Private Payers Need to Join Humana, CMS With EHR Subsidies

Ever since the American Recovery and Reinvestment Act became law in February 2009, giving birth to the phrase “meaningful use,” I’ve wondered when private insurers would follow the federal government’s lead and start offering financial carrots and sticks for using and not using EHRs. After all, one of the purposes of the Medicare and Medicaid incentive program was to address the fact that payers tend to reap the greatest financial gains from hospitals and physicians adopting EHRs, even though most if not all of the cost of acquiring the technology falls on the provider.

Federal officials have made it clear all along that “meaningful use” is just that, the meaningful use of the technology. The government was not simply going to write checks so providers could go out and buy technology. As the country’s largest purchaser of  healthcare services, CMS wanted some value for its money (not exactly something you hear every day when it comes to government spending).

I’d been hearing for years that major commercial health insurers also were willing to share some of the savings from EHR adoption, but not until the largest payer of them all, Medicare, did so first. The private sector usually does follow Medicare’s lead when it comes to major policy shifts. Medicare now has done so, but private payers have been mostly silent. Mostly.

This month, as InformationWeek reports, Humana teamed up with Allscripts Healthcare Solutions to offer physician practices financial incentives for purchasing Allscripts EHR systems. The deal is similar to one Humana cut last year with Athenahealth. A few Blue Cross and Blue Shield plans, notably in Massachusetts and Rhode Island, have led similar programs at the state level, with eClinicalWorks the main partner.

But unless I’m forgetting something, Humana is the only big payer that has jumped into the game. Where are the UnitedHealthcares, Aetnas, Cignas and WellPoints of the world?

Payers, it’s time to make good on the lip service you gave years ago and start passing on some of the savings you will realize from Medicare, Medicaid and hundreds of thousands of providers spending billions of dollars on EHR technology and health information exchange efforts.


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Neil Versel

Neil Versel

1 Comment

  • Some thoughts …

    1. Why would private or publicly held companies “pass on” windfall savings resulting from others’ investments back to providers. More likely in a competitive market those savings would go to their customers (subscribers).

    2. Maybe their piece of the individual provider’s market isn’t big enough to justify making an investment?

    3. Payer-application vendor alliances if they got strong enough could change the entire EHR market place through cohersion of the providers.

    What if CMS (ONC) instead of opening up a 300 plus vendor forest had told docs “use one of these three EHRs in your practice or we will not accept your billing … but if you do adopt one of our choice packages we will foot the entire bill of implementation?” What would that have done to the market?

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