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Can RECs Become Self-Sustaining?

February 15, 2010
by David Raths
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With last Friday’s announcement of the first 32 regional extension center (REC) grant winners, some health IT groups were ready to hit the ground running.

A look at the list of organizations reveals that the Office of the National Coordinator for Health Information Technology was not locked in on just one type of organization to lead these technical assistance efforts to boost electronic health record adoption. In some regions Medicare quality improvement organizations, such as CIMRO in Nebraska and QSource in Tennessee, will lead. In other regions, successful health information exchange efforts, such as HealthBridge in Cincinnati, will run the REC. In Illinois, the two RECS will be led by Northern Illinois University and Northwestern University.

In anticipation of the grant funding, consortium Key Health Alliance, the REC for Minnesota and North Dakota, went to work in 2009 to garner commitments from physician groups. With a goal of providing technical assistance to 5,100 priority primary care providers in the two states over the next four years, it already has commitments from 4,628 providers representing 417 practices to avail themselves of technical assistance services.

So who will pay for the REC’s services? As Key Health’s web site makes clear, in the first two years of the program, practices that have been targeted as “priority primary care providers” serving medically underserved populations will receive subsidies of approximately 90 percent of the cost. So if consulting services cost $50,000, the practice would pay $5,000. But for all other providers and for the priority providers after the first two years, there will be a fee scale based on the services needed.

One huge challenge facing the RECs is that they must demonstrate their value quickly enough that some providers will want to pay for their services within two years. ONC expects that by the middle of 2012, “the Regional Extension Centers will be largely self-sustaining and their need for continued federal support in the remaining two years of the program will be minimal.”

It will be interesting to see, for example, how many specialist practices sign up for services without the large subsidy. It is not clear whether critical access hospitals are eligible for REC assistance, although physicians who work in their outpatient clinics are.

Can these organizations meet their goals of boosting physician EHR adoption? And can they become self-sustaining in two years? It will be interesting to see how well they do.

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