How does the EHR impact health care consolidation? The Obama administration has tried to entice physicians, hospitals and health care providers to recoup some of the cost of purchasing and EHR by providing financial incentives for the “meaningful use” of certified EHR technology. …show more content…
Health care systems cite consolidation as a way to efficiently initiate a boost in revenue by adopting EHR software systems. So far there has been mixed results on the cost recovery of implementing and EHR, with some experts citing a return on investments in as little as 10 months and others showing only 27% of practices achieving an ROI (Jang, Lortie & Sanch, 2014; Lowe, 2013). Smaller practices with fewer than 6 physicians are especially vulnerable to the costs of an EHR with study authors noting that practice consolidation will become a necessity (Lowe, 2013). The Medicare and Medicaid EHR Incentive Programs which has been implemented in stages since 2011 has put forth objectives that if met by the providers results in a stimulus payout, but if unmet, results in financial penalties in the form of reduced provider reimbursement for fee-for-services. In January 2015 the Meaningful Use criteria kicked in at high speed with increased criteria and objectives that must be met before stimulus reimbursement can be paid out to providers who provide care for Medicare and Medicaid patients. The criteria is meant to improve “quality, safety, efficiency, and reduce health disparities”(healthIT.gov, 2015). It is intended to encourage the doctor-patient relationship thru improved care coordination, public and population engagements and protection of patient health information and lastly improved health outcomes (healthIT.gov, 2015). The premise is laudable, but the implementation is arduous and time-consuming. Attesting to meeting the criteria sets a provider up for scrutiny by the Centers for Medicare and Medicaid Services (CMS) serving as a disincentive to participating in “Meaningful Use”. Even an inadvertent error can kick in a Medicare audit resulting in large fines for a small unknown reporting error. Most physicians practice in good faith and want to comply with regulations, but complying means time away from their practice attending seminars or listening to webinars to stay up to speed on the newest government regulations. For example, when the ICD-10 diagnosis coding becomes law on October 2015, every hospital, health care provider, clearing house and insurance company must possess the software to enable the correct coding for billing. The financial burden of purchasing this software and maintaining licensing and update can be cost prohibitive to some physicians who often feel forced to sell out to health care systems. Large health care systems are able to negotiate the purchase of an EHR and navigate its implementation by support of an IT department, something primary offices often lack. …show more content…
It should be noted that very few argue against e prescribing, but many argue against the constant “clicking in boxes” that restricts provider-patient conversations. Gains in efficiency have been offset by reduced provider productivity with providers citing an EHR “associated loss of 48 minutes of free time per day (Cebul et al.,, 2011; McDonald et al., 2014). Meaningful use criteria which started in 2011 with 15 objectives, and now in 2015 has a total of 20 objectives that must be met and attested to before federal stimulus money is released to the provider is time-consuming (cms.gov,2014). The release of stimulus money by adoption of an EHR into a providers office or hospital systems is meant to incorporate best practices and evidence-based care into a practice, not just the adoption of technology to fulfill a government mandate (cms.gov, 2014). Arguably EHR’s are here to stay and for the most part create more solutions than problems. Physicians will be forced to embrace them and will need to use them to their