Is the IT Bar Set too High?
Has the federal government set the bar too high for EHR adoption?
Both the meaningful use and PQRI programs have reported disappointing numbers recently. The American Medical News reported last week that
A recent report from CMS shows that fewer than 200,000 physicians, out of the more than 600,000 who were eligible for the (PQRI) incentive program, reported PQRS measures in 2010. More than 125,000 physicians reporting as individuals met enough of the requirements to share a total of nearly $400 million in bonuses, but hundreds of thousands of eligible doctors did not attempt to meet the pay-for-reporting criteria. More than 50,000 tried for the bonuses but did not report enough quality measures to hit the minimum.
The article notes that this low participation rate means a “huge segment” of physicians caring for Medicare patients will soon be penalized. In essence, 2012 is the last year without penalties. In 2013 physicians must begin reporting quality measures, or they will face a 1.5% noncompliance penalty. The penalty is not scheduled to be assessed until 2015, but it will be based on 2013 reporting.
Physicians face yet more penalties, according to the article.
In addition to the 2015 PQRS penalty, Medicare rates would be reduced by 1% that year for those who do not achieve meaningful use of an electronic health record system. CMS also plans to adjust pay with a value-based modifier for physicians starting in 2015. The modifier would increase pay for some doctors who are deemed to provide high-quality, efficient care, but it would decrease rates for an as-yet-unknown pool of other physicians.
The Medicare EHR meaningful use program, which jumped off to a strong start in 2011, has slowed considerably in recent months. Combined registrations by eligible professionals (physicians) for the Medicare and Medicaid EHR incentive programs dropped in April to 12,228, down 12% compared with March numbers. Through May some 155,000 physicians had registered for the Medicare program and 56,214 had qualified. Those qualifying earned $953 million in incentive payments.
The AMA and a number of other organizations want the deadlines for both the PQRI and meaningful use programs pushed back by a year or more.
Would a change of administration make a difference in the programs? Would President Romney take a more “hands off” approach
Probably. Remember that President Bush mentioned EHRs in seven out of eight state-of-the-union messages, but his administration did very little (with either incentives or penalties) to stimulate adoption.