Will There Be Help For Your Health IT Clients Who Aren't Eligible For EHR Incentives?
By Megan Williams, contributing writer
EHR adoption is low when a healthcare provider isn’t eligible for incentives.
With all the debate around the effectiveness of Meaningful Use programs, it’s impossible not to ask the question of what EHR (electronic health records) adoption would look like without government intervention.
A recent report from Health Affairs might shed some light on that question.
EHR Adoption Beyond The Post-Acute Setting
Study Authors Larry Wolf, Jennie Harvell, and Ashish Jha used national data to examine adoption of EHR systems among inpatient providers that were not eligible for federal Meaningful Use incentives. These included long-term acute care hospitals, rehabilitation hospitals, and psychiatric hospitals.
Overall the report found adoption rates to be extraordinarily low, and less than half the rate of short-term acute care hospitals that have been eligible for incentives. The breakdown of facilities with at least a basic EHR system is as follows:
- Short-term acute care: 12 percent
- Long-term acute care: 6 percent
- Rehabilitation hospitals: 4 percent
- Psychiatric hospitals: 2 percent
Why It Matters
While not at the forefront of care, these facility types see a large number of patients. As the study states, nearly one-third of Medicare patients discharged from short-term acute care hospitals are sent to post acute care settings, rehab hospitals included. It’s expected that that number will increase as time goes on. Additionally, case studies involving post-acute care providers indicate that they stand to see similar benefits around quality and efficiency gains as their acute care counterparts that have implemented EHR systems.
Policy Implications
The study emphasizes the importance of EHR adoption to care coordination issues and a potential trickle-down effect of EHR adoption: “A major cause of inefficiency in our health care system is fragmentation and lack of coordination across care settings. The Affordable Care Act makes some efforts to address these challenges by requiring the Centers for Medicare and Medicaid Services to experiment with new delivery and payment models, such as bundled payments and accountable care organizations. Fundamental to the success of any of these programs is the ability to share clinical data across providers. These emerging payment models — along with the needs of post acute care providers to maintain relationships with acute care hospitals — may force ineligible hospitals to adopt EHR systems and use electronic health information exchange, although they will be at a financial disadvantage because of their lack of HITECH [Health Information Technology for Economic and Clinical Health Act] incentive payments.”
Recommendations
The paper recommends that, in order to create a nationwide health IT infrastructure, policy makers at both the federal and state levels should consider solutions such as adopting additional measures around HIT standards for ineligible hospitals, including them in state HIE programs, and creating low-interest loan programs to ease the financial burden of EHR adoption.