On the other hand, they could throw private practice a bone and help them weather the storm until MU goes away or loses its teeth. Let me explain.
Payers could take the easy money and penalize according to the upcoming ACA “adjustment” schedule. Lots of people think this is inevitable. This would certainly provide an easy way to increase payer revenue and is as simple as letting the practices [continue] to do all the work.
However, this would be incredibly short-sighted.
Meaningful use, as things stand in 2014, has not been shown to improve patient care. Indeed, it is common for Stage 1 attesting MDs to abandon the program during Stage 2, with many doctors citing lack of efficacy of the program. Stage 3 MU is projected to have even worse results.
What this tells me is that the stress and time-cost of MDs and their staff is not worth the benefits of Meaningful Use. Don’t get me wrong – there are some great things in the MU guidelines, and we are implementing them in the software we create, but they are overshadowed by the onerous, less-effective 5% and it’s all or nothing. There is no MU wiggle-room. These days you have to have real grit and determination to stay in private practice, no matter your specialty.
Without financial support or legislative reform, Meaningful Use will eventually drive independent doctors out of business.
That’s bad news for payers.
Let’s say you run a Big Name Private Insurance Company. In 10 years, if most doctors are on salary at a large healthcare organization, will you wish you had helped those doctors stay independent so you could pay ⅓ the cost for the same bone marrow biopsy or routine follow-up visit?
The Blue Cross Blue Shield BQPP program is an example of one way payers can help. Blue Cross Blue Shield of NC is taking a proactive approach to help independent doctors stay independent. By developing their own metrics of what makes a productive and cost-efficient practice, they are rewarding those physicians who show that they are providing cost-effective care. In doing so, they are reducing the sting of Meaningful Use.
Another way to help private practices is to convince the administrators of the Meaningful Use guidelines to loosen the requirements to attest to MU so that practitioners can get back to taking care of patients and not worry about whether their practice is producing enough clicks to safely attest to MU.
It is certainly noble to look at the good points of MU with regard to evaluating physician performance and gathering population health metrics, but surely we can accomplish this through less invasive means and in a way that will not alienate doctors who just want to care for patients.
Nicholas Orlaski is a programmer and the founder of Ankhos software. He lives in North Carolina.