Health IT On Congressional Chopping Block?

Experts outline several ways that healthcare could be affected by deficit reduction committee's $2.4 trillion in cuts to federal spending.
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The Healthcare Information and Management Systems Society (HIMSS) has released a fact sheet that outlines how the Joint Select Committee on Deficit Reduction (better known as the "Super Committee") mandate to cut federal spending may impact health IT.

The fact sheet was created in response to a number of phone calls to the organization from members and others who wanted to know if funds, such as those under the Medicare and Medicaid EHR Incentive Programs, would be cut by the Super Committee.

"The point of the paper is that everything, except for a few things, is on the table right now," Dave Roberts, HIMSS VP of government relations, told InformationWeek Healthcare.

Roberts said the fact sheet's intent is to alert people about what's happening in Washington D.C. without alarming them. The Budget Control Act of 2011, passed Aug. 2, specifies a multi-part process to reduce the federal deficit, and many people are concerned that federal funds for health IT (HIT) programs may be on the chopping block.

HIMSS noted that: "Congress and the President have given the Joint Committee authority to consider all federal programs (including normally protected programs such as Defense, Social Security, Medicare, and Medicaid), as well as potential revenue enhancements." The statement went on to say: "To date, there is uncertainty around implications of this Act for health IT, as there is for many federal programs, including Medicare, Medicaid, and other federal health programs."

The HIMSS fact sheet focused on three specific ways that cuts could occur as a consequence of interactions among three elements of the new deficit reduction process. The statement emphasized that:

-- The Act requires $2.4 trillion in spending cuts over the next decade, with provider payments for Medicare facing automatic reductions as much as 2% starting in 2013 if the Joint Committee process does not lead to at least $1.2 billion in savings over 10 years. The Joint Committee could enact specific cuts that reduce the ability of providers to acquire and implement HIT, despite the existence of the HIT incentive program. HIMSS said it's critical that the Joint Committee resolve the sustainable growth rate problem that will create a 29.5% cut in Medicare physician payments on January 1, 2012, absent Congressional action, in a way that maintains Medicare providers' ability to continue to provide high-quality healthcare and invest in needed technology.

-- The Joint Committee could specifically look to changes in the HIT incentive program as a means to achieve overall budget savings (along with the many other budget items that will be on the table). There are no specific indications that it will do so at this juncture.

-- If the Joint Committee's legislation is rejected by the House or Senate, the Act mandates an automatic 2% cut to Medicare payments to providers and health plans. Although the specific mechanics of such a sequestration have not been fleshed out, this action could reduce Medicare EHR incentives by 2% from what they otherwise would have been, leaving 98% of the incentive amount intact.

Roberts hopes the Joint Committee will understand that the money the federal government has assigned for health IT implementation is "worth the investment to the taxpayers." He also noted that there are many physician practices that are small businesses with very low profit margins. These practices are financially challenged and need federal assistance to implement EHRs so that they can avoid penalties after 2015. Furthermore, it is important to provide funds to healthcare organizations implementing health IT systems in rural and economically disadvantaged areas, he said.

"If you want to tell your elected officials something, tell them that when they are looking at how to resolve issues, health IT is not one of those issues that should be on the cutting table because of the value that it's providing in transforming healthcare," said Roberts.

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