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The Feds Are On the Move (And Not Stopping Anytime Soon)

July 17, 2008
by Mark Hagland
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While most of the mainstream media attention to the politics of Medicare in the past few days has understandably been on the dramatic battle between the U.S. Congress and President Bush regarding whether to cut or reinstate Medicare physician payments, the override of Bush’s veto of the Medicare Improvements for Patients and Providers Act of 2008 (H.R. 6331) should be noted in healthcare IT as a significant step forward in federal incentivization around automation.

That’s because the bill—whose veto-override passage came in lopsided House of Representatives and Senate votes of 383-41 and 70-26, respectively—will also provide physician incentive payments of 2 percent for e-prescribing in fiscal years 2009 and 2010 under Medicare, payments that will continue at a rate of 1 percent in FY 2011 and 2012, and 0.5 percent in FY 2013. Then, beginning in 2012, Medicare payments to physicians who do not e-prescribe will be reduced by 1 percent in 2012, 1.5 percent in 2013, and 2 percent in subsequent years.

This is a big deal, folks. Not only have federal legislators for the first time enshrined the use of clinical applications by providers into federal law; they have created a dual carrot-and-stick strategy for the new initiative, a strategy that is unlikely to be reversed anytime soon, and will almost certainly be used in other contexts going forward.

This relates strongly to one thing I’ve said for years: healthcare IT adoption is one thing that legislators from both parties will gladly stand for and that is largely non-controversial. We all know how divided our country has been politically on a host of issues in the past decade between our two major parties and even between and among factions within those parties. So it’s only natural that our federal legislators would look to implement progress in the few areas that are largely non-controversial, and healthcare IT adoption is definitely one of the shiniest examples of a largely non-controversial area, at least as far as members of Congress are concerned.

Years from now, we’ll look back on this moment and say, yes, this is when things really began to accelerate on the federal legislative level. So don’t forget this moment in legislative history—and don’t be under any illusion that it’s in any way unique; instead, expect that coming sessions of Congress will only continue to move forward to incentivize, using a combination of carrots and sticks, healthcare IT adoption. And don’t say no one ever warned you.

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