Sept. 18, 2008
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Under August 2006 exceptions to the federal physician self-referral and anti-kickback lawsboth intended to prevent hospitals from offering financial incentives to physicians in return for patient referrals-hospitals can subsidize up to 85 percent of the upfront and ongoing costs of EMR software and related information technology (IT) support services for physicians. Physicians must pay the full cost of any hardware, and the exceptions are scheduled to sunset on Dec. 31, 2013, when physicians must assume any ongoing EMR costs.
Hospital strategies to aid physician EMR adoption include offering direct financial subsidies, extending the hospitals ambulatory EMR vendor discounts and providing technical support, the study found. Two key factors driving hospital interest in supporting physician EMR adoption are improving the quality and efficiency of care and aligning physicians more closely with the hospital.
A few hospitals in the study had begun small-scale, phased rollouts of subsidized
EMRs, but the burden of other ongoing hospital IT projects, budget limitations
and lack of physician interest were among the factors impeding hospital action,
according to the study funded by the Robert Wood Johnson Foundation.
"While hospitals have strategic incentives to provide support, particularly to tie referring physicians to their institution, the effects of the regulatory changes on physician EMR adoption will ultimately depend both on hospitals willingness to provide support and physicians acceptance of hospital assistance," said Joy M. Grossman, Ph.D., HSC senior researcher and coauthor of the study with Genna Cohen, an HSC research assistant.
The studys findings are detailed in a new HSC Issue BriefDespite
Regulatory Changes, Hospitals Cautious in Helping Physicians Purchase Electronic
here. The study is based on HSCs 2007 site visits to 12 nationally representative
metropolitan communities: Boston; Cleveland; Greenville, S.C.; Indianapolis;
Lansing, Mich.; Little Rock, Ark.; Miami; northern New Jersey; Orange County,
Calif.; Phoenix; Seattle; and Syracuse, N.Y. HSC has been tracking change in
these markets since 1996.
The Center for Studying Health System Change is a nonpartisan policy research organization committed to providing objective and timely research on the nations changing health system to help inform policy makers and contribute to better health care policy. HSC, based in Washington, D.C., is funded principally by the Robert Wood Johnson Foundation and is affiliated with Mathematica Policy Research, Inc.