Anyone not living under a rock during the past decade knows that relations between the two major national political parties have been contentious, with partisanship scuttling many pieces of legislation in the U.S. Congress. This partisanship means that the limited areas of “common ground” attract attention. One such area is healthcare IT.
In fact, if recent legislative developments are a harbinger, some movement in areas such as e-prescribing, financial support or incentives for EMR development — and perhaps pay-for-performance expansion under Medicare — seems very possible, say those in the know. Take for example the Medicare Improvements for Patients and Providers Act of 2008 (H.R. 6331), which passed in both houses of Congress this summer, and sustained an override of President George W. Bush's veto. Among the numerous provisions of the bill, was a provision calling for financial incentives for e-prescribing, inserted into the legislation late in its gestation by Rep. Allyson Schwartz (D-Pa.).
“Getting the electronic prescribing element in the Medicare bill shows that the opportunity to improve accountability and quality, to save lives and to save money, is doable,” says Schwartz, who represents the 13th congressional district of Pennsylvania.
“Both parties are very interested in healthcare information technology and its use,” Schwartz continues. “All of the stakeholders are also very interested in leveraging information technology in order to improve the delivery of healthcare, and to provide more timely information to patients and providers.”
In terms of the specifics of federal funding for EMR development, Schwartz says, “I think there's a very high likelihood” of passage of such legislation either later this year or in the next Congress. “Of course, it depends on who the president is,” she says. “But we've made this a very high priority. There's increasing recognition of the tremendous value in this. And certainly, as a member of the Ways and Means Committee, I realize that Medicare needs to find ways to achieve quality and cost savings. And this is a tremendous opportunity to do both.”
Another member of the U.S. House of Representatives leading the charge on healthcare IT legislation is Rep. Dennis Moore (D.-Kan.). He says the time is ripe for legislation that will improve patient care, improve service to healthcare consumers, and make the healthcare system more efficient. Moore's bill, H.R. 2991, the Independent Health Record Trust Act, calls for patients to receive electronic copies of their records.
As Moore, who represents a suburban area of Kansas City, puts it, “This would allow the establishment of a nationwide system of electronic medical records.” In practice, if passed, Moore's bill could advance the cause of personal health records (PHRs), while leaving the broader issue of a nationwide EMR mandate untouched — though hinted at, unless more specific language were written into the bill after its passage.
In fact, “That same legislation is being implemented in the state of Washington,” notes Dave Roberts, vice president for government relations at the Healthcare Information and Management Systems Society (HIMSS, Chicago). “What's interesting is that (Moore) is proposing to have these independent repositories of health records around the country, and people would be able to plug into those,” says Roberts, who officially works out of HIMSs' Washington office in Arlington, Va., but is based in Solana Beach, Calif.
Meanwhile, in the Senate, John Kerry (D-Mass.) and John Ensign (R-Nev.) are cosponsoring S.B.2408 / H.R. 4295 (Rep. Schwartz is sponsoring the House version of the bill, H.R. 4295) which would give physicians a 1 percent bonus payment for every claim submitted based on an e-prescription. The legislation, known as the Medicare Electronic Medication and Safety Protection Act, also would impose a pre-claim financial penalty on physicians who continue to handwrite prescriptions as of Jan. 1, 2011, though it would also give the Department of Health and Human Services the authority to grant one- or two-year hardship waivers for individual physicians.
During a Dec. 5 press conference in Washington announcing the introduction of the legislation, Kerry said, “Electronic prescribing does save lives, it does save money, and it is an enormously effective way of beginning to move toward the information technology age.” Kerry's press secretary, Whitney Smith, adds, “Bringing the healthcare system into the 21st century's digital age is a top priority for Sen. Kerry. The eRx law shows that Democrats and Republicans can stand together to modernize healthcare, saving lives and money. The next step is to use the eRx carrot-and-stick approach to drive broader adoption of health IT, including computerized physician order entry in hospitals and fully functional and interoperable electronic medical records.”
Not surprisingly, this bill was easy for members of the opposite party to sign onto. As Tory Mazzola, communications director for Ensign put it, “Too often, when the issue of healthcare comes up, it falls along partisan lines, because quite frankly, the Democrats keep trying to push government-sponsored, Washington-controlled healthcare. Senator Ensign disagrees with that. Fortunately, e-prescribing is one of the issues that doesn't fall along those lines; it has broad bipartisan support. And fortunately, it makes passage much more likely.”