Private Insurers Getting on the EHR Train

Discussion in 'Healthcare/Insurance/Govt Healthcare' started by Greenbeard, Aug 6, 2010.

  1. Greenbeard

    Greenbeard Gold Member

    Jun 20, 2010
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    New England
    For years the adoption of electronic health records has been hampered by a well-known misalignment of incentives: the people who have to pay for it are generally different from the people who benefit from it.

    Doctors and hospitals (i.e. providers) have to pay to install and maintain health information technology systems, they have to put in the time to learn to use it (and train staff to use it), they're the ones that potentially have to trouble shoot or seek technical assistance. But the benefits generally accrue to payers like insurance companies. If an HIT system reduces medical errors, or helps providers to avoid doing unnecessary procedures, or prevents a re-hospitalization, that's a savings for the insurance company that would be reimbursing for that extraneous care (and, ultimately, for you the consumer). But providers get paid for all that stuff so they may actually lose money in the deal. They bear the costs for HIT systems and the benefits are enjoyed by somebody else.

    Now that stalemate seems to be on the verge of being broken and the American health care system is getting ready to take a big step into the 21st century. In our system, the public payers--Medicare and especially Medicaid--are often the innovators driving system change (and, yes, there is a significant private presence in many state Medicaid programs). That's what's happening in this case.

    As explained in this thread, the public payers are offering bonus payments to any of their doctors or hospitals who adopt and start using electronic health records. Now, in the wake of the final meaningful use regulations, a number of private payers are lining up behind the federal efforts and coming up with some EHR adoption incentives/assistance of their own to encourage meaningful use:

    There's an unprecedented effort going on in every state in the country right now and now some big players are bringing additional resources to the table. Exciting times.

    And if you want a bit more detail:

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