Physicians Practice - June 2008 - (Page 62) TECHNOLOGY The hospital decided to offer only one product because it believed that would be the best way to improve community health, says Mike Bush, Butler’s vice president and chief strategic officer. He also points out • Blue Cross and Blue Shield of Massachusetts offers a maximum incentive of $1 per member, per month to doctors who meet its goals for preventive and chronic care, generic prescribing, and health IT adoption; It has also supplied about $1.5 million to EHR of Rhode Island, an organization of 1,100 doctors who have pledged to computerize their practices. Recently, the Blues announced that it would give primary-care physicians who implement EMRs an extra 5 percent raise on top of other fee increases. UNCLE SAM AND HEALTH TECHNOLOGY VERY HELPFUL Hospitals can negotiate hardware discounts, serve as intermediaries with EMR vendors, and help physicians navigate past the inevitable technical bumps and glitches inherent in complex system implementations. that the system wanted to provide an EMR to doctors before one of its competitors did, and that physician job candidates are increasingly demanding that the hospital give them an EMR. • The seven plans that belong to the Integrated Healthcare Association P4P program in California have paid groups substantial rewards for EMR adoption, as well as quality improvement; • The Hawaii Medical Service Association, PAYER SUBSIDIES Health plans, like hospitals, are still rather timorous about subsidizing EMRs for doctors. Most of the technology donations from payers have been e-prescribing programs, which promise a faster and surer bang for the payers’ buck via increased generic and in-formulary prescriptions. Yet there are exceptions. Nine percent of health plans include incentives for EMR adoption in their pay-for-performance programs: also a Blues plan, has reportedly committed $50 million to subsidize EMRs. But it has given out only $3 million so far, at $20,000 per doctor, because just 150 physicians accepted its offer; and • The Rhode Island Blues has provided $5,000 per physician, plus performance incentives, to 250 primary-care doctors who’ve adopted EMRs, according to chief medical officer Augustine Manocchia. The Bush Administration has been promoting health IT since 2004. Its most recent initiative is a three-year pilot program launched by the Department of Health and Human Services. In this demonstration project, 1,200 small- and medium-sized practices in 12 markets will be given incentives for acquiring EMRs. The as-yet-unspecified rewards will be provided for EMR implementation in the first year, for quality reporting in the second year, and for “showing value” from using electronic records in the third year. The Centers for Medicare & Medicaid Services is also on the EMR bandwagon. For the past couple of years, CMS has required its quality improvement organizations in every state to help a limited number of small practices choose and acquire EMRs. As a result, hundreds of physicians received free assistance in preparing for the digital leap (but no subsidies). Also, as part of a fiveyear demonstration project, CMS is signing up 1,200 small- and mediumsized primary-care practices that will receive subsidies for acquiring EMRs and using them to improve quality. In 2005, CMS released a modified version of the Department of Veterans Affairs’ VistA EMR for use in pri- 62 | PHYSICIANS PRACTICE | JUNE 2008 WWW.PHYSICIANSPRACTICE.COM http://WWW.PHYSICIANSPRACTICE.COM http://WWW.PHYSICIANSPRACTICE.COM
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