Hospitals stand to gain at least $2 million a year to aid in the adoption of healthcare information technology under the American Recovery and Reinvestment Act, but only if they qualify in time.
The proposed meaningful use rule, released in December, would require hospitals to comply with 23 measures to qualify for the financial incentives. The government is expected to issue the final rule this month.
At the American Hospital Association’s recent annual conference in Washington, D.C., many hospital executives voiced complaints about the proposed requirements.
Rick Pollack, the AHA’s executive vice president, said the rule is "asking for too much too soon."
Chief information officers at some of the most wired hospitals in the country agreed with Pollack’s assessment, admitting their facilities would be hard-pressed to qualify for incentives by next year.
Mark Probst, CIO at Intermountain Healthcare in Salt Lake City, said he would like to see more flexibility in the qualification requirements so that his system could use some of the extensive measures they already have in place. Since the proposed rule came out, Intermountain has had to add 19 to 20 new items to its IT strategy for this year.
“It’s a bit disconcerting,” he said.
In a letter to the Centers for Medicare & Medicaid Services, Richard Clarke, president and CEO of the Healthcare Financial Management Association, said the proposed definition could “make it impossible for the majority of providers to qualify for financial incentives and avoid substantial penalties.”
The HFMA believes that, in some instances, the definition will actually serve as a barrier to achieving CMS’ intended outcome.
“We have concerns about the timing and scope of the phases, the reporting burden, the broad definition of hospital-based physicians, the identification of hospitals for incentive payments and the Medicaid incentive payment requirements,” Clarke said.
Pam McNutt, senior vice president and CIO at the Methodist Health System in Dallas, said her organization began a complete healthcare IT overhaul in 2003 and now has some advanced functionality. But Methodist will only qualify for 2011 incentives “if there is some relief to the all-or-nothing approach,” she said.
Without flexibility, Methodist won't be ready until 2013.
Under ARRA, Methodist believes it could receive $450,000 for its Medicare physicians in its teaching clinics, $10.4 million for its four acute care hospitals and a similar amount for Medicaid, McNutt said.
CMS expects that 30 percent to 40 percent of providers (approximately 1,500 to 2,000 hospitals) will achieve meaningful use by 2011. But given the current range of baseline capabilities among U.S. hospitals and the time required to install an electronic health record, Clarke said HFMA believes this estimate is “optimistic.”