Vermont trust fund aims at physicians' EHR adoption

Just 13 percent of Vermont physician practices have electronic health record (EHR) systems in place. However, due to a recent move by state legislators to create a health information technology trust fund, EHR adoption is expected to increase to more than 50 percent over the next five years.The Vermont Health IT Trust Fund will be subsidized by a quarterly tax on all health insurers operating in the state. The fund’s sponsors said it will provide a stable source of funding for health care providers that want to install EHRs. It will also support operation of a statewide health information exchange and an advanced medical home project.“What really drove this is that it will enable the clinical transformation necessary to support the Governor’s Blueprint for Health Program,” said Greg Farnum, president of Vermont Information Technology Leaders, Inc., a non-profit public-private partnership that operates Vermont’s statewide HIE.“What we found is that the state is really the only stakeholder in this whole mix of stakeholders who can apply the surcharge and basically force the fair and equitable distribution of funds across all stakeholders. And it does it with the necessary speed to enable health care reform.”The first quarterly payment to the trust fund will be due on October 1, 2008. Health insurers can choose between paying two-tenths of a percent of all health care claims for their Vermont members in the previous quarter or pay a fee based on a proportion of their overall claims in the past year. The effort is expected to raise an estimated $32 million over the next seven years.The funds will be managed by the Vermont Secretary of Administration and will be made available through application to state government entities and VITL. Physicians can then apply to VITL and the other entities for their own funding.Farnum said VTIL will focus on funding approximately 300 independent, primary care physicians in Vermont that are not affiliated with any hospital or large practice group and tend to get the lowest reimbursements.