Electronic Health Records

Adoption & Implementation News

Are Meaningful Use Incentives Worth a Provider’s Investment?

By Kyle Murphy, PhD

Recent reports show that physician EHR adoption is increasing but that the implementation and use of this EHR technology will not be directed toward the EHR Incentive Programs and receiving meaningful use incentives.

As reported earlier this month, a survey of more than 2000 members of SERMO showed that 55 percent would not be demonstrating Stage 2 Meaningful Use in 2015. Meanwhile, an ongoing study by SK&A indicated a ten-percent increase in EHR adoption among physician offices.

These findings led to a question for our readers: If EHR adoption is increasing among physician offices, then why is meaningful use non-participation trending downward?

According to respondents, the answer to that question simply comes down to mathematics:

I was at a healthcare conference recently and a panel of four hospitals that were going gung-ho for Stage 2 Meaningful Use but did not know their costs to implement and continue to meet meaningful use requirements. Now, they were pretty big and had lots of Medicare patients so it “probably” makes sense ROI-wise, but I disagree that most providers have done the math — at least I see no evidence that there is a preponderance of providers that really know their costs — for anything.

In the case of meaningful use, there is a lot more to it than having a meaningful use-certified EHR. But it does not take a CPA to tell you that if you are doing $500,000 in billing and 50/50 Medicare, the penalty is $2500. However, I sort of see how some people can get suckered into this thinking they are recovering their EHR (sunk) costs, but you really need to look at other costs (including hidden and opportunity costs) and balance that against the revenue (incentive).
—Healthcare IT Consultant

The ROI is negative. Meaningful use requires a compliant software platform and too many of the gorilla’s didn’t get their reporting together on time for practices to react to and attest to Stage 2 requirements.

My experience is that on the front end. Providers go into meaningful use hopeful and clueless as to the value, cost, and ROI and over the course of time realize they are drilling holes in the bottom of their boat to let water out. I agree — most practices don’t have the information and too many are not sophisticated enough to discern the hidden and opportunity costs those of us in the industry are aware of.
—Informaticist & Healthcare Consultant

From the provider’s perspective, return-on-investment is about more than money — it is also a matter of quality. Meaningful use could prevent physician office EHR selection from running its full course and finding the right product at the right price:

EMRs have mixed (at best) popularity among physicians, but they are gaining some traction. Meaningful use, and especially Stage 2 Meaningful Use, provides no noticeable benefit with regard to patient care but requires a major investment of time and energy. The hours spent understanding and keeping up with the ever-changing requirements and deadlines are significant, let alone the hours spent meeting them. The financial penalty is judged to be the smaller and less painful option.

The choice of an EMR and the decision to participate in MU is often made by administrators in large, hospital-owned practices. Alternatively, lead physicians more often make that call in doctor-owned groups. That often leads to a different choice of EMRs, and, in my opinion, is likely to lead to a higher meaningful use participation rate in the big, hospital-owned Epic/Allscripts practices.

You simply have to look at the complexity and the time spent in meeting Stage 2 Meaningful Use standards. As we move forward the end simply doesn’t justify the means. This is a hoop jumping contest at best and any physician can see that the “initiatives” will have very little impact on saving money or improving care.

I had to hire a consultant like many providers to make sure all the boxes were checked properly. Two providers in my office attested to Stage 1 Meaningful Use in March 2014 and we still have yet to be reimbursed. I get a plethora of excuses at the state CMS office that they are simply overwhelmed and working on hospitals that attested last year. I am curious if this is a state-by-state phenomena. I suspect the infrastructure was not in place to provide timely payments.
—Healthcare CEO

Have thoughts of your own? Let’s here them.




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