Six Republican Senators have released a report arguing that there’s no evidence the $32 billion spent on Meaningful Use is delivering the benefits it was designed to offer.
The report, entitled “Reboot: Re-Examining The Strategies Needed to Successfully Adopt Health IT,” was released by Senators Thune, Alexander, Roberts, Burr, Coburn and Enzi. In the report, these Senators dig into the implementation of Meaningful Use and critiquing how the money’s being spent.
The Senators’ concerns are as follows:
* Interoperability: They argue that HITECH is not doing enough to promote interoperability. The Senators say that incentive payments are being doled out without clear evidence that providers can connect with one another.
* Cost savings: Health IT has been promoted as a tool for taking costs out of the health system, and, the Senators concede, is projected by the CBO to save Medicare and Medicaid $12.5 billion through 2019. However, they note that some reports state that health IT may have accelerated ordering of unnecessary care as well as increased billing per procedure.
* Oversight: The Senators cite reports from the HHS Inspector General and the GAO which seem to suggest that the Administration hasn’t done enough to prevent fraud and waste in the Meaningful Use program.
* Security: The report argues that Meaningful Use standards don’t do enough to secure private patient data; they cite reports from the HHS OIG claiming that Medicare and ONCHIT are “lax” in this area.
* Sustainability: When the Meaningful Use money runs out, will providers still be able to keep their health IT equipment running? In the report, the Senators suggest that the ongoing cost of maintaining EMRs and other health IT may be too much to bear, especially for small practices, when the money runs out.
As with most reports of this kind, I’d argue that there’s some truth mixed in with some partisan posturing. For example, I can see where Senatorial observers might be frustrated with the pace of interoperability efforts. On the other hand, I think the sustainability argument may be a straw horse; my gut tells me that once a practice or hospital has spent years implementing an EMR, they’re not going to drop it like a hot potato when the incentives stop coming.
What do you think of the Senators’ critique?