In continuation of yesterday’s Meaningful Use chat, PYP editor, Salvador, and I kept the ball rolling with a discussion on the controversial, ONC proposed EHR vendor certification fee and its possible impact on health care providers.
Here’s part deux of our email thread for your reading pleasure:
Xavier: I’m glad you brought up the proposed EHR vendor fee.
Apparently, Dr. Farzad Mostashari, National Coordinator for Health Information Technology at the U.S. Department of Health and Human Services, wants to apply a fee to EHR vendors who wish to certify their products for Meaningful Use standards.
His goal is to raise an additional $1 million to support the various activities of the ONC.
Do you think this proposed fee will help or hurt the government’s overarching goal of comprehensive health IT adoption?
Salvador: I’d like to say it helps since the fee is supposed to ensure the viability of a certification process, which helps providers choose EHRs that are actually going to help them attest to Meaningful Use. This gives qualified EHR vendors a competitive advantage over those vendors lacking certification.
Unfortunately, this will hurt universal health IT adoption, because if EHR vendors are charged with extra fees guess who the costs will be passed off to? Providers, of course. If so many providers are trying to avoid adopting EHRs due to high costs, hence the previously discussed bill, there’s no way these providers are going to adopt more expensive EHR solutions.
Xavier: Well, the HIMSS EHR Association (EHRA) is definitely against it.
“EHR developers are already devoting extensive resources to successful implementation of the EHR Meaningful Use Incentive Program and other healthcare delivery reform efforts, including the significant fees associated with EHR product certification,” the group said in a statement.
Rather than the proposed user fee approach, the EHRA suggests that HHS reevaluate all of the requirements in the Meaningful Use program and streamline any associated certification activities.
Whatever happens I think the government will get its way. I just hope that if the fees are implemented the funds will be allocated properly.
Salvador: Streamlining the process could work, but it would have to be done without creating an avenue for lower-quality EHRs to enter the market as certified.
Maybe the ONC could just sell cookies to raise the money. It seems to work for the Girl Scouts. Nothing like Sug-EHR cookies to make the mouth water.
Seriously though, I’m worried about small EHR vendors. Could the proposed fee eliminate some small vendors from the market place? Competition for the so-called ‘big boys’ is key for small-practice physicians, giving them a multitude of capabilities and prices to consider when shopping for an EHR.
Xavier: Heh. Sug-EHR cookies, good one…
It doesn’t look like the fee is going to be too high because the ONC is only looking to raise $1 million in total revenue from it, an amount that should be divided amongst the hundreds of EHR vendors out there, making it less expensive.
Yet, no details of the fee structure, assessment strategies, or potential exemptions have been released by the agency.
All I know is that nobody likes to pay more, and as you said, the danger lies in vendors passing on these additional, unanticipated costs to providers.
I think a solution could emerge if the ONC agrees to meet with the EHRA and representatives from the medical community to iron out a deal that proves beneficial for everyone involved.
Reminds me of a President Obama quote I heard recently, “A good compromise, a good piece of legislation, is like a good sentence; or a good piece of music. Everybody can recognize it. They say, ‘Huh. It works. It makes sense.’”
Let’s hope the ONC can “make sense” of this mess.
Salvador: It has to. With the 2% sequestration induced cuts to the Meaningful Use incentives combined with the Medicare payment cuts proposed in President Obama’s 2014 budget request, health care providers could use some good news.
Anyway, let’s stop this thing before we end up with part three. Always a pleasure hearing your insights. Let’s do it again sometime.
Xavier: Alright… Til next time bud.
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