Incentive Payments Meant to Jump-start 'Meaningful Use' of EHRs

The federal government's push for physician implementation of electronic health record, or EHR, technology is all about facilitating the delivery of higher-quality health care and supporting early detection of illness. And that's a change from how America's "chronic sick care" system long has operated, said CMS Regional Administrator Jeff Hinson, who delivered the keynote address at the Second Annual Electronic Health Records Forum held here Nov. 2-3.

During the address, the Denver-based Hinson focused primarily on CMS' final EHR "meaningful use" rule that the agency issued on July 13. He cautioned health care professionals to think of the government's EHR bonuses as a "starting pointing" rather than a final destination.

"It's an incentive, a motivation to get folks off the stump and thinking about where do we go next," said Hinson. Meaningful use is in its infancy, and health care system reform and transformation will span an eight-year timeline from 2011-2019, he added. Although the EHR incentive programs were written into the American Recovery and Reinvestment Act, said Hinson, health information technology, or health IT, will play a mighty role in implementing health care reform.

"Without EHR systems in medical practices, CMS can't achieve the necessary cost savings that will move CMS from paying piecemeal for health care to paying for quality outcomes," said Hinson.

According to Hinson, CMS has a "triple set of goals" when it comes to use of health IT in health care:

However, said Hinson, the measure of each American's health status -- be it good or bad -- is determined by a combination of personal lifestyle patterns and genetic makeup. If lifestyle accounts for about 60 percent of that equation, said Hinson, "People need to take personal responsibility for their health."

Regarding EHR incentive money that physicians can earn, Hinson said, "It's not a lot of money, but it will get the focus off of "sick care."

He noted that physicians often ask him when they'll see a return on their investment in EHR technology. He could not offer a clear-cut answer but acknowledged that, if he could, he'd go back to Congress and say, "We need more money."

Why? Because evidence shows that when organizations (and physician practices) have good data -- collected and made accessible via an EHR -- and begin to use it appropriately, their health care costs go down and the quality of care goes up, said Hinson.

He acknowledged that barriers still exist that keep physicians from implementing EHRs and adopting meaningful use criteria, but he reminded the audience that CMS would begin rewarding physicians who comply with EHR meaningful use rules by paying them bonuses in May 2011.

"We're hoping that the early implementers will energize everyone else. If we have lower numbers (of participants) than expected, what are we going to do? We'll have to keep pushing," said Hinson.

Following Hinson's remarks, a three-member panel that included Steven Waldren, M.D., director of the Academy's Center for Health IT, discussed how health care professionals could best meet CMS' aggressive timeline for implementation and meaningful use of EHRs.

Waldren noted that physicians first must build success in their practices. "They must be financially stable, have a good team working together and then drop health IT in on top of that," he said.

About 60 percent of AAFP members have implemented EHRs, a percentage that puts FPs way ahead of the 16 percent national average referred to by Hinson in his presentation, said Waldren.

However, family physicians must overcome the same hurdles as other EHR implementers. Waldren said the technology is not necessarily "built for the new world of meaningful use regulations," and that physicians "have their feet stuck in two different worlds."

"We want to make sure that family physicians can jump across that chasm," and land squarely on both feet with an EHR that captures the concept of patient-centered care, said Waldren

"I tell family physicians that they need e-prescribing, a point-of-care registry and a patient portal in their EHR systems. If they do those three things, they've got stage one of meaningful use covered."

The EHR forum was presented by the Center for Business Intelligence, a Massachusetts-based company whose health care conferences highlight industry trends and provide attendees an opportunity to network with leading policymakers.