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Sunday, November 11, 2012


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How Health IT Benefits From Obama's Re-election
The fed's health IT incentive program will continue, along with related programs, but one prominent analyst suggests the biggest threat to the EHR incentive program now is the 'fiscal cliff.'

By Ken Terry, InformationWeek
November 08, 2012 09:38 AM

The day after President Obama was re-elected and Democrats held onto control of the U.S. Senate, the future looked bright to folks in the health IT field.

The election outcome suggested that attacks on the government's electronic health record incentive program by Congressional Republicans may lose steam or disappear altogether. Coincidentally, the Health IT Policy Committee met on Oct. 7 to discuss a draft of its Meaningful Use Stage 3 recommendations...

Robin Raiford, research director for the Meaningful Use practice of the Advisory Board Co., a healthcare consulting firm, listened in on the committee meeting, which was chaired by Farzad Mostashari, national coordinator of health IT. The tenor of the discussion, she told Information Week Healthcare, was that the committee would "move forward and finish the work that's been started."

Raiford was elated. "Like many other people working in this space, I hoped that the momentum would not stop. So it was a great relief to know it would continue on."

Even before the election, she said, she hadn't expected abrupt changes in federal support for health IT, no matter who won. One reason for this stability, she noted, is that the HITECH Act authorizing the EHR incentive program -- part of the American Recovery and Reinvestment Act -- can't be changed or repealed by executive order.

For the same reason, Congressional critics of the incentive program, which to date has disbursed about $7.7 billion, can't force the Department of Health and Human Services to suspend the payments unless they can muster enough political support to repeal the law. That could have happened only if there had been a Republican sweep of Congress and the White House...

Raiford also pointed out that the government is likely to recover some or all of the funds it's now expending on health IT, if only in penalties. ""Where the money is going to come from [to fund the incentive program] is the people who don't show Meaningful Use and start paying it back in payment adjustments, starting in 2015. That money will be huge if people don't keep up. That money will trump the incentives by far." [emphasis mine]...
 On the final paragraph cited above: let me get this straight: The better we at the RECs do our jobs helping physicians comply with the program and attest for the incentives they earned, the more incentive funds will be remitted AND the lower will be the CMS penalty payment adjustment for non-participating clinicians and hospitals, costing the taxpayers MORE money, net?

Can you say "cross purposes"?
 Unreal. This is effectively an argument for letting the REC effort expire (though I'm sure she didn't intend that; it likely never crossed her mind), precisely during a time (2013) when the low hanging Meaningful Use fruit of Stage 1 HIT savvy EPs and EHs will have been plucked. I'm sure some adroit young CBO econometrician spreadsheet jockey could model this out to forecast the precise "budget neutrality" pull-the-plug point.

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