Sunday, April 22, 2012

Are EHR Government Bribes, Bonuses, and Subsidies for Real?

I tell everybody very plainly I take bribes, but what kind of bribes?

Nicolia Gogel (1809-1882), Russian writer and critic of government bureaucracy, The Inspector-General (1836)

The American Republic will endure until the day Congress discovers it can bribe the public with its own money.

Alexis de Tocqueville (1805-1859), Democracy in America, (1840)

April 22, 2012- “Bribe” isn’t a bad word.  “Bribe” has many beneficent-sounding synonyms – bonus, favor, inducement,  subsidy, and incentive.   When government applies the word to EHRs, “bribe” is transmogrified into “incentives” for “meaningful use, ” of course.  “Incentives,” as every bureaucrat and capitalist knows, are a good thing. 

What government wants from EHR incentives is a nation-wide, interoperative, coordinated  computer system – with EHRs in every hospital and every doctor’s office.  

 These incentives resonate with government bureaucrats and EHR entrepreneurs, who have gathered together at the $27 billion EHR feeding trough.

Government has made a good start towards its goal of a national system.  CMS has just announced it has so far contributed $4.5 billion of taxpayer money to hospitals and doctors for installing EHRs that qualify for cash payments for meeting “meaningful use” criteria..

These EHRs are the basis for vast computer systems that will:

·         --speak and communicate with one another

·         --allow government to track health use and expenditures

·       ---  improve care though comparative outcomes

·        --- achieve “transparency “ in government health care dealings

·         --separate “good” hospitals and doctors from their “bad” counterparts, “good” being those who scrupulously follow CMS rules, regulations, and mandates

·         --reward hospitals and doctors who are “good” providers, to the tune of some $43,000 for Medicare and $52,000 for each doctors and several million dollars for hospitals who qualify by installing EHRs qualifying for “meaningful use.”

Given the fact that Medicare/Medicaid is the biggest  health payer by far of them all,  reaching these goals has the ring of inevitability.   

 Furthermore,  the government strategy seems to be working.  And why not?  Hospital executives and practicing doctors are smart people.   They will willingly accept the cash government is handing out and are not about to bite the hand that feeds them.

At least, that’s why I conclude from this article by Joseph Conn in the April 20 issue of Modern Healthcare,  and I quote.

“Nearly  $4.5 billion in federal incentives to implement electronic health-record systems has been paid out thus far, with program enrollments and payments still increasing in the first quarter of 2012.”

“There are now more than a quarter of a million (225,765) actively enrolled participants in the Medicare and Medicaid EHR incentive programs created under the American Recovery and Reinvestment Act of f2009, according to CMS.  Hospitals can receive payment under both the Medicare and Medicaid programs, and most do, but physicians and  other professionals can participate in one program or the other.”

“There have been 2, 667 payments made to hospitals under the Medicare and Medicaid technology programs, or both, totaling $3.1 billion.”

“Meanwhile, 222, 282 eligible professionals have enrolled, and 73,945 have been paid.  Medicare payme ts to 44,014 eligible professionals have totaled $792 million, while various state Medicaid programs hve paid 29,931 eligible professionals $628 million.”

“Active registrations by hospitals increased by 406, or 13%, in the first quarter of this year to 3, 483 participating hospitals.”

“Registrations for eligible professionals rose to 49,319,  29%, during the quarter to 222, 282.  Medicaid program enrollments of eligible professionals jumped nearly 51%."

“The average Medicare payment payment to hospitals l receiving Medicare and Medicad  payments has been $1.78 million.”

Are EHR incentives for meaningful use for real?  You bet they are.

Tweet:  CMS has paid $4.5 billion for hospitals and physicians who install EHRs.  CMS still has $22.5 billion in the till for more installations.

1 comment:

rosacea said...

Government has made a good start towards its goal of a national system.