The fed's health IT incentive program will continue, along with related programs, but one prominent analyst suggests the biggest threat to the EHR incentive program now is the 'fiscal cliff.'

Ken Terry, Contributor

November 8, 2012

4 Min Read

IW 500: 10 Healthcare IT Innovators

IW 500: 10 Healthcare IT Innovators

IW 500: 10 Healthcare IT Innovators (click image for larger view and for slideshow)

The day after President Obama was re-elected and Democrats held onto control of the U.S. Senate, the future looked bright to folks in the health IT field.

The election outcome suggested that attacks on the government's electronic health record incentive program by Congressional Republicans may lose steam or disappear altogether. Coincidentally, the Health IT Policy Committee met on Oct. 7 to discuss a draft of its Meaningful Use Stage 3 recommendations.

Robin Raiford, research director for the Meaningful Use practice of the Advisory Board Co., a healthcare consulting firm, listened in on the committee meeting, which was chaired by Farzad Mostashari, national coordinator of health IT. The tenor of the discussion, she told Information Week Healthcare, was that the committee would "move forward and finish the work that's been started."

Raiford was elated. "Like many other people working in this space, I hoped that the momentum would not stop. So it was a great relief to know it would continue on."

Even before the election, she said, she hadn't expected abrupt changes in federal support for health IT, no matter who won. One reason for this stability, she noted, is that the HITECH Act authorizing the EHR incentive program -- part of the American Recovery and Reinvestment Act -- can't be changed or repealed by executive order.

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For the same reason, Congressional critics of the incentive program, which to date has disbursed about $7.7 billion, can't force the Department of Health and Human Services to suspend the payments unless they can muster enough political support to repeal the law. That could have happened only if there had been a Republican sweep of Congress and the White House.

Raiford also questioned the grounds on which four House committee and subcommittee chairs complained about the program to Health and Human Services Secretary Kathleen Sebelius. The Republican leaders charged that there had been insufficient progress toward interoperability, but Raiford noted that "[the Office of the National Coordinator of Health IT] had to start somewhere. They couldn't just choke folks and say, 'this is what we're going to do.'"

The biggest threat to the EHR incentive program now, Raiford said, is the "fiscal cliff" over spending and taxes that the country is facing. With the gridlock in Congress between Democrats and Republicans, she expects a fierce battle over what will have to be cut to reduce the deficit. But given the success to date of the EHR incentive program, she said, it will be difficult for Congressional leaders to come up with a reason to kill it.

Hurricane Sandy might provide another reason to preserve the program, Raiford noted. Contrasting the widespread loss of medical records in New Orleans after Hurricane Katrina with the survival of records after Sandy, because of a health information exchange in New York, she said, "You have to think about what it means when you see those little newborn babies being evacuated [from NYU Langone Medical Center]. You have to bring data to life, as Farzad said today."

Raiford also pointed out that the government is likely to recover some or all of the funds it's now expending on health IT, if only in penalties. ""Where the money is going to come from [to fund the incentive program] is the people who don't show Meaningful Use and start paying it back in payment adjustments, starting in 2015. That money will be huge if people don't keep up. That money will trump the incentives by far."

Health IT will also benefit healthcare providers in many other ways, she noted. Once physicians get past the learning curve, it helps make them more efficient, which will enable them to see more patients when demand starts rising because of the Affordable Care Act.

Also, Raiford said, health IT will help healthcare organizations improve quality and lower costs, which will not only benefit patients but also enable them to do well under Medicare's value-based reimbursement program.

For these and other reasons, she said, health IT should continue growing at its current rate for some time to come. "For any of those programs, from shared savings to value-based purchasing to Meaningful Use -- for any of that, you can't get there on paper."

InformationWeek Healthcare brought together eight top IT execs to discuss BYOD, Meaningful Use, accountable care, and other contentious issues. Also in the new, all-digital CIO Roundtable issue: Why use IT systems to help cut medical costs if physicians ignore the cost of the care they provide? (Free with registration.)

About the Author(s)

Ken Terry


Ken Terry is a freelance healthcare writer, specializing in health IT. A former technology editor of Medical Economics Magazine, he is also the author of the book Rx For Healthcare Reform.

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