Three bipartisan bills introduced in Congress since May 10 would help establish universal use of electronic health records by "paving the highway" and helping physicians "buy the cars."
Two proposals focus on infrastructure but give a nod to encouraging physician investment in health information technology. The third focuses on providing incentives to physicians who buy the EHR hardware, software and training services.
The most recent proposal, the Health Technology to Enhance Quality Act of 2005, or Health TEQ Act, was announced June 16 by Sens. Bill Frist, R-Tenn., and Hillary Clinton, D-N.Y. It calls for federal grants to help establish regional health technology systems that are both secure and interoperable among all health care professionals and facilities. The bill also would launch pay for performance pilot programs under Medicare; establish a similar program for Medicaid; and work to establish uniform quality measures through Veterans Affairs, HHS and the Department of Defense.
The bill's provisions "appropriately focus on developing the network necessary to support the exchange of a patient's health information in a way that assures privacy and flexibility," said AAFP Board Chair Michael Fleming, M.D., of Shreveport, La., in a letter to Frist and Clinton.
The Health TEQ Act comes on the heels of the Health Information Technology Act, or Health-Tech Act, introduced June 13 by Sens. Olympia Snowe, R-Maine, and Debbie Stabenow, D-Mich.
Strongly endorsed in a letter from Fleming, the Health-Tech Act would provide grants of up to $15,000 to physicians, tax incentives and restructured Medicare payments for physicians who purchase, implement or improve their electronic health records systems.
Likewise, the 21st Century Health Information Act of 2005, introduced May 10 by U.S. Reps. Timothy Murphy, R-Pa., and Patrick Kennedy, D-R.I, garnered Academy support. Now referred to the House Energy and Commerce Subcommittee on Health, the Murphy-Kennedy bill resembles the Frist-Clinton proposal by focusing on the EHR infrastructure and adjusting Medicare payments for physicians who participate in an accredited information technology network.
"If the (Murphy-Kennedy) bill passes, it will remove the barriers preventing hospitals from sharing technology with local physicians and will permit Medicare and Medicaid to reimburse physicians for acquiring health IT and participating in health information networks," said David C. Kibbe, M.D., director of the AAFP Center for Health Information Technology, in a statement.
"The Frist-Clinton bill is like a highway construction bill," said Kevin Burke, director of the AAFP Division of Government Relations. "The Snowe-Stabenow bill is like providing subsidies for the cars. And the Murphy-Kennedy bill is a mixture of both."
Though the Academy generally supports the intent of all three proposals, it does have reservations about the Frist-Clinton bill's pay-for-performance clauses, according to Burke. Generally, those provisions call for pay-for-performance programs to be budget-neutral, which policies oppose.
