Should Pathologists Buy EHR Systems for Their Practices?
Meaningful use of electronic health records has become one of the ongoing war cries in the healthcare reform battles and proposed cost-saving, incentive-laden programs, to reward those who do and demonstrate doing so while penalizing those who don’t want to play along and face the consequences.
One of the more popular programs has been reimbursement to hospitals and practitioners for adoption of electronic health records (EHR) and showing meaningful use of the technology by satisfying some of a long list of “meaningful” health care items such as diabetes control, smoking cessation, monitoring of blood pressure, asking about use of seat belts and other low-cost, preventive “health care measures” that will, the thought it, promote positive outcomes through healthier, fuller and longer lives and lower number of hospital admissions, hospital stays, chance of nosocomial infections, prevent costly complications of treating the disease rather than preventing it, etc… You get the picture.
Medicine is the only professional continuously trying to put itself out of business. Fortunately, most of us do our part to insure that medicine remains in business.
Apparently, the $85 billion dollars set aside for these reimbursements as part of the $787 billion dollars or so of stimulus funding that this was a part of did not take into consideration pathologists and I would gather radiologists or anesthesiologists or other healthcare providers that may be hospital-based or non-direct patient care specialities. What about neonatologists? What about medical geneticists?
Since those specialties, pathology among them typically do not invest in EHRs for their practices, there would be no way to apply or compete for meaningful use dollars to offset the costs of those investments. Therefore, pathologists would be at risk for facing penalties for not going along with the program. It is almost as absurd as penalizing an gynecologic surgeon because their patient complains of abdominal pain following a hysterectomy, which I have heard is being discussed in hospital and CMS committees alike.
Anyways, the College of American Pathologists has been fighting this problem and recently through its Statline publication to its members notified subscribers of their ongoing efforts. Let’s hope Congress, specifically, the House Ways and Means Committee and Energy and Commerce Committee notice the issue here and resolve this matter permanently:
New legislation, H.R. 1309, the Health Information Technology Reform Act, was introduced last week to exclude pathologists from facing penalties for failing to meet federal requirements for meaningful use (MU) of electronic health records (EHR).
The Meaningful Use incentive program for Medicare and Medicaid physicians currently awards incentive payments to physicians who can demonstrate “meaningful use” of EHRs based on a set of rigid requirements. Starting in 2015, physicians who fail to demonstrate meaningful use of EHRs will face a 1% penalty on their Medicare payments. That penalty could rise to as much as 5% in 2017 and beyond.
Most pathologists are unable to participate in the current federal MU incentive program because the requirements do not allow for differences among physician practices, and specialists like pathologists who practice in medical laboratories using laboratory information systems, (rather than EHRs) cannot meet the prescribed MU requirements.
Through CAP’s advocacy, CMS granted pathologists a hardship exception from penalties in 2015, but the exception is granted only for one year at a time, for a maximum of five years. This bill will permanently exempt pathologists from participating in the program.
A similar bill introduced in the 112th Congress by Rep. Tom Price, MD (R-GA) was supported by CAP and received 60 co-sponsors before the session ended. This new bill was co-sponsored by Rep. Price and Rep. Ron Kind (R-MI), both members of the House Ways and Means Committee. The bill has been referred to that committee and the Energy and Commerce Committee.
