Senators Question HITECH Act's Effect on Care Quality, Costs
In a Health Affairs blog post, a group of Republican senators write, "There is inconclusive evidence that the [HITECH ACT] has achieved its goals of increasing efficiency, reducing costs and improving the quality of care."
Under the 2009 economic stimulus package, providers who demonstrate meaningful use of certified electronic health records can qualify for Medicaid and Medicare incentive payments.
The blog post was written by Sens.:
- Lamar Alexander;
- Richard Burr;
- Mike Enzi;
- Pat Roberts; and
- John Thune.
They write that after six years and "spending $28 billion so far of the [HITECH Act's] $35 billion total taxpayer investment, significant progress toward interoperability has been elusive."
The lawmakers criticize previous ONC leaders who they say "did not understand the difficulty and enormity of creating government-approved products in a market that struggled to exist before government incentives arrived," adding, "As a result, our nation's health care providers are stuck with the huge cost of unwieldy systems trying to conform to government mandates."
The lawmakers note that while "ONC has taken an important turn under the leadership of Karen DeSalvo" and released a roadmap for interoperability, they "are concerned that the draft speaks in generalities and does not address all of the concerns raised about interoperability."
To address this issue, the lawmakers recommend that ONC:
- "[D]elineate how it will find specific solutions" to concerns about interoperability and present "practical and actionable steps to ensure a proper return on the American people's investment";
- Describe how "costs associated with the adoption of expanding interoperable platforms" will be determined;
- Create "clear, obtainable goals regarding security requirements and implementation" of EHRs;
- Implement measures to gauge success and "describe[e] how the metrics will be collected, analyzed, reported and used for decision making"; and
- Describe how EHR systems will be sustained in the long term as funding under the HITECH Act diminishes.
The lawmakers conclude, "High-level ideas are important, but we are concerned that without specific requirements and action items, we will not advance towards the goal of improving health care coordination and patient care, which was the intent of the HITECH Act" (Thune et al, Health Affairs blog, 3/4).
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