Tuesday, September 7, 2010

Private Sector and Meaningful Use

There was an article in the September 2010 Health Affairs How Health Plans, Health Systems, And Others In The Private Sector Can Stimulate ‘Meaningful Use’ written by David Blumenthal, M.D., National Coordinator for Health IT; Sachin H. Jain, M.D., Special Assistant to the National Coordinator; Joshua Seidman the Director, Meaningful Use, in the Office of the National Coordinator. They argue that the private sector can further accelerate health IT adoption by implementing these five strategies that are complementary to the CMS incentive programs:
  • enhanced incentive payments to providers from private-sector payers
  • benefit designs, such as lower copayments, that will steer patients to providers who are “meaningful users”
  • adopting other strategies to encourage consumers to see these providers, such as through a “star” rating system
  • requiring clinicians to be meaningful users to participate in payer contracts or qualify for hospital admitting privileges
  • alignment between meaningful use and other regulatory imperatives
They point out that many payers such as Highmark Blue Cross Blue Shield, WellPoint, Aetna, and UnitedHealthCare have announced programs to better align their existing incentive programs with the definition of meaningful use. The article states:
The industry also could offer loans for small physician practices and hospitals that lack investment capital to purchase the health IT necessary to qualify for meaningful use incentive payments. WellPoint, for example, has said it will launch in 2011 a zero-interest loan program for hospitals in rural, critical access, or medically underserved areas of California and Georgia to enable them to adopt health IT and achieve meaningful-use criteria.
UnitedHealth Group is also deploying its performance-based contracting program, which provides outcomes-based financial incentives to physicians who use EHRs in ways that meet meaningful-use criteria. The article also suggests that health plans and employers could offer patients lower copayments for seeking care from providers that have demonstrated meaningful use.

One of the more provocative methods of further encourage meaningful use of health IT could be the suggestion that hospitals, health systems, and physician networks by requiring it as a condition for participation in these contracts or as a condition of receiving admitting privileges. This may meet with some stiff resistance in the provider community...

Perhaps the first adoption we'll see of these strategies is in the area of regulatory alignment. If bodies such as National Committee for Quality Assurance (NCQA) and the Joint Commission ( formerly the Joint Commission on Accreditation of Healthcare Organizations or JCAHO) incorporate meaningful use requirements into their accreditation process it will certainly drive adoption. . The American Board of Medical Specialties (ABMS) has said that it would incorporate tools to promote meaningful use of health IT into its maintenance-of-certification program. ABMS is also interested in data interchange utilities that would enable physicians to submit Physician Reporting Quality Initiative and health IT meaningful-use measures to the boards in the same format used by the CMS in an effort to avoid redundant data submissions.

The piece ends with a call to collaboration that makes a strong case for all of the different sectors to work together to achieve the aims of meaningfully using health IT to improve care and lower healthcare costs. We can not, and should not, rely on the government to do everything for us. It is going to take cooperation between the government and all of the various private sector stakeholders to reach our common ends.


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