HIT Voices: The Policy Challenges Facing Health IT Leaders (Part 3)

Without any timing [on the part of the federal government], the possibility of that lower part being a bigger chunk will be much greater. We jokingly called it ‘no hospital left behind.’ There will always be people who will lag and not want to do this. It’s ‘don’t leave anyone behind that wants to be a part of this.’ Let’s give this a reasonable shot of being successful.

We’ve offered several timing differences that we think either one works within the legislative construct. We shared that with the senior team at both the CMS [Centers for Medicare & Medicaid Services] and the ONC [Office of the National Coordination for Health IT], both in an initial blush said they could see how this [their altered timeline] would work, they didn’t say they necessarily wanted it work. Even some of the most recent rhetoric [from the government] at the Finance Committee Hearing was about not slowing down and putting pedals to the metal, does serve some concern on our part. Is that just political fodder?

Hickman: What will happen is you’ll see a lesser success rate of meeting the incentive over the next year. That will happen if they don’t make an adjustment. Then you have to question, is it about performance of the organizations or is it about policy?

If you are an eligible physician or you’re implementing that sort of ambulatory record, you earn that incentive money one doctor at a time. You have to have the EHR in place, the elements of support in place, the exchange, portal, and the transitions of care and then you are attesting doctor at a time. So depending on behavior of physician and that clinic, you can still get incremental money. It may be that you earned a million and a half in incentive money last year, well maybe that number goes down some because you don’t have as many doctors that are able to meet the bar. However, if don’t get all of the elements to meet the bar, you lose it all. The hospitals work that way to start, it’s all or nothing. You have to get the elements in place to get the incentive money. It is an all or nothing game. In terms of the  money on the table and the risks of collecting incentives, it is greatly increased.

Branzell: I’ve heard from several CIOs, who were early adopters of Stage 1 and have advanced electronic environments, and they are saying, ‘Why should we do Stage 2 considering the financial risk of ICD-10?’”