Julie Miller
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Down payments are fairly easy. It's those ongoing, long-term payments that are the challenge. This is true for homes, boats,
automobiles and now healthcare reform.
Obviously, the biggest healthcare down payment President Obama has made so far is the $150 billion included in the American
Recovery and Reinvestment Act. Based on reaction in the industry, it seems that the $19 billion health IT investment is producing
the most discussion.
Avalere Health predicts small physician practices with little capital will be worse off financially should they take the offer
and implement an EMR system because the incentives and penalties outlined in the Reinvestment Act won't offset their costs.
Researchers forecast a $124,000 investment over five years with incentive payments only adding up to $44,000. Penalties would
be assessed starting in 2015 and amount to $5,100 a year, which is probably less than the cost of system maintenance.
Ideally, the market will drive down the price of EMRs, and small practices will have a better shot at affording them. Wal-Mart
has opportunistically announced plans to offer an EMR product for $25,000. If Wal-Mart's chintzy trash bags are any indication
of its product quality, I would be cautious about buying wares from them that are meant to facilitate health. This big-box
brand and its contracted supplier will have to win over physicians on more than just price.
As for the administration's long-term payment on healthcare, Henry Waxman (D-Calif.), the House Energy and Commerce Committee
Chairman, believes reform legislation will be written before the August recess. Senate leaders are hoping for some action
by July.
Within the forthcoming policies, further IT issues must be addressed. For example, even if EMRs were in place nationwide,
there is still the bigger problem of setting standards for interoperability and clinical integration.
The American College of Physician Executives recently asked its members how they feel about technology. While more of them
are using EMRs (64%, up from 33% in 2004), they still find them difficult to use and poorly integrated. They say physicians
should be consulted more often and be more involved in the technology's design.
Are you listening, Wal-Mart?
Julie Miller is editor-in-chief of MANAGED HEALTHCARE EXECUTIVE. She can be reached at julie.miller@advanstar.com
