Connecting The Dots of Healthcare

The EMR movement has been touted to promote savings in healthcare dollars by eliminating redundant care with access to records, a way to compare performance of healthcare by standardization and uniformity, and with a seamless network to share data nationwide, despite ongoing concerns about privacy and who will have access  (authorized and unauthorized), and for what purposes.

But at whose expense will these savings be reaped? According to the MGMA, (Medical Group Management Association), the average cost per physician to purchase and implement an EMR is $32,606.00. P4P, (Pay for Performance), incentives may bring physicians in compliance with guidelines may bring in an extra $10,000 a year but with the history of Medicare reducing incentives over time as “voluntary” programs become required to avoid future reimbursement reductions is there any doubt what will happen in the future? Physicians are now basically being paid to accept P4P, but that gravy train can’t last indefinitely.

Contrast this with the world when a paper claims cost a third party payer money to process (the third party payer once-upon-a-time had to pay a person money to enter the paper claim information into the insurance company’s computer system):  we now have physician offices submitting an electronic claim, (obviating the need for the third party payer labor cost), and physicians now having the privilege of PAYING for electronic submission. The “cost savings” to an insurer has not manifested much financial benefit to the physician other than a faster claim turnaround.

Is not the EMR an effective way to collect data on not only patients, but of physicians and of course, outcomes? The type of data collection that when coupled with P4P can be used to assess, rank, credential, and eventually calculate pay for individual physicians. And who is paying for this? Sounds like we’re working to pay the company store!

I often have said that left up to our own devices, physicians would prefer medical records on index cards. But financial, regulatory, and quality demands have made this physician- friendly, inexpensive, effective technology a dinosaur.

While the stated goals of having unlimited access to patient records is good,  what it amounts to is another foray into what certainly will develop into still yet an additional unfunded mandate by the federal government on the backs of physicians who have become all too accustomed to declining Medicare reimbursement. It will join the ranks of HIPAA and Medicare claims processing expenses. And will it ultimately help patients, or help payers control costs… and physicians?