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Quality Payment Program Tops List Of Regulatory Burdens On Medical Practices

Posted on October 10, 2018 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. Contact her at @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

A new survey by the Medical Group Management Association has found that meeting the demands of the Medicare Quality Payment Program tops the list of regulatory burdens named by respondents in medical practices.

The survey, which collected responses from 426 medical groups, found that their regulatory burdens were climbing, with 86% reporting that such burdens had increased over the past 12 months. A smaller but similar share of respondents (79%) reported that the overall regulatory burden associated with participating in Medicare specifically had increased during the same period.

When asked to name the regulatory requirements they considered to be very or extremely burdensome, 88% named the Quality Payment Program, followed by prior authorization (82%), lack of EHR interoperability (80%), government EHR requirements (77%) and audits/appeals (68%). In contrast, just 49% of respondents saw compliance with HIPAA privacy and security requirements to be a major concern.

Given the challenges it imposes on practices, it’s no wonder that the MGMA respondents struggle with MIPS, with just 9% stating that they were satisfied or very satisfied with the performance feedback the program offers. Two-thirds of respondents told the MGMA that at least in its current form, MIPS doesn’t support their practice’s clinical quality priorities.

Perhaps the most irksome aspects of the MIPS program seemed to be the full-year quality reporting period and scoring methodology. Roughly two-thirds of respondents were dissatisfied or very dissatisfied with these aspects of the program. “The lack of clarity and constant readjusting of the MACRA regulations regarding MIPS/APMs is also frustrating,” one group member said.

In addition, despite ongoing efforts to support patient data exchange, the percent of respondents who rated a lack of EHR interoperability as very or extremely burdensome has climbed over the last 12 months, from 68% last year to 80% in 2018.

Ultimately, this problem could have serious financial consequences for some organizations. “Interoperability will never be achieved at the rate we’re going without bankrupting most private medical practices,” wrote one respondent. “As each of the EHR vendors moves towards their own interpretation of interoperability, they create different versions of their own software that cost all of us more to implement and we can’t afford any more.”

If these issues aren’t addressed, it seems likely Medicare’s drive toward value-based payment will be less successful than its leaders would hope.  Seventy-nine percent of practices responding to the MGMA survey said they didn’t think the move toward value-based payment had been successful to date, and it doesn’t seem likely that this will change if physicians continue to feel overburdened and misunderstood

Payers Say Value-Based Care Is Lowering Medical Costs, But Tech Isn’t Contributing Much

Posted on June 22, 2018 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. Contact her at @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

A new survey of health insurers has concluded that while value-based care seems to be lowering healthcare costs significantly, they aren’t satisfied with the tools they have to analyze value-based performance.

The report, which draws on a survey sponsored by Change Healthcare, including answers from 120 payers across several types of insurance, including managed Medicare, managed Medicaid and commercial plans.

The topline finding from the report was that value-based care (VBC) has lowered healthcare costs by 5.6% on average, with one-quarter of respondents reporting savings of more than 7.5%.

Meanwhile, the volume of fee-for-service payments has dropped dramatically as a percent of overall payments, now accounting for just 37.2% of all reimbursement among respondents. That number is expected to fall below 26% by 2021.

Not only that, 64% of payers said that provider relationships improved, and 73% said patient engagement improved. This suggests that providers have made some strides in delivering value-based care, as many had a hard time restructuring their business in the past.

That said, some payers haven’t met their own VBC goals. In particular, 66% of payers are investing administrative staffers to support episode-of-care programs given what the study terms “exceptional” medical cost savings. Also, one third to one-half said that episode-of-care models were either very or extremely effective at improving care quality.

However, payers haven’t made much progress as they’d like in rolling out episode-of-care programs. While 21% of payers said they were capable of rolling out a new episode-of-care program in 3 to 6 months, more than a third said the needed a year to launch such a program, 21% said it would take 18 months, and 13% said it would take up to 24 months or more. In other words, many payers are so far behind the curve that the programs they’re designing might be obsolete by the time they roll them out.

What’s more, they’ve had a tough time getting providers interested in episode-of-care programs. Forty-three to 58% reported that it is either very or extremely difficult to get providers to participate in these efforts. Not only that, even when they find interested providers, payers are having a hard time finding common ground with them on episode definitions, budgets, the details of risk and reward sharing and performance metrics. These disagreements could prove a major hurdle to overcome.

In addition, more than half of payers said they were not very satisfied with the current value-based analytics, automation and reporting tools, even though most of the tools were developed in-house by the payers themselves. It could be that given provider resistance, the payers aren’t quite sure about what to look for. Regardless, it seems that payers have a longer-than-expected road to travel here.

Medicare ACOs May Be Slated For Big Changes — And Health IT May Be Part Of It

Posted on May 25, 2018 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. Contact her at @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

Before I get started, I want to offer a hat tip to Becker’s Hospital Review, which turned me onto the following news. That news, in brief, is that CMS might make changes to its ACO program that could have a big impact on the doctors and hospitals that participate.

According to Becker’s, CMS Administrator had some negative things to say about so-called “upside only” risk contracts, which don’t pay out anything to the agency if they miss financial and clinical benchmarks: “These ACOs are actually increasing Medicare spending, and the presence of these ‘upside-only’ tracks may be encouraging consolidation in the marketplace, reducing competition and choice for beneficiaries,” Verma told the AHA’s Annual Membership Meeting earlier this month.

At present, a whopping 460 of 561 ACOs in the Medicare Shared Savings Program are in Track 1, the agency’s upside-only program. At present, ACOs can only participate in two three-year contracts on this track, so next year 82 ACOs will be required to take on financial risk. Obviously, they don’t like this.

However, CMS isn’t exactly being unreasonable to consider curtailing Track 1. Looked at one way, the Medicare Shared Savings Program has failed utterly achieving its core purpose, and upside-only contracts are the primary reason.

According to Becker’s, which cited research from Avalere, while the program was supposed to generate $1.7 billion in net savings from 2013 to 2016, upside-only contracts were responsible for $444 million in federal spending. On the other hand, downside-risk ACOs cut spending by $60 million, a relatively tiny number when you consider the scale of CMS’s budget but positive side nonetheless.

All that being said, let me interject here and note that HIT may be part of the problem. I’m betting some of the expected savings was based on assumptions about how health IT would help ACOs meet clinical and financial benchmarks.

After all, the federal government spent many billions of dollars paying doctors and hospitals Meaningful Use incentive, which obviously gave them a convincing reason to adopt EMRs. No one approves that level spending without believing it would make everything better.

As it turns out, though, that might have been a flawed assumption. If I’m right, the Track 1 failure suggests that health IT isn’t doing as much to create efficiencies as federal health leaders had hoped. I know, particularly if you’re a doctor reading this, you’re saying “I could’ve told you this a decade ago.” Still, it’s worth repeating.

While health IT organizations — especially those housed in progressive health systems — are making great progress with improving care, we haven’t met the lofty goals of such approaches by any means. But if they want to progress toward value-based care, they’ll probably have to put their health IT to better use.

How Will CMS Handle Issues Surrounding MACRA Changes?

Posted on May 14, 2018 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. Contact her at @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

As most readers will know, when CMS released details on MIPS and the Alternative Payment Model incentives it embarked on a new direction for quality programs generally. As most readers will know, MIPS consolidated PQRS, the Physician Value-based Modifier and the Medicare EHR Incentive Program for EPs (Meaningful Use). But CMS is still updating the Medicaid incentive program.

If I were a physician, I’d be even more interested in the CMS initiative dubbed Promoting Interoperability. In some of the biggest news to come out of the agency in ages, CMS is restructuring the EHR Incentive Programs to become the Promoting Interoperability Programs. Promoting Interoperability replaces the Advancing Care Information category of MIPS.

Whoa. That would be a big enough deal on its own, but the issues the rule raises are an even bigger one.

CMS’s has been working towards this goal for a few years. Per HIMSS, here are some changes suggested in the proposed rule that might have the biggest impact on the health IT world:

  • The rule would cut down measures from 16 to six
  • It would use a new performance-based scoring methodology which would include measures of performance on e-prescribing, health information exchange, provider to patient exchange and public health and clinical data exchange
  • The agency will define and work to prevent “information blocking”

On a related note, CMS has posted a request for information asking for stakeholder feedback on program participation conditions. This is pretty unusual for the agency.

Like many CMS proposals, this one leaves some important questions open. (Apparently, CMS itself wonders how this thing will work, as the request for information suggests.)

For example, the new performance-based scoring method will award providers anywhere from 0 to 100 points. Measuring health IT performance is always a tricky thing to do, and there’s little doubt that if this becomes a final rule, both providers and CMS will have to go through some struggles before they perfect this approach. In the meantime, providers face some big challenges. How will they adapt to them? Its too soon to say.

Addressing so-called “information blocking” should be an even bigger challenge. Everyone from members of Congress to providers to vendors acts as though there’s one way to describe this practice, but there’s still a lot of wiggle room. Honestly, I’ll be amazed if CMS manages to pin it down the first time around.

Still, the time is more than overdue for CMS to take on interoperability directly. Without real data interoperability, many promising digital health schemes will collapse under their own weight. If CMS can figure out how to make it happen, it will be pretty neat.

AAFP Opposes Direction Of Federal Patient Data Access Efforts

Posted on April 4, 2018 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. Contact her at @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

Not long ago, a group of federal agencies announced the kickoff of the MyHealthEData initiative, an effort designed to give patients control of their data and the ability to take it with them from provider to provider. Participants in the initiative include virtually every agency with skin in the game, including HHS, ONC, NIH and the VA. CMS has also announced that it will be launching Medicare’s Blue Button 2.0, which will allow Medicare beneficiaries to access and share their health information.

Generally speaking, these programs sound okay, but the devil is always in the details. And according to the American Academy of Family Physicians, some of the assumptions behind these initiatives put too much responsibility on medical practices, according to a letter the group sent recently to CMS administrator Seema Verma.

The AAFP’s primary objection to these efforts is that they place responsibility for the adoption of interoperable health IT systems on physicians. The letter argues that instead, CMS should pressure EHR vendors to meet interoperability standards.

Not only that, it’s critical to prevent the vendors from charging high prices for relevant software upgrades and maintenance, the AAFP argues. “To realize meaningful patient access to their data, we strongly urge CMS to require EHR vendors to provide any new government-required updates such systems without additional cost to the medical practice,” the group writes.

Other requests from the AAFP include that CMS:

  • Drop all HIT utilization measures now that MIPS has offered more effective measures of quality, cost and practice improvement
  • Implement the core measure sets developed by the Core Quality Measures Collaborative
  • Penalize healthcare organizations that don’t share health information appropriately
  • Focus on improving HIT usability first, and then shift its attention to interoperability
  • Work to make sure that admission, discharge and transfer data are interoperable

Though the letter calls CMS to task to some degree, my sense is that the AAFP shares many of the agency’s goals. The physician group and CMS certainly have reason to agree that if patients share data, everybody wins.  The AAFP also suggests measures which foster administrative simplification, such as reducing duplicative lab tests, which CMS must appreciate.

Still, if the group of federal organizations thinks that doctors can be forced to make interoperability work, they’ve got another thing coming. It’s hard to argue the matter how willing they are to do so, most practices have nowhere near the resources needed to take a leading role in fostering health data interoperability.

Yes, CMS, ONC and other agencies involved with HIT must be very frustrated with vendors. There don’t seem to be enough sanctions available to prevent them from slow-walking through every step of the interoperability process. But that doesn’t mean you can simply throw up your hands and say “Let’s have the doctors do it!”

The “Enthusiasm Gap” in Health IT

Posted on January 5, 2012 I Written By

Dr. Michael J. Koriwchak received his medical degree from Duke University School of Medicine in 1988. He completed both his Internship in General Surgery and Residency in Otolaryngology-Head and Neck Surgery at Vanderbilt University Medical Center. Dr. Koriwchak continued at Vanderbilt for a fellowship in Laryngology and Care of the Professional Voice. He is board certified by the American Board of Otolaryngology-Head and Neck Surgery. After training Dr. Koriwchak moved to Atlanta in 1995 to become one of the original physicians in Ear, Nose and Throat of Georgia. He has built a thriving practice in Laryngology, Care of the Professional Voice, Thyroid/Parathyroid Surgery, Endoscopic Sinus Surgery and General Otolaryngology. A singer himself, many of his patients are people who depend on their voice for their careers, including some well-known entertainers. Dr. Koriwchak has also performed thousands of thyroid, parathyroid and head and neck cancer operations. Dr. Koriwchak has been working with information technology since 1977. While an undergraduate at Bucknell University he taught a computer-programming course. In medical school he wrote his own software for his laboratory research. In the 1990’s he adapted generic forms software to create one the first electronic prescription applications. Soon afterward he wrote his own chart note templates using visual BASIC script. In 2003 he became the physician champion for ENT of Georgia’s EMR implementation project. This included not only design and implementation strategy but also writing code. In 2008 the EMR implementation earned the e-Technology award from the Medical Association of Georgia. With 7 years EMR experience, 18 years in private medical practice and over 35 years of IT experience, Dr. Koriwchak seeks opportunities to merge the information technology and medical communities, bringing information technology to health care.

My next piece is published at Townhall.com:

 

Despite the success of information technology (IT) in transforming many parts of the economy, the health care sector has proven itself immune to the seduction of smart phones and iPads.  This is puzzling at first glance.  It is certainly not due to any shortage of health IT products.  The problem appears to be on the demand side.

A recent article by Olga Khazan in The Washington Post provides some explanation. She reports on the third annual mHealth Summit, held earlier this month in Washington D.C.  The event has attracted such notables as Bill Gates and Ted Turner, according to the mHealth website.  The piece laments the “enthusiasm gap” between Health IT startup companies offering dozens of miracle products and those darn stick-in-the-mud physicians who just can’t get with the program.   But meetings like the mHealth Summit actually hurt the movement of Health IT that they profess to support.

The poster child for Ms. Khazan’s article is Dr. Eric Topol, one of the Summit’s keynote speakers.  HHS Secretary Kathleen Sebelius joined Dr. Topol behind the podium.  Together they offered Health IT Utopia – where “you can take a video of a rash on your foot and get a diagnosis…without making a doctor’s appointment.”  Then they criticized practicing physicians using the same old Obamacare propaganda.  Ms. Sebelius continued, “Americans still live sicker and die sooner than many of the people in other nations…Healthcare has stubbornly held on to its cabinet and hanging files.”  Dr. Topol called the medical community “ossified” regarding the adoption of health information technology.  The author starts the online post-article comment thread herself with the question, “How do we encourage doctors to be more open to these technologies?”

This kind of meeting is common in the Health IT (HIT) community.  A bunch of self-described HIT experts get together, pump each other up about the absolute perfection of their products, and then start bashing physicians because – literally and figuratively – we aren’t buying it.  At similar meetings I have heard HIT people brag about walking out on their doctor the minute he pulled out a paper prescription pad.  Doctors are called fearful, stupid, or rich fat-cats protecting their turf.  Now thanks to our “colleague” Dr. Topol we can add, “ossified” to the list of unflattering terms.  It comes as no surprise that the government is happy to join in the sing-along.  It is a free opportunity to serve Obamacare Kool-Aid.

I am a dedicated supporter of HIT.   Our practice’s EMR implementation reached a reasonable level of maturity long before Obamacare, HITECH incentives, and Ms. Sebelius came along.  We became Meaningful Use – compliant the first of October.  I believe in the potential of HIT to revolutionize the practice of medicine by reducing costs and improving efficiency and quality of care.  But I do not believe the HIT community is on a course that will take us to that vision.

Read the rest of the article here at Townhall.com

The Nitty-Gritty of Meaningful Use – Part 2

Posted on September 18, 2011 I Written By

Dr. Michael J. Koriwchak received his medical degree from Duke University School of Medicine in 1988. He completed both his Internship in General Surgery and Residency in Otolaryngology-Head and Neck Surgery at Vanderbilt University Medical Center. Dr. Koriwchak continued at Vanderbilt for a fellowship in Laryngology and Care of the Professional Voice. He is board certified by the American Board of Otolaryngology-Head and Neck Surgery. After training Dr. Koriwchak moved to Atlanta in 1995 to become one of the original physicians in Ear, Nose and Throat of Georgia. He has built a thriving practice in Laryngology, Care of the Professional Voice, Thyroid/Parathyroid Surgery, Endoscopic Sinus Surgery and General Otolaryngology. A singer himself, many of his patients are people who depend on their voice for their careers, including some well-known entertainers. Dr. Koriwchak has also performed thousands of thyroid, parathyroid and head and neck cancer operations. Dr. Koriwchak has been working with information technology since 1977. While an undergraduate at Bucknell University he taught a computer-programming course. In medical school he wrote his own software for his laboratory research. In the 1990’s he adapted generic forms software to create one the first electronic prescription applications. Soon afterward he wrote his own chart note templates using visual BASIC script. In 2003 he became the physician champion for ENT of Georgia’s EMR implementation project. This included not only design and implementation strategy but also writing code. In 2008 the EMR implementation earned the e-Technology award from the Medical Association of Georgia. With 7 years EMR experience, 18 years in private medical practice and over 35 years of IT experience, Dr. Koriwchak seeks opportunities to merge the information technology and medical communities, bringing information technology to health care.

This is the second in the series of how our practice is getting the work of MU done.  The first of the series can be found here.

Starting with Core Set Item #7:

7.   Record demographics as structured data.  We have been doing this for a long time but MU requires us to add race and “ethnicity.”  Isn’t ethnicity the same as race but more specific?  If you have the latter you don’t need the former.  Furthermore we have had patients push back on asking this question.  Some find this question offensive.  They shouldn’t; since many diseases are race / ethnicity – specific the question is medically appropriate.  Fortunately MU considers the term “undetermined” as acceptable for this data point.

8.  Record vital signs as structured data.  This conflicts with lower level CPT E/M coding with does not require vital signs.  Once again the left hand of government doesn’t know what the right is doing.  Nobody thought it through.

9.  Record smoking status.   No problem here.  Medically appropriate for all specialties.

10.  Quality measures.  These are poorly designed and confusing.  There are 2 redundant measures both dealing with tobacco use and cessation, and these are both redundant (but not identical) to core set #9.  Weight screening is reasonable enough but the follow-up requirements are ambiguous and burdensome.  Are we really supposed to bombard our local dietician with weight loss consultations?

11.  Decision support rule.  We will configure our EMR to prompt for hearing loss screenings in patients over 50 years old.  Fair enough.

12.  Provide an electronic copy of health information to the patient upon request.  Who are they kidding?  This should have been delayed to Phase two.  Qualified EMRs can do this easily enough but the product is exported to your remote server desktop; it is cumbersome to copy from there.  We have had few such requests from patients; I wonder if those few are asking just to prove a point.  I don’t know that for sure.

13.  Provide clinical visit summaries.  Again should have been delayed to Phase two.

14.  Exchange key clinical information between systems.  This one is unbelievable.  Fortunately, as I understand it, you only have to do it once.  You are supposed to upload all or part of someone’s chart (or perhaps a test chart or other hypothetical data) to portable media, go to someone else’s EMR and try to upload the data.  Doesn’t matter if you succeed or not.  Am I misunderstanding this one?  If anybody has a better handle on this one please leave a comment.

15.  HIPAA security risk analysis.  Although I hate paying for it I must admit that is a good idea.

 

The last installment will cover the Menu Set Measures.

Meaningful Use Will be on Life Support by the End of 2012.

Posted on September 15, 2011 I Written By

Dr. Michael J. Koriwchak received his medical degree from Duke University School of Medicine in 1988. He completed both his Internship in General Surgery and Residency in Otolaryngology-Head and Neck Surgery at Vanderbilt University Medical Center. Dr. Koriwchak continued at Vanderbilt for a fellowship in Laryngology and Care of the Professional Voice. He is board certified by the American Board of Otolaryngology-Head and Neck Surgery. After training Dr. Koriwchak moved to Atlanta in 1995 to become one of the original physicians in Ear, Nose and Throat of Georgia. He has built a thriving practice in Laryngology, Care of the Professional Voice, Thyroid/Parathyroid Surgery, Endoscopic Sinus Surgery and General Otolaryngology. A singer himself, many of his patients are people who depend on their voice for their careers, including some well-known entertainers. Dr. Koriwchak has also performed thousands of thyroid, parathyroid and head and neck cancer operations. Dr. Koriwchak has been working with information technology since 1977. While an undergraduate at Bucknell University he taught a computer-programming course. In medical school he wrote his own software for his laboratory research. In the 1990’s he adapted generic forms software to create one the first electronic prescription applications. Soon afterward he wrote his own chart note templates using visual BASIC script. In 2003 he became the physician champion for ENT of Georgia’s EMR implementation project. This included not only design and implementation strategy but also writing code. In 2008 the EMR implementation earned the e-Technology award from the Medical Association of Georgia. With 7 years EMR experience, 18 years in private medical practice and over 35 years of IT experience, Dr. Koriwchak seeks opportunities to merge the information technology and medical communities, bringing information technology to health care.

Earlier this week I attended the annual meeting of the primary professional organization for my specialty, the American Academy of Otolaryngology – Head and Neck Surgery.  As you might expect the first thing I did was attend a mini-seminar on strategies to meet Meaningful Use (MU) requirements.  These “mini-seminars” typically include 3-4 speakers presenting various viewpoints regarding the subject at hand.  Presenting the supporting viewpoint on MU was Dr. K.J. Lee, who has been an icon in our specialty for decades.  He had distilled MU requirements for Otolaryngology down to a few typed pages and reviewed each requirement, emphasizing how easy it should be.

The most interesting part of the presentation was the reaction of the audience.  Presumably based on his professional reputation the audience initially bought into Dr. Lee’s enthusiasm for MU, hopeful that he was right.  However, as he continued through the list of MU requirements his point of view became less credible, and the enthusiasm began to fade.  When he suggested that it was no problem for ENT docs to ask and counsel patients about mammograms and colonoscopies, audience members began to stare at the floor and shake their heads.  By the end of his presentation he had lost just about everyone.  I have seen this happen before at MU meetings.

Later that morning in a different mini-seminar I gave my own brief presentation, a MU update.  I was asked to give an update on how MU payments were going, presumably specific to our specialty.  The August CMS report shows MU payments given to about 1100 providers so far (as of 7/31/11) totaling about $18 million.  For the 6 weeks leading up to the meeting I tried, without success, to get MU payment data from CMS for ENT doctors.  The best I could infer from the data available is that more than 1 but less than 28 individual ENT docs have been paid for year 1 MU.  In any case the conclusion is clear:  only about 0.1% of all eligible providers – and essentially no ENT docs – have met MU so far.

But isn’t it too early to draw conclusions?  After all, the program just got started a few months ago.  And the number of payments going out is increasing month to month.  And providers still have a year to get the full payment.

My opinion is that the situation is worse than it looks, not better.  I believe even this tiny number of payments represents an early peak of MU payments to providers who implemented EMR long before MU came along.  Our practice is in this group, and we will begin our 90 day attestation period October 1.  MU is achievable only for those providers that have already acquired several years worth of EMR skills.  Once these early adopters are paid, no one else will be left.  If I am right we should see MU payments plateau in Spring 2012 and start declining in the summer and fall.

MU remains a bad idea, especially for surgical specialties.  It is not possible for a paper-based medical practice to complete the long process of selecting, installing and implementing EMR on the schedule imposed by MU.  The provider skill set required to meet MU requirements takes at least 2-3 years to develop, and providers can’t even begin to acquire those skills until the EMR is chosen and installed.  The MU schedule forces providers to rush the process, raising the risk of making catastrophic mistakes in the EMR selection and implementation process.

Why Should Doctors Trust the Government?

Posted on July 26, 2011 I Written By

Dr. Michael J. Koriwchak received his medical degree from Duke University School of Medicine in 1988. He completed both his Internship in General Surgery and Residency in Otolaryngology-Head and Neck Surgery at Vanderbilt University Medical Center. Dr. Koriwchak continued at Vanderbilt for a fellowship in Laryngology and Care of the Professional Voice. He is board certified by the American Board of Otolaryngology-Head and Neck Surgery. After training Dr. Koriwchak moved to Atlanta in 1995 to become one of the original physicians in Ear, Nose and Throat of Georgia. He has built a thriving practice in Laryngology, Care of the Professional Voice, Thyroid/Parathyroid Surgery, Endoscopic Sinus Surgery and General Otolaryngology. A singer himself, many of his patients are people who depend on their voice for their careers, including some well-known entertainers. Dr. Koriwchak has also performed thousands of thyroid, parathyroid and head and neck cancer operations. Dr. Koriwchak has been working with information technology since 1977. While an undergraduate at Bucknell University he taught a computer-programming course. In medical school he wrote his own software for his laboratory research. In the 1990’s he adapted generic forms software to create one the first electronic prescription applications. Soon afterward he wrote his own chart note templates using visual BASIC script. In 2003 he became the physician champion for ENT of Georgia’s EMR implementation project. This included not only design and implementation strategy but also writing code. In 2008 the EMR implementation earned the e-Technology award from the Medical Association of Georgia. With 7 years EMR experience, 18 years in private medical practice and over 35 years of IT experience, Dr. Koriwchak seeks opportunities to merge the information technology and medical communities, bringing information technology to health care.

This article is published at Townhall Finance and was written for a Docs4PatientCare.   This is much more politics than Health IT but still a good read.

MK

Find the article here