Not surprisingly, the Healthcare Information and Management Systems Society, the Chicago-based trade group for healthcare information technology developers and users, supports the call yesterday by HHS Secretary Mike Leavitt for Congress to tack a healthcare IT adoption mandate onto pending legislation to the annual, year-end fix of the Medicare physician payment system.
Dave Roberts, HIMSS vice president of government relations, said with a key House IT booster bill, the Healthcare Information Technology Enterprise Integration Act, stalled and the Wired for Health Care Quality Act still under negotiation in the Senate because of challenges over privacy, security and healthcare quality provisions, "It looks like the Medicare fix might have some opportunity for providing healthcare IT legislation" in the near term.
Discussions on that legislation are under way with a decision on final language expected tomorrow in the Senate Finance Committee. Roberts said that committee members Sen. John Kerry (D-Mass.) and Sen. Debbie Stabenow (D-Mich.) "would like to put some HIT or e-prescribing language into that legislation."
There has been a lot of talk about the government investing only in electronic-prescribing systems, Roberts said, but HIMSS has been lobbying members of Congress that a boost be given to a wider spectrum of healthcare IT.
Still, he said, "We support any legislation that encourages the use of IT to transform healthcare."
Spokesmen for the two major organizations representing physician medical groups were far less enthusiastic about Leavitt's attempt to mix legislation with vastly different priorities. Fixing what they consider to be a broken payment mechanism is crucial to their members' financial well-being. In contrast, a plan to boost healthcare IT adoption, which is a concept they generally support, is by no means viewed as being as vital to their interests.
The Medical Group Management Association, which represents physician group practices, has the annual fix of the flawed Medicare reimbursement formula as its top priority. It doesn't want to see apples mixed with oranges. Robert Tennant, senior policy adviser for the MGMA, said, if allowed to stand, the 10.1% cut to Medicare Part B payments that the current formula would produce "would be a tremendous disincentive for practices to invest in healthcare IT."
"Obviously, we want to see a very clean bill that focuses squarely on fixing the physician payment issues," Tennant said. "We'd like to see financial incentives for health IT separated from the payment issue. That's obviously the best-case scenario."
Chet Speed, vice president for public policy for the American Medical Group Association, said members of his organization, which include large physician groups such as the Mayo and Cleveland clinics, already have a fairly high rate of adoption of electronic health-record systems. About 80% of AMGA members either have an EHR or are implementing one, Speed said.
But the AMGA still sees an EHR mandate as a bridge too far, Speed said.
"I think tying in an EHR fix may not be a realistic goal this year," Speed said. "There may be better ways to encourage HIT adoption, by providing incentives for uptake." Speed said the AMGA is supportive of a Kerry proposal to give a 1% Medicare payment bump to physicians for e-prescribing.