How Will the Coming Election Year Impact Healthcare IT?

It seems like the Presidential election should be closer since we’ve been hearing about possible Presidential candidates for the past year. However, we still have a whole year before the next Presidential election. Does anyone else think we’re going to be tired of this process a year from now? (But I digress)

In past years, there was certainly a lot to talk about when it comes to the impact a new president would have on healthcare IT. However, I don’t think that this presidential election will be the same. I think that’s true for healthcare in general as well.

On the healthcare IT side, meaningful use has basically run its course. Sure, Jeb Bush has asked to eliminate meaningful use and government mandates and penalties for EHR use. Although, John Halamka and Marc Probst have both recently asked for the same. We’ve written previously about how getting rid of meaningful use wouldn’t do much of anything to alter the current course of EHR and healthcare IT. It just wouldn’t change much of anything.

What could a presidential candidate do to impact healthcare IT? I really don’t see them having an interest in doing much of anything to impact the current course of healthcare IT. If you think otherwise, I’d love to hear why.

On the healthcare side of things we might see more changes. Certainly the topic of healthcare costing the US too much money is a very big an important topic for the president. However, I think Obamacare and those healthcare reform efforts are too far gone to be able to really go back and change them now. Sure, we could see some changes here and there, but I think it’s too late for a new President to really drastically change what’s already been done.

Related to this is the move away from fee for service to a value based reimbursement environment. Would any President condone this direction? Would any President advocate for a return to the old fee for service environment? I don’t see it happening. As many people have told me, the shift to value based care has left the building. There’s no coming back. Could they modify the approach and some of the details. Certainly! However, they’re not likely going to change the trajectory.

Long story short, I’m not sure any Presidential candidate will do anything that will drastically impact healthcare IT and healthcare as we know it. Sure there will be some tweaks that will have some impact, but nothing major like Obamacare or the HITECH Act.

Do you agree or disagree? I always love to hear other perspectives.

About the author

John Lynn

John Lynn

John Lynn is the Founder of the HealthcareScene.com, a network of leading Healthcare IT resources. The flagship blog, Healthcare IT Today, contains over 13,000 articles with over half of the articles written by John. These EMR and Healthcare IT related articles have been viewed over 20 million times.

John manages Healthcare IT Central, the leading career Health IT job board. He also organizes the first of its kind conference and community focused on healthcare marketing, Healthcare and IT Marketing Conference, and a healthcare IT conference, EXPO.health, focused on practical healthcare IT innovation. John is an advisor to multiple healthcare IT companies. John is highly involved in social media, and in addition to his blogs can be found on Twitter: @techguy.

4 Comments

  • Good post John,
    I think meaningful use is dead with or without anyone’s intervention. I’m glad that some want to put the nail in now before more damage to the provider community occurs. ONC and CMS has alienated and disenfranchised 100’s of thousands of providers. Penalties and forced regulation never ever works. I’ve been around long enough to see many different programs come and go. Without a doubt, MU is dead. The question is how do we get health IT back on track. It seems that ONC has no idea on how to do this. They would rather keep piling on Stage 3 measures/objectives to the 10% remaining providers that are trying to do MU. They don’t seem to get it that you need an ecosystem of all healthcare providers to make this thing work. Somehow they feel more 1000 page complicated regulation is the answer. Its kind of sad that they do not listen to the front line providers out here. If you look at regulations.gov at the stage 3 meaningful use comments that have arrived since October (the new comment period, sort them to most recent), they are 100% all negative and disturbingly similar that EHRs are in the way, unsafe, not usable, inefficient. I’m not sure what planet ONC or CMS is on, that they think that piling on with Stage 3 is even an acceptable idea at this point.
    As for value based care or shared savings, this is nothing more than the same stuff tried many different ways in the past. Similar to HMOs etc. That you get one fee, and try to make the patient use as little healthcare as possible. It just does not work. Look at the pioneer ACO models, over half of the providers orgs have quit. Prominent ones. I’m not saying its not a good idea to try, but truthfully, it just does not work well. Everyone is looking for that magic pill, but its just not there. You need a vibrant working Health IT system to get this better. You actually need EHR vendors to work with providers on what they need. Not what ONC and CMS and MU wants. ONC and CMS should be working towards one thing, interoperability. Stop worrying about certification, MU, counting this and that. Its just not necessary. Let us customize our workflows, and we get our information to an HIE or whatever we all decide is the best place to share information. To accept that over hundreds of thousands of providers are not participating in health IT and MU should be a huge wake up call to anyone that wants to do VBC or ACO or CCM (chronic care management). There are just no providers left that want to take all this on…all this data entry, attestation, audit risks, counting measures and numbers, etc. We just have more important things to do. Or worse they are driving people out of practicing or participating in medicare or these programs. Penalizing providers and then putting us out of the ecosystem really devalues our work. Many of us want to participate in some important way, but just cannot risk the costs, complexity, inefficiency, auditing, 100% or none method they have set up with certified only EHRs. Its actually a much bigger mess that they even realize.

  • I think a new administration will want to take a fresh look at how ONC has promoted EHRs. There is great disatisfaction that crosses most traditional partisan lines, however that does not mean whoever is in the White House would act the same.

    Democrats would take more of an incremental approach focusing on interchange, etc., problems. Republicans would probably wipe out ONC and its programs and substitute something else or decide to do an elegant bug out and leave the field to sort itself out.

    Either way, ONC and MU will not look the same.

  • Hi John,

    I agree with Meltoots. I, too, have been around this game for a few decades (hard to admit, but true!) and MU as it currently exists is toast for all the reasons Mel said. As for value-based bundled payments based on outcomes, they’ve been doing it in hospitals under DRGs for decades (even longer than I’ve been writing about it – haha!) and it can work there because the hospital controls the whole process end-to-end. When you start smooshing together different kinds of providers in different scenarios, not having a good way for them to communicate with each other, and having significant players not part of the package – eye, teeth, psych – those ACOs are going to tank. I haven’t at all been surprised that the Pioneer ACOs are leaving the wagon train. Nobody can afford to do it that way. You can’t predict without good data, and you can’t control without having all the players under your roof. So, enough about that.

    As for what will or should happen with Health IT – well the government is trying to rally what they’ve got and refocus. They have a new strategic plan and a bunch of pieces that look like they make sense. I haven’t taken a close look at it, although it’s on my agenda to do so at some point and then I’ll blog about it.

    As for presidential politics, yes, the guy in the White House can have an impact but healthcare has been on the same trajectory through about five administrations on both sides of the aisle, so the party is only about the tweaks and the pace. Bush gave us ONC and a great first chief in David Brailer, but has the ONC outlived its usefulness? I am inclined to think that it can play an important role under any administration. Just my paltry two cents.

    For now, yes, Meltoots, I agree with what you said. And John, this is a great post and this is a terrific venue to meet up with people with like concerns. Thank you for your dedication to the task. You provide a very valuable service!

    Best,
    Peggy

  • meltoots,
    What a great point about the value of MU3 being so diminished because only 10% (or whatever the number) are actually participating. I’m going to write a post about that idea.

    Carl,
    I think what you describe is what they’d do if they cared enough about ONC and health IT. I just think the new president will have so many other things on their plate that dealing little old ONC and health IT won’t even reach their agenda.

    Peggy,
    Glad you enjoy it and thanks for joining in on the conversation.

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