AMA meeting: Doctors object to penalties for avoiding EHRs
Delegates call for eliminating Medicare penalties for failing to show “meaningful use” of electronic records by 2015. But some fear incentives could also go.
By Emily Berry, AMNews staff.
Chicago – Physician-delegates at the AMA Annual Meeting in June formally came out against planned penalties included in this year’s federal stimulus bill that would dock Medicare pay for physicians who do not have a qualifying electronic health record.
The “adjustments” start at 1% of the physician’s Medicare fee schedule and are set to begin in 2015, after four years of available incentives for adoption. The penalties are set to increase each subsequent year to a maximum of 5%.
Delegates passed a resolution calling for the Association to ask the federal government to eliminate the penalties and advocate for federal assistance with up-front and maintenance costs of EHR use.
The stimulus package, officially titled the American Recovery and Reinvestment Act of 2009, sets out incentives for both physicians and hospitals who can demonstrate “meaningful use” of an EHR, including the use of an e-prescribing component. Qualifying physicians will be eligible for additional Medicare payments of as much as $44,000 over the course of five years, beginning in 2011.
The national Health IT Policy Committee, an advisory group charged with defining principles for “meaningful use,” released its first draft recommendations June 16, but the Centers for Medicare & Medicaid Services has indicated proposed rules won’t be released until late 2009.
There is a case-by-case exemption written into the law for physicians who can demonstrate “significant hardship, such as in the case of an eligible professional who practices in a rural area without sufficient Internet access.”
Delegates at the Annual Meeting argued that the penalties violate the AMA’s pay-for-performance policies and unfairly punish physicians who can’t afford the up-front cost of adopting an electronic record system.
“My financial calculations say it’s cheaper for me to take the penalty than to put the system in, and that’s what I’m going to do,” said David McKalip, MD, a neurosurgeon and alternate delegate for the Florida Medical Assn.
No coverage for up-front costs
There are no provisions in the stimulus package that cover the up-front cost of adopting an EHR for a physician in private practice, and some physicians are concerned about buying an EHR now without knowing exactly what type of system will qualify them for incentives.
“Whatever you’re buying now is going to be obsolete in the near future,” said Stephen Sebert, MD, a family physician and president of the West Virginia State Medical Assn.
Other physicians speaking to the issue in reference committee urged delegates to “not throw the baby out with the bathwater” and pointed out the incentives represent the first assistance the government has offered for health IT adoption.
“I think if we ask for this to be rescinded, what we’ll wind up with, possibly, is nothing,” said Steven Kanig, MD, a nephrologist and delegate for the New Mexico Medical Society.
Above article published on
http://www.ama-assn.org/amednews/2009/06/29/prsd0629.htm
1 comment
This short, but revealing article conjures up visions of physicians standing in conference and debating whether it makes sense to actually inject a remedy into a patient’s vein, rather than use the standard, fully accepted and easily procured leech. Can we all imagine when the first physician stood up and suggested that we actually keep a record of what we administered to a patient, just in case she lives and we need to treat her again? “Ridiculous”, some would say. “My calculations show that it is cheaper for me to just treat them and not know their name, I don’t need a record?” Another might say, “keeping records will never catch on. Most of my patients die before I get to treat them again anyway. In the near future, you will have to burn all that paper just to make room for more patients.”
Am I missing the point? Did physicians really put up this much resistance when telephones were suggested to allow patients to call ahead and make an appointment. Oh my god. Now I have to buy an appointment book!
I was a grown man when the first fax machine was introduced. It was mesmerizing to watch as a single sheet of paper took seven minutes to be sent across the street. Today, I provide a practice management suite of tools for sensible minded physicians that virtually eliminates the need for paper, substantially reduces the over-all cost of running a practice, increases the number of patient visits, increases revenue, maintains a real-time document retrieval system that allows the doctor and his staff to do his job faster and more efficiently than ever before.
The innovative technology that has allowed physicians to process their claims electronically has saved countless hours of paperwork and drudgery. But, if we remember, they balked about that too.
Forget the stimulus package. Forget the penalties. Stop disguising your resistance as a financial issue. The cost of a complete practice management system, with EMR and dozens of applications and functionality should cost less that a part time employee. If you doubt that, please call me at 773-767-1844.
To resist the technology and implementation of a tool that will eliminate countless hours of paper pushing, searching and retrieving patient data or a tool that will increase the speed in which you review, notate, chart, plan and complete a patient visit is tantamount to the childish pouting that physicians surely displayed when it was mandatory that they wash their hands before touching a patient.
You are professionals. You can do something that most men and women can not do. That and your diploma makes you a physician.
There are many, many other types of professionals in the healthcare arena. Some are administrators. Some researchers and engineers. From designers to programmers, all are struggling to improve the workflow accessibility, portability and completeness of a patient record at the point-of-care.
Remember the patient?
It was once said that the physician holds the patient’s life in his hands. That was true once, but not any more. The patient’s life is held by your receptionist, your admissions clerk, your records management office, your scheduler, your coder, your nurse, your assistant and your billing department before you even get to see the patient. One mistake in that pile of paper you currently call a patient record, can mean the difference between life and death.
Ok, forget the patient! Forget the penalties, forget the stimulus package.
The implementation of an electronic medical record and a transition from a paper work-flow to a streamlined, real-time computer accessible medical record will make you money!
No! It should not cost you an arm and a leg. It should not require financing. It will not disrupt your office environment. It will not replace employees. It will increase your cash flow and reduce your expenses.
Yes, you can flush the leeches down the toilet, now!
Donald Calarco
MPS Remedy, Inc.
http://www.mpsremedy.com
773-767-1844
Let’s talk about your wallet.
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