The following article is written by Eric J. Stenson, director of enterprise applications for Surgical Notes. The views expressed are those of the author and are not endorsed by Surgical Notes.
Many ambulatory surgery centers are under the impression that there is legislation pending that will provide subsidies for implementing EMR systems, similar to those made available to physician practices and hospitals. This is not accurate. Moreover, the likelihood of ASCs gaining eligibility for EMR incentives is highly unlikely given the current economic/political climate. The following are the top five reasons ASCs will not see technology incentives from the government.
1. Budget Control Act of 2011. The Budget Control Act of 2011, which was passed to increase the borrowing authority of the United States to reduce the deficit and prevent default, provides $841 billion of immediate reductions in federal spending and more than $2.5 trillion in budget cuts over the next 10 years. As the federal government and Congress are now tasked with implementing these spending reductions, new discretionary spending will be carefully watched.
2. Medicare is bankrupt. The board of trustees for Medicare believes the program will have insufficient money to pay benefits five full years sooner than anticipated. As the core programs become unsustainable and policymakers are currently seeking methods to reduce spending and stabilize Medicare, it would be inconsistent with public policy for the government to add discretionary subsidies to private sector enterprise when all financial resources are needed for core programs.
3. Tea Party movement. During the last election cycle, there were 138 candidates with Tea Party support, which resulted in a large freshman class of Congressmen driven to reduce federal spending. In fact, core platform principals are to examine the constitutionality of each new law, audit federal spending for waste and constitutionality, balance the federal budget and reduce earmarks and federal spending. The Tea Party is unlikely to support any new measures designed to invest government money in healthcare and healthcare reform.
4. Hospital lobby. According to the Center for Responsive Politics, the healthcare industry spent $280 million dollars on lobbyists. A significant portion of lobby spending originates from the hospital lobby, which fervently opposes measures that support the ASC business model. ASCs already feel the pressure from hospitals on Medicare reimbursement rates, and a no-contest subsidy on EMR technologies is highly unlikely.
5. Electronic medical records: Promise and problems. For providers that have adopted EMR technologies, the benefits are not always as apparent as the promise. One study by Margalit et al. (2006) found "physicians spent close to one-quarter of visit time gazing at the computer screen." Similarly, a study published by the Archives of Internal Medicine found that there was "no consistent association" between EHRs and better clinical quality of care. Thus, Congress is unlikely to rely on EMR adoption as a real strategy for healthcare cost reform.
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