Like most of the world, I spent the latter part of the summer watching the debt ceiling impasse with growing amazement (not the good kind) and dread (definitely not the good kind). I was, of course, concerned for my personal well-being and the state of the world economy in general.
When the final deal was struck, I was hit by a new concern: the healthcare industry.
It’s not that I’ve never been concerned about the state of healthcare before; it’s just that the deficit reduction deal gave me a whole new thing to worry about.
For those who don’t remember (or are trying hard to forget), the budget impasse in Congress ended when the parties agreed to cut the deficit and raise the debt ceiling right away but also to cut another $1.2 trillion before the end of the year.
It doesn’t all have to come from the current year’s budget, of course – they’ll spread the cuts out over time. But that’s still a lot of spare change to find in the Congressional sofa cushions. And the supercommittee that has to make the cuts is made up of six Democrats and six Republicans — two groups that haven’t found it very easy to agree on anything lately.
My concern is this:
The U.S. Department of Health and Human Services is offering incentive payments to Medicare and Medicaid providers who adopt EHRs. The Medicare EHR Incentive Program provides each doctor with up to $44,000 over five years. A similar program for Medicaid offers up to $63,750 over six years. You could try multiplying that by the number of doctors out there to estimate how much money we’re talking.
Every hospital, clinic, provider, coding company, medical transcription firm, documentation specialist, software vendor and janitor in the healthcare field has been working tirelessly for years to retool all of our systems, all of our thinking and all of our workforce to get ready for these EHRs.
Some providers have already begun implementing their EHRs and collecting money but the vast majority of the funds haven’t been spent yet. The money has been budgeted and planned but it’s just sitting there waiting.
And now the supercommittee has to find $1.2 trillion.
They don’t want to cut existing Medicare or Medicaid payments to doctors. They don’t want to cut existing Medicare or Medicaid services to seniors. They don’t want to cut defense. They don’t want to cut Social Security. They don’t want to raise the retirement age. They don’t want to raise taxes.
They’re running out of options here.
It’s going to be a lot more palatable politically to cut money that’s been promised but not paid, than to take back funds or services that are already in people’s pockets. Killing those EHR incentives would be a lot easier for politicians to stomach than most of the other things they could cut.
We’ve got another month to wait before we start hearing what they’re planning to do. It’s just going to be a long month.
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