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Insurers, Health Care Providers Vow to Step Up on Health Tech

By Jane Norman, CQ HealthBeat Associate Editor

August 5, 2010 -- Insurance companies, health care providers and professional organizations that oversee physicians on Thursday announced a host of private-sector initiatives aimed at complementing the federal push for wider use of electronic health records in health care.

But the insurers said that, at least for now, they're not interested in penalizing doctors or hospitals who don't adopt electronic recordkeeping that meets federal standards. Instead they are offering incentives ranging from zero-interest loans to outcome-based bonus payments.

The announcements at a forum at the National Press Club came a month after the Department of Health and Human Services released a final rule setting the standards for electronic health record use by doctors and hospitals. That regulation governing the "meaningful use" of electronic records grew out of a larger health information technology program in the 2009 economic stimulus law that will provide up to $27 billion in incentives over a decade.

"Making this work is not a piece of cake," said Stuart Altman, a professor of national health policy at Brandeis University, at the event sponsored by the Health Industry Forum and Health Affairs magazine. He added that when the federal government and private sector are on different paths when it comes to technology, "it just doesn't work," including when one jumps ahead of the other. "If we are going to make this work as a country, both parts of our big system have to play together," said Altman.

David Blumenthal, the national coordinator for health information technology at HHS, said the private companies are "allies" in the effort to spread the use of technology and to improve the health care system's quality, control its costs and boost its efficiency. "We have, from the beginning, and will continue, to seek partnerships with private sector organizations of all types," he said. "This is going to be a team sport."

Charles Kennedy, vice president for health information technology at WellPoint, Inc., with more than 33 million members, said the company will be aligning its pay-for-performance incentives with the federal meaningful-use standards, which will make it easier for physicians since they will have a single measurement to meet.

WellPoint also will set up a short-term program to help with financing for health tech needs for hospitals in rural, critical access or medically under served areas. It will be launched in California and Georgia. "We don't want health IT to create a world of have and have-not," Kennedy said. WellPoint will spend in the "hundreds of millions," he said.

Lonny Reisman, senior vice president and chief medical officer at Aetna, Inc., said Aetna has spent $1.8 billion on health technology over the last five years, "so this is not new to us." Aetna will provide incentives related to achievement of specific goals by physicians, he said.

At Highmark Blue Cross Blue Shield, the company will also be aligning its pay incentives for physicians and hospitals with federal meaningful-use standards, said Donald Fischer, chief medical officer. "What we'd like to be able to do is not just give credit to physicians" for using electronic records "but having an impact," he said. More points will be given to doctors for using electronic recordkeeping, he said.

Rhonda Medows, chief medical officer at UnitedHealthGroup, said the company would push a five-part effort, including a national program with outcome-based payments for physicians who have successfully adopted electronic recordkeeping that meets federal standards. In the past the program has just been regional.

In addition, UnitedHealthGroup will give new credit toward its "premium designation" for physicians who meet federal standards for health technology, Medows said. That designation is publicized to consumers, she noted.

In the company's physician advocacy program, experts who help doctors with administrative work will be trained to help physicians assess the gaps in their practices' programs, and zero-interest loans will be made available to help physicians access a care management program, until they can receive federal reimbursement in 2011, Medows said.

One provider organization that has moved forward on health tech is Partners Healthcare, a system founded by Brigham and Women's Hospital and Massachusetts General Hospital, said Tom Lee, network president. In 2007 they made implementation of electronic records a criteria for remaining in the network. "At the end of the day we threw out about 188 physicians who did not want to implement and it was a landmark moment for us," he said. Incentives and tougher approaches will be used in the future, he said.

"About 200 physicians will be finding out this fall they are in danger of being thrown out of our network for not using electronic prescribing" at a set level, he said. Residents also are being trained in health IT.

On another front, the American Board of Medical Specialties, which oversees physician certification, said it will reward doctors for meaningful use of health tech in its continuing program for maintaining certification. And the Federation of State Medical Boards said it "recognizes widespread adoption of electronic health records could be used by doctors to both improve patient outcomes" and assess competence for the purposes of issuing licenses.

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