CSC report on meaningful use tells private payers to get in the game

Of all the 800-pound gorillas in the room (or elephants or whatever cliché you prefer) when it comes to health IT policy, none has been more widely ignored than the question of when private payers might jump on the "meaningful use" bandwagon and start offering their own financial incentives for hospitals and physician practices to adopt health IT. I mean, I've been hearing for as long as I've been covering this topic--close to a decade now--that the greatest financial benefits from EMRs accrue to those paying the bills, namely health insurers and plan sponsors, and that providers wouldn't invest in EMRs until that changed.

Certainly, the federal stimulus program is changing that paradigm, but only to the extent that providers participate in Medicare and Medicaid. I've heard from many quarters that the extra government money won't be enough to cover the cost of installing and using an EMR for the average hospital or practice. (This argument ignores non-financial benefits of health IT, something we address elsewhere in today's issue.) That's where private payers can and should come in.

A new report from Computer Sciences Corp. tackles this issue in a way that might actually grab the attention of the health insurance industry, currently fixated on the recently passed insurance reform legislation.

"At first glance there appears to be much less at stake in the HITECH provisions and in demonstrating meaningful use for the payer sector of healthcare and health plans, and payers are likely to be far more concerned with the business challenges posed by healthcare industry reforms and the passage of the Patient Protection and Affordable Care Act," the CSC report says. "However, there is a strong argument to be made that the success of long term healthcare reform and the promotion and meaningful use of HIT are linked together. Artificially separating the issues is a luxury that health plans and payers cannot afford."

In identifying five considerations in meaningful use that payers shouldn't ignore, CSC says the wider health IT adoption that the stimulus is creating can enhance the private sector's existing cost-containment and quality-improvement programs. Plus, according to CSC, it is "not hard to imagine" that CMS will eventually include privately administered Medicare Advantage plans in quality measurement for meaningful use. And then there's the financial realities of EMRs that will place a huge burden on many providers.

"At minimum, plans should use this as an opportunity to reformulate and realign existing pay-for-performance incentives with health IT implementation and meaningful use deadlines," CSC says. "Minimizing differences between plan-sponsored incentive programs and Centers for Medicare & Medicaid-sponsored programs will also serve to simplify compliance and achievement, for provider organizations."

Those statements are long overdue. Private payers, it's time to ante up for the quality game. - Neil