HIT Needs Medicare's Leadership

Avalere Health researchers have concludedthat Medicare has the clout to create a healthinformation technology (HIT) incentive and financingprogram that will directly persuade physiciansto adopt it. The company's analysis, reported inHealth Affairs (September/October 2005), alsodiscusses the different policy options the federalgovernment should review to fully leverage thepower of Medicare in shaping the direction of HIT.

Medicare is a significant player in the marketplace.In 2004, >700,000 physicians participatedin Medicare. There are 41 million Medicare beneficiaries,expending >$290 million in health carecosts. Although the health care industry agreesthat HIT adoption could enhance patient safetyand health care quality while reducing cost,Medicare has done little to encourage HIT adoption.Aside from recent pilots, Medicare has notpaid physicians or institutional providers eitherthrough direct reimbursement or outcome-basedincentive programs.

Avalere's paper, "Medicare's Next Voyage:Encouraging Physicians to Adopt Health InformationTechnology," suggests that the Centers forMedicare and Medicaid Services (CMS) shouldexplain its technology objectives, open a dialoguewith the physician community, shape the developmentof standards and technology certificationcriteria, and adopt concrete payment systems topromote adoption of meaningful technology thatfurthers the interests of Medicare beneficiaries.

Sheera Rosenfeld, lead author and an HITexpert at Avalere, noted that the CMs' recentactions—including the VistA Office electronichealth records initiative, pay-for-performancepilots, and exploration of personal healthrecords—are positive signs of progress. "However,these are all areas in which CMS needs to considerthe broad range of implications," she said.