Incentives for EMR

For several years, Washington circles have been talking about establishing incentives and disincentives for those physician practices that implement electronic medical record (EMR) systems. However, such plans have not come to reality. Now we see the first cautious steps to motivate you toward clinical computer systems.

In July, the Centers for Medicare & Medicaid Services' (CMS) program, Physician Quality Reporting Initiative (PQRI), went live. Based on legislation signed by the President in December 2006 and known as the Tax Relief and Health Care Act of 2006, the program offers an incentive to all those practices that submit their data in digital format. PQRI establishes a financial incentive for eligible professionals to participate in this voluntary pay-for-performance, quality- reporting program. Eligible professionals who successfully report a designated set of quality measures on claims within the traditional Medicare fee-for-service program for dates from July 1 to December 31, 2007, may earn a bonus payment, subject to a cap of 1.5% of total allowed charges for covered Medicare physician fee schedule services.

For a practice with large revenues, this may be very attractive. However, the process is cumbersome and some physicians have reported that it may be necessary to hire one more employee just to manage the program. Therefore, smaller practices have often said that this "is not worth the effort."

Nevertheless, there are considerations to use this legislation to expand the incentive toward adoption of EMRs. CMS representatives stated at Towards Electronic Patient Records 2007 that it is possible this process may be implemented as early as next year to establish a general pay-for-performance and EMR incentive program. It has been argued that even for small practices, it is worthwhile to familiarize yourself with the program. If EMR incentive systems will be implemented next year, the experience indeed would be worthwhile. Of course, nobody knows if and when the pay-for-performance program will become real; for more information on PQRI, visit www.cms.hhs.gov/PQRI/ 35_2008PQRIInformation.asp.

Note also that Safe Harbor Legislation has made it possible for health care organizations to fund, under certain circumstances, EMR software for physician practices at reduced prices. This option is already being used by a number of hospitals and other organizations. While many physicians are skeptical, because such financial assistance also means more influence and control over your daily care management, it is a movement many physicians cannot avoid.

Another potential incentive is that the government will help with the cost of implementing EMR systems. A number of legislative efforts have been successful in getting bipartisan support. Whether they will become reality is hard to say.