HIT Reform: Tapping the Carrot

Healthcare organizations, providers and health plans should start working immediately on their plans and health information-technology (HIT) strategies for participating in a changed U.S. healthcare economy, according to Greg DeBor, a client partner in CSC’s healthcare group. Besides educating themselves on specific provisions of the Health Information Technology for Economic and Clinical Health Act (HITECH) and the direction of health-reform policy at the federal and state levels, he adds, organizations can position themselves for funding to assist in the effort by doing the following:

• Align clinical and organizational leadership around the importance of interoperable electronic health records, HIE and HIT in general.
• Align with state efforts; learn what has been done to date and help state officials shape policy and programs. Since significant federal funds will flow through the states, get involved in crafting local direction and make needs known.
• Explore participation in, and resources from, associations and public/private partnerships that can help with HIT adoption. In many states and at the national level, these organizations, not state government, will play leading roles in implementing HIT programs and may qualify for sizable funding themselves, either independently or as the organization designated by a state to lead the effort.
• For provider organizations, establish a plan for achieving meaningful use and earning maximum incentives. Requirements are well known today, and encompass vendor HIT and electronic health-records (EHR) systems, health information-exchange (HIE) capabilities (including e-prescribing), quality measurement and many forms of public-health reporting.
• Consider developing an IT strategy to prepare for the coordination capabilities and data requirements of health reform. One component of the strategy is operational (supporting-care coordination), and another should consider how data will be gathered, stored, shared and analyzed for managing a clinically integrated-organization’s performance and profitability under new payment and contracting arrangements.
• Explore funding opportunities for providing HIT-related services to other organizations, if you have some advanced expertise (as a regional extension center, a medical school or related institution, or as some other form of nonprofit entity that may qualify for funds).
• Consider participating in pilots, especially in establishing medical home- and accountable-care organization models, including pilots funded by states and in partnership with commercial health plans.

Organizations should expect government programs to fund no more than a third of their investment, depending on their function, size and type. In order to earn that funding, organizations will be required to show some degree of matching funds, either in the literal sense or by making the upfront investment in HIT to earn payments and be in a position to enter into new contracts and revenue arrangements based on having an HIT-enabled capability that sets them apart.

“As health reform becomes a reality in 2009 and over the next five to 10 years, HIT will play a substantial enabling role,” DeBor says. “HIT holds the greatest promise for delivering cost savings in the near term. Organizations need to plan today for their participation in the new post-reform healthcare economy, with EHRs, HIE and HIT deeply integrated into their strategies.”

He notes that federal programs under the HITECH Act provisions of the federal stimulus, and further programs proposed in health-reform legislation, offer a framework for HIT strategy, along with developments at the state level and related changes and opportunities in the commercial health-insurance sector. “Significant federal funding will soon begin to flow to seed these efforts,” he says, “but organizations will need to make their own investments in HIT, as well, to earn even greater federal incentives and to participate in the changed healthcare economy in years to come.”