When Is Congress Going to Learn?

Stanley Feld M.D.,FACP,MACE

When is congress going to learn that punitive action is not a wise course to pursue against a vital workforce? Real incentives work. Bogus incentives always fail. My e-prescription plan would provide physicians incentive to use the software because it would be free and driven by their patients demand.

The U.S. Senate on July 9 passed legislation to revise several Medicare provisions and authorize incentive payments for use of electronic prescribing technology.”

Please notice the complexity of the schedule. Physicians have learned that anything incomprehensible is a trick. Therefore they do not participate. If they do not participate the incentive fails. It is similar to the art of war. You simply do not show up to fight.

The bill calls for Medicare incentive payments for e-prescribing of 2% in fiscal 2009 and 2010, 1% in 2011 and 2012, and 0.5% in 2013. Sec. 132. Incentives for electronic prescribing.

The initial question is 2% of what? Will it cover my cost of installing an E-prescription system? What is the trick? Does the government want to develop an easy way of following my prescribing habits so they can reduce reimbursement?

Provides positive incentives for practitioners who use a qualified e-prescribing systems in 2009 through 2013. Requires practitioners to use qualified e-prescribing system in 2011 and beyond. Enforcement of the mandate achieved through a reduction in payments of up to 2% to providers who fail to e-prescribe. Prohibits application of financial incentives and penalties to those who write prescriptions infrequently, and permits the Secretary to establish a hardship exception to providers who are unable to use a qualified e-prescribing system.

Note the legislation also requires more reporting by physicians. The increased reporting consists of any e-prescribing quality measures established under Medicare’s physician reporting system. Beginning in 2012, payments to physicians not electronically prescribing would be reduced by 1%, then 1.5% in 2013 and 2% in subsequent years. I believe congress is mistaken if they think this will work. It will be costly to the healthcare system and someone other than physicians will make some money. The plan will only generate more mistrust among physicians for the government.

The opinions expressed in the blog “Repairing The Healthcare System” are, mine and mine alone.