David Blumenthal, one year from his first day as national coordinator of health information technology, met with New York hospital executives on Tuesday who pressed for changes to proposed rules for hospitals' share of billions of dollars to promote electronic health records.
Hospitals with more than one campus are unfairly penalized under the proposed rules, New York health system executives argued.
Blumenthal, speaking before the Greater New York Hospital Association's annual meeting, told the crowd he could not discuss rules under development, but said his office was aware of executives' concerns.
The economic stimulus law, or American Recovery and Reinvestment Act of 2009, included $2 million—plus an additional payment per hospital patient—for hospitals that adopt EHRs and meet criteria to demonstrate meaningful use of the IT.
Under proposed rules, federal health officials will use hospitals' Medicare provider number to identify hospitals eligible for incentives.
That leaves hospitals with a single Medicare number but multiple campuses at a disadvantage, Steven Safyer, president and CEO of Montefiore Medical Center, which includes 1,300 beds at three campuses, told Blumenthal.
The New York City hospital stands to lose $25 million under the proposed rule, Safyer said in an interview.
The American Hospital Association has urged the CMS to instead identify hospitals by separate location.
Blumenthal said the fix hospitals are seeking faces a challenge that another recent amendment to EHR stimulus funding did not.
The Congressional Budget Office did not project how much awards to each hospital campus would increase the federal deficit, he said. Deficit projections did include the cost of extending EHR incentives to hospital-based physicians, which was included in a law signed by President Barack Obama in mid-April after hospitals and doctors lobbied for legislation
to overrule the CMS rule that excluded hospital-based doctors .
Blumenthal stressed the scope of efforts to expand health IT and reform the nation's health system before the crowd of New York healthcare executives.
Blumenthal said his endorsement for EHRs stemmed not from an interest in technology, but from personal experience as a physician. Comfortable and familiar with paper records, he nonetheless found electronic records improved care, he said. And doctors entering the workforce have a far greater expectation that medicine will include such technology, he said. “I don't think young physicians are going to tolerate the system I was so comfortable with,” Blumenthal said.
