Government & policy
US recovery package has $19 billion
for health IT
Colo. – On February 17, U.S. President Barack Obama (pictured) signed
into law a US$787 billion economic stimulus package that includes more
than $19 billion for healthcare IT. At the signing ceremony, President
Obama said that digitizing U.S. residents’ health records was long
overdue and would help eliminate duplication and save billions of
Of the $19 billion for healthcare IT, about $17 billion will be
delivered through the Medicare and Medicaid programs to those who use
Electronic Health Records and report quality data to the government.
However, those programs are not expected to begin until 2011.
With funding from the stimulus package, the Centers for Medicare and
Medicaid Services (CMS) will pay physicians between $44,000 and $64,000
over five years, for deploying and using a certified Electronic Health
Record to care for patients. Physicians who have not adopted certified
Electronic Health Record systems by 2014 will have their Medicare
reimbursements reduced by up to 3 percent beginning in 2015.
James R. Morrow, MD, a physician at North Fulton Family Medicine in
Alpharetta, Ga., who was named Physician IT Leader of the Year by the
Health Information and Management Systems Society (HIMSS), welcomed news
of the new law’s passage. “In one stroke, Congress has all but removed
the biggest stumbling block to EHR adoption - cost,” Dr. Morrow said.
“It’s time for doctors to stop complaining about the cost of an EHR and
take the ball and run with it toward the goal of better medicine with
better records and information sharing across the healthcare team.”
The bill also gives the Office of the National Coordinator for Health IT
$2 billion to spend on grants, contracts and other steps along the path
to a nationwide health information network. It’s a major boost for this
agency, which currently operates with an annual budget of $61 million.
Some of the $2 billion will help support regional health information
exchanges and similar services. Other funds would go to states, and ONC
would establish health IT regional extension centres to help advance
It also includes health IT money for the Social Security Administration,
Indian Health Service, community health centers, medical schools and
Ted Epperly, MD, president of the American Academy of Family Physicians,
also welcomed the bill. “This is a great harbinger of what’s to come in
terms of what the priorities are,” he said.
While the stimulus calls for a system of Medicare and Medicaid bonuses
and penalties to encourage health IT adoption, it does not specify how
much of the $19 billion in spending would go to physician practices as
opposed to hospitals or community health centers.
The bill would charge the National Coordinator for Health Information
Technology and a Health IT Standards Committee under the Dept. of Health
and Human Services with guiding spending by developing health IT
standards to improve healthcare quality, efficiency and consistency.
Privacy and security is a major issue. Deborah C. Peel, MD, founder of
the Coalition for Patient Privacy, on Jan. 19 wrote to a bipartisan
group of nine House leaders urging them to ensure that medical data
shared electronically will only be used to improve patients’ health. “If
we fail to ensure privacy and engender trust, Americans will avoid
participation, or worse, avoid care altogether and undoubtedly
misrepresent their medical histories,” she said.
Overall, the stimulus package reportedly would:
• Provide $2 billion to the Office of the National Coordinator for
Health IT, in part to support regional health information exchanges and
establish regional extension centers.
• Require ONC to appoint a chief privacy officer;
• Strengthen HIPAA medical privacy rules;
• Establish health IT policy and standards committees as federal
• Require insurers and healthcare providers that participate in Medicare
and Medicaid to use health IT systems that comply with national
• Tap the National Institute of Standards and Technology to test health
• Restrict the sale of information included in health records;
• Permit state attorneys general to sue individuals to enforce HIPAA
medical privacy and security rules; and
• Require vendors of electronic health records to alert individuals and
the Federal Trade Commission of data breaches.
The legislation aims to make electronic health records available to all
U.S. residents by 2014 but would not require individuals to use EHRs.