Under the American Recovery and Reinvestment Act of 2009 (ARRA), hospitals can apply for incentive payments from Medicare and Medicaid starting in October 2010 for the successful implementation and effective use of EHRs. The incentive payments are substantial: a typical 275-bed hospital would be eligible for approximately $6 million. Hospitals that do not meet federal guidelines by 2015 face reductions in Medicare reimbursement.
The survey reveals that work to achieve meaningful use is well underway: 67 percent of hospital executives have already implemented or are in the process of implementing new capabilities in order to meet the federal requirements, and 51 percent are targeting fiscal year 2011 to qualify for meaningful use. Roughly one-third (34 percent) are looking at fiscal year 2012.
The biggest barrier for hospitals to move forward in preparing for meaningful use, as indicated in the survey results, was the absence of final rules - reported by 60 percent when the survey was conducted. Given that the final rules were released on July 13, that barrier has been removed, but other barriers remain, including insufficient IT staff (40 percent), other priorities taking precedence (32 percent) and limited capital (28 percent). Only a small number of hospitals (5 percent) have not taken any actions to prepare for meaningful use requirements.
The survey also reveals a clear recognition of challenges in meeting meaningful use incentive requirements. The three biggest challenges based on the proposed requirements are use of electronic physician documentation functionality (48 percent), capturing and reporting designated quality measures (44 percent), and data exchange with other entities (44 percent).
"Achieving meaningful use is clearly top of mind among hospital executives, but the CSC survey also reveals there are many competing priorities, including changes to payment models, that are slowing the progress", stated David Hampshire, senior partner and managing director of Health Delivery for CSC's Global Healthcare Services Group. "The next few years are filled with opportunities and challenges for hospitals, and success will depend on starting early and building the right infrastructure."
Additional findings from the survey of hospital executives include:
- 11 percent currently participate in a statewide health information exchange (HIE) while 26 percent have established a private hospital-sponsored HIE. However, 66 percent are planning to participate in a state HIE.
- When more than 30 million newly insured people enter the health care system in 2014, one-quarter predict that their organisation will experience a significant strain on capacity to provide care, and an additional 43 percent expect to experience a slight strain on capacity.
- Hospital executives anticipate the biggest impact will be on outpatient primary care (36 percent) followed by demand in the emergency department (33 percent).
- More than 50 percent of operational executives cite preparing for new models of care as their first or second priority for 2011 and 2012.
- 49 percent see the ability to form accountable care organisations and share savings with Medicare and Medicaid as a future opportunity, although almost as many (44 percent) see this as both an opportunity and a threat.
- About one-quarter are planning on participating in a bundled payment or accountable care pilot, but less than 10 percent have already decided not to and 67 percent have not yet made a decision.