costs for at least 5000 Medicare beneficiaries. The shared savings are only possible if the Providers achieve quality benchmarks that interestingly, correspond with the meaningful use measures and policy priorities.
Further, at least fifty percent (50%) of the primary care physicians in the ACO must achieve meaningful use for the ACO to be eligible to share in the savings. Thus, in order to establish a successful ACO, the meaningful use measures are part of the foundation and this is just the beginning. Providers should anticipate the integration of meaningful use measures in many of the payment reform models forthcoming and it is better to start now while there is a financial carrot before the financial stick emerges.