News, Analysis, Trends, Management Innovations for
Clinical Laboratories and Pathology Groups

Hosted by Robert Michel

News, Analysis, Trends, Management Innovations for
Clinical Laboratories and Pathology Groups

Hosted by Robert Michel
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Behavioral Economics Likely to Push Up Utilization of Clinical Pathology Laboratory Tests

Wellness Programs Require Appropriate and Timely Use of Medical Laboratory Tests

Pathologists and clinical laboratory managers know that smoking, obesity and unnecessary utilization are major factors in the skyrocketing cost of healthcare. These are primary reasons behind the desired transition from reactive and acute care to a health system organized to deliver proactive care.

Consumer cooperation will be essential for this transition to succeed. Each year, the number of employer-funded or insurer-funded health and wellness programs increases. That trend is consistent with the federal government’s interest in promoting its own health and wellness programs as one way to lower the total cost of healthcare.
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Medicare Pays Small and Mid-Size Practices to Participate in EHR Study

Reluctance of small and mid-sized physician practices to invest in electronic medical record (EMR) systems has been oft noted by Dark Daily. Now, Medicare is hoping to motivate these physician groups to adopt electronic health records (EHRs) with a new incentive program.

In an effort to jump-start physician adoption of EHR systems, the Centers for Medicare and Medicaid launched a five-year demonstration that offers small and mid-size physicians offices the opportunity to earn bonuses and receive a free EHR system.

Over the five years of the project, each doctor chosen for the demonstration could receive up to $58,000, with a limit of $290,000 per practice. The initiative will operate in Alabama; Delaware; Georgia; Louisiana; Maine; the Maryland/Washington, D.C., area; Oklahoma; and Virginia. Demonstration sites with communities in multi-county areas will also be in South Dakota; Jacksonville, Florida; Madison, Wisconsin; and Pittsburgh, Pennsylvania.

Participation alone will not guarantee the extra Medicare payments. CMS will randomly choose only half of the 200 practices recruited in each community to get EHR incentive payments The other half will serve as a control group and will get no bonuses, even if they use certified systems. Some physicians are frustrated about the prospect of being in the control group and not getting bonuses, but most accept the control group system as necessary.

According to coverage from American Medical News physician practices put into the control group will know from the outset. These groups will be required only to complete an annual survey of their EHR status. They will receive a small fee for participating in the survey. CMS wants to see how physician practices in the group progress in IT adoption, despite not receiving financial incentives from the Medicare program. No physicians in the control group will be required to use an EHR. Incentive payments will not be available to non-primary care doctors or to practices with more than 20 physicians.

“This demonstration is designed to show that streamlining health care management with electronic health records will reduce medical errors and improve quality of care for 3.6 million Americans,” stated Health and Human Services (HHS) Secretary Mike Leavitt. “By linking higher payment to use of EHRs to meet quality measures, we will encourage adoption of health information technology at the community level, where 60% of patients receive care. “We also anticipate that EHRs will produce significant savings for Medicare over time by improving quality of care. This is another step in our ongoing effort to become a smart purchaser of health care-paying for better care, rather than simply paying for more care.”

According to the HHS press release, the demonstration will be open to participation by up to 1,200 physician practices. Over a five-year period, the program will provide financial incentives to physician groups using certified EHRs to meet certain clinical quality measures. A bonus will be provided each year based on a physician group’s score on a standardized survey that assesses the specific EHR functions a group employs to support the delivery of care.

This EHR incentive program demonstrates the federal government’s resolve to push providers to eliminate paper charts and adopt electronic health records. Because this demonstration project will last five years, that fact alone indicates that health policy makers don’t expect to see rapid acceptance of EHRs by small and mid-sized physician groups in the near future.

Related Articles:
HHS Announces Project to Help 3.6 Million Consumers Reap Benefits of Electronic Health Records

CMS selects communities for Medicare EHR bonus pilot project

Doc groups back EHR study (Modern Healthcare subscription required)

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