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EMR or you are out of network

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Ducknet Posted: Wed, Oct 17 2007 12:16 PM

It appears to be getting pretty agressive out there with managed care...and no financial support...and what if some have already invested in their own EMR that is not one of the selected choices?  

From the blog.... 

Electronic Records - or you are "out of network"

They anticipate losing some physicians with this move...and the burden of the expense is on the practice with no financial support and no choice as far as the program they would like to use...there is a higher reimbursement rate for using electronic records, but does this cover the expense of getting the software and hardware in place?  Again, the same question arises that has been posed so many times...is there any ROI for the physician?  BD 

While insurance companies are getting behind greater electronic communication among doctors and their patients by paying for such care, Partners HealthCare System is forcing the use of electronic health records on the physicians in its community network. Primary-care physicians who have not implemented or agreed to implement an EHR by Jan. 1, 2008, are out of the Partners network, said Tom Lee, chief executive officer of Partners Community HealthCare, the physicians network of the Boston-based hospital system. The implementation of EHRs throughout the physician network will allow information across the system to flow in a timely and more efficient manner, he said.

"We did it with a lot of care and thought; if you're going to be one of us, this is the criterion," Lee said. Partners hasn't lost any doctors yet as a result of the decision, but some physicians are complaining about the change. Lee said he recognizes that the mandate seems "tough." He added: "Believe me, some of (the doctors) are mad."

Partners expects to lose 15 to 20 primary-care physicians this year because of the mandate, and could lose some patients if those doctors stop referring them to Partners hospitals, Lee said.  There are about 5,000 doctors in the Partners network. The primary-care doctors have until the end of 2007 to implement either Partners' EHR or one created by GE Healthcare. If they don't have the EHR but sign an agreement to implement one in 2008, they will retain their network status. At this point, specialists have through 2008 to implement an EHR, but by Jan. 1, 2009, any physician still not connected is out of the network.

Mario Motta, another cardiologist in the network, called the mandate a "two-edged sword." Motta, who uses Partners' EHR, said that there is a benefit to having an EHR because insurance companies reimburse at higher rates for their use; however, the health system is not financially supporting their physicians to implement them. "They (physicians) are being asked to carry the freight," he said.

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>>It appears to be getting pretty aggressive out there with managed care<<

What I despise are the manage care companies that demand that you fill out their often antiquated, online forms. Talk about boring and slow. My EMR and many others can give them everything they want and more, but the data has to be on their forms. They refuse to let me submit with my EMR data. I fax it to them anyway. Let them deal with the paper.Angry

 

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DrMurdoch replied on Wed, Oct 17 2007 5:15 PM

Ducknet:
 

Hey I came to post about that too ! 

 

 

Boston Health Network Requires All Physicians To Adopt EHRs by 2009 

Physicians are required to adopt either Partners' or GE Healthcare's electronic health record system to remain in the Partners HealthCare System network. The network expects to lose between 15 and 20 primary care physicians this year because of the EHR mandate. Modern Healthcare.

source: http://www.ihealthbeat.org/articles/2007/10/17/Boston-Health-Network-Requires-All-Physicians-To-Adopt-EHRs-by-2009.aspx?topicID=54

 

 

My EMR is: Synapse It is what we know already that often prevents us from learning.  Pioneers are the ones with the arrows in their backs.

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We are our own worst enemies.  We put up with stuff when we should say "No."  Maybe we should say it just to hear what it sounds like coming out.

 
Cheers,Gil
Ten Second Medical RecordTM http://www.TenSecondMedicalRecord.com.  Use Microsoft Word to make your medical notes.  “Take a Peek” real time video demos less than two minutes each are at EMRupdate: http://www.emrupdate.com/blogs/showcase/archive/2007/09/20/the-ten-second-medical-record-with-gil-carter.aspx.  TSMR now has a link to Microsoft’s HealthVault.
 
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DrMurdoch:

Ducknet:
 

Hey I came to post about that too ! 

 

 

Boston Health Network Requires All Physicians To Adopt EHRs by 2009 

Physicians are required to adopt either Partners' or GE Healthcare's electronic health record system to remain in the Partners HealthCare System network. The network expects to lose between 15 and 20 primary care physicians this year because of the EHR mandate. Modern Healthcare.

source: http://www.ihealthbeat.org/articles/2007/10/17/Boston-Health-Network-Requires-All-Physicians-To-Adopt-EHRs-by-2009.aspx?topicID=54

 

 

Dude! Yes

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HTAdvocate replied on Wed, Oct 17 2007 11:08 PM

Despite being an EMR vendor I find this news disturbing. Encouraging and supporting doctors to adopt EMR technology is needed. Threatening them and not providing meaningful financial incentive to do so is ridiculous.  This is a prime example of the problems with the majority of payers out there and how the adversarial relationship between doctors and payers is perpetuated. I don't know the specifics related the "financial incentives" that are being offered in this case but I suspect they are minimal.  Here is the fundamental issue with certain profit hungry payers. It is has been described as the "rider" factor where a payer does not want another payer to profit from investments they make. Several years ago our company was approaching payers to see if they would subsidize the cost of our eprescribing system for physicians. The system delivers evidence-driven decision support at the point of prescribing and presents the best drug therapies based on cost and efficacy based on the medical evidence. One payer organization did and acheived a 20x ROI where their drug costs were greatly reduced.  Even with this proof in hand every other payer we spoke with would not participate strictly because other payers would also benefit from the cost savings.  This "rider" issue can get even more disturbing when considering denial of treatment and certain payers' short-term view of their member's health. I won't go down that disturbing rathole here. :)

 www.purkinje.com

 

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Joel, it almost sounds like you are complaining a little bit about HMO extortion.

Oh, that's right. Extortion is illegal, so it couldn't be anything like that, could it?

 

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alborg replied on Thu, Oct 18 2007 4:18 AM

As much as I love the concept of EMRs, I find this frightening... Heck, even if you recently paid for a non-GE EMR you'd be scr*wed.

Al Borges, M.D.

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sweaner replied on Thu, Oct 18 2007 9:04 AM

This shouldn't be a problem, as the doctors would just band together and agree that this is unacceptable!   Oh, wait, we aren't allowed to do this.

Scott
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Ducknet replied on Thu, Oct 18 2007 10:06 AM

Oh, wait, we aren't allowed to do this.

Good point...people ask me the same question as to why doctors don't do this...and most are not aware of the restrictions imposed.     

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Ducknet:

Oh, wait, we aren't allowed to do this.

Good point...people ask me the same question as to why doctors don't do this...and most are not aware of the restrictions imposed.     

Ah but those docs who are part of a Clinically Integrated IPA are legally justified to negotiate as a collaborative. However being deemed clinically integrated by the FTC is not an easy endeavor. It is something we are working on with our various IPA partners around the country. 

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But I think it's ok if everyone decides on their own ...

to get a life.

Aloha,

Gil

Gil Carter, MD, JD, FP & medical programmer
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