Show Them the Money

Final rules governing the adoption of electronic medical records, released this week by the Health and Human Services Department, significantly softened proposed requirements floated earlier this year. The draft regulations generated some 2,000 comments, yet modification of the rules was largely a concession to large special-interest groups, notably the American Medical Association and the American Hospital Association, that had pilloried the proposed regulations as unreasonable and unrealistic.

Having won the day, the docs and hospitals are happy, right? Not really, says BNET blogger Ken Terry:

Despite the significant changes made in the regulations after overwhelming criticism from industry groups, those same groups were hostile or skeptical toward the final rules, which they'd still like to soften further so that providers can get the money with minimal effort.

At the heart of the modified rules are provisions that provide more flexibility to doctors and hospitals seeking to adopt health IT and share in an estimated $27 billion in taxpayer-provided incentive funds, which Congress set aside to offset IT procurement costs.

In a touching expression of gratitude, the AMA released a statement promising to scour the regulation "to see if the requirements have been reduced to allow more flexibility than the proposed rule," said Dr. Steven Stack, an AMA board member, who seized the opportunity to lobby the federal government for more money. "Costly EHR systems are out of reach for many physicians because of low Medicare payments and the prospect of steep cuts in December," he said.

The American Hospital Association complained that the Centers for Medicare & Medicaid Services, which will play a key role in the transition to electronic medial records, "continues to place some barriers in the way of achieving widespread IT adoption by our nation's hospitals and physicians," according to a statement by Rich Umbdenstock, AHA's president. "Today's rule raises some serous concerns and needs to be further evaluated to determine its impact on hospitals and the communities they serve."

Dr. William Jessee, president of the Medical Group Management Association, vowed that MGMA "will work closely with the CMS administration to incorporate additional changes related to implementation of the incentive program to allow the greatest number of practices to achieve meaningful use of EHRs," reported BNET's Terry.

"In other words," translates Terry, "MGMA will try to find some way to get more money for physician groups by influencing the Centers for Medicare and Medicaid Services."