The Security Scrutinizer with Howard Anderson

Health Reform: Follow Medicare's Lead?

Health Reform: Follow Medicare's Lead?

Some are saying that the healthcare reform measure signed into law March 23 should have required all insurers to provide EHR incentives. Do you think commercial insurers should follow in Medicare's footsteps, with or without a federal mandate?

Under the HITECH Act, Medicare soon will begin paying provider organizations extra if they adopt qualifying EHRs and follow required privacy and security measures. Although participation is not mandatory, those organizations that are not using a qualifying EHR system will see escalating cuts in their Medicare reimbursement in 2015 and beyond. (For a complete guide to the HITECH Act, click here.)

"It's unfortunate that health insurance reform and health information reform, which is what HITECH was all about, weren't connected at the hip," says William R. Braithwaite, M.D., Ph.D. 

Back in the 1980s, after Medicare changed the way it paid for hospital treatment by shifting to diagnosis-related groups, many insurance companies adopted similar approaches. So it will be interesting to watch whether insurers, once again, imitate Medicare's actions.

"It's unfortunate that health insurance reform and health information reform, which is what HITECH was all about, weren't connected at the hip," says William R. Braithwaite, M.D., Ph.D.

While he worked for the government back in the 1990s, Braithwaite played a lead role in drafting the administrative simplification provisions of HIPAA, including sections on privacy and security. Today, he laments that the healthcare reform bill didn't call on all insurers to provide EHR financial incentives.

Lacking incentives from insurers who pay the bills, "many doctors who don't have Medicare patients won't bother with EHRs," Braithwaite fears.

Many physicians have been dragging their feet for years, saying that EHRs are too expensive and make them less productive. Braithwaite acknowledges that moving to electronic records definitely creates short-term productivity losses. But he argues that over the long haul, automating records leads to huge gains in quality as well as cuts in costs, such as from ordering fewer redundant tests.

Braithwaite contends that with a little extra push from payers, more doctors will overcome their fears and adopt EHRs.

So what do you think? Should private insurers devise creative incentives for physicians to use secure EHRs? Will the Medicare incentives prove to be effective on their own? Or are there better ways to convince doctors to jump on the electronic records bandwagon?

Braithwaite also is urging regulators to beef up the security provisions in the HITECH Act rules to make them far less ambiguous and help ensure that electronic records remain private. To hear his comments on the pros and cons of HITECH, click here.

About the Author

Howard Anderson

Howard Anderson

News Editor, ISMG

Anderson is news editor of Information Security Media Group and was founding editor of HealthcareInfoSecurity and DataBreachToday. He has more than 40 years of journalism experience, with a focus on healthcare information technology issues. Before launching HealthcareInfoSecurity, he served as founding editor of Health Data Management magazine, where he worked for 17 years, and he served in leadership roles at several other healthcare magazines and newspapers.

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