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HHS to pay doctors to use prescription systems

The Centers for Medicare and Medicaid Services will use financial incentives to encourage more doctors to use electronic prescribing systems to reduce medical errors, the Health and Human Services Department secretary said at a press conference on Monday.

Comment on this article in The Forum.Mike Leavitt said illegible physician handwriting on prescriptions results in drug errors that cause adverse reactions for 1.5 million Americans every year and requires pharmacists to make 150 million phone calls annually to doctors to decipher their prescription. "That's a lot of people injured due to bad handwriting," he said.

In 2009 and 2010, Medicare will pay clinicians 2 percent of the total allowable Medicare charges that a clinician files that year. The payment drops to 1 percent of Medicare charges in 2011 and 2012, and then to 0.5 percent in 2013. The incentive payments, Leavitt said, should serve be powerful motivation for adoption of e-prescribing systems.

After using this carrot approach, Medicare will use a stick to convince clinicians to use e-prescribing systems. After 2012 doctors who do not use e-prescribing systems will be hit with an unspecified reduction in payment, Leavitt said.

Congress included the payments in the 2008 Medicare Improvements for Patients and Providers Act, which it overwhelmingly passed on July 15 after an initial veto by President Bush.

Currently, only 50,000 physicians, or about 10 percent, of doctors use e-prescribing systems, said Rick Ratliff, co-chief executive officer of SureScripts-RxHub, which provides electronic connections between clinicians and nearly three-quarters of the 58,000 pharmacies nationwide. He expects that number to rise to 15 percent by the end of the year and to 30 percent by 2011, which will cover 80 percent of the total number of prescriptions.

Medicare incentive payments for e-prescribing will "help drive adoption and utilization and accelerate the shift to paperless prescriptions," Ratliff said. The government could encourage further use of e-prescribing systems if it changed Drug Enforcement Administration regulations, which require clinicians to handwrite prescriptions for controlled substances or prescribe the drugs through a semi-paperless system, he said.

Medicare should save $156 million during the next five years by clinicians using e-prescribing systems from avoiding adverse drug effects, said Kerry Weems, the administrator for the Centers for Medicare and Medicaid Services.

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