Smaller medical practices get help with electronic records

The Obama administration's implementation of stimulus package incentives intended to spur nationwide adoption of electronic medical records will give special attention to solo practitioners and small group practices, HHS Health IT Coordinator David Blumenthal told lawmakers Wednesday.

He testified before the House Small Business Regulations and Healthcare Subcommittee, which heard from pediatricians, optometrists and others who fear they could be disadvantaged when the government doles out about $17 billion in Medicare and Medicaid bonuses, grants and technical assistance.

Under the statute, physicians beginning in 2011 will be eligible for up to $44,000 under Medicare for using health IT, although what constitutes "meaningful use" of that technology has yet to be determined. Starting in 2015, penalties for those who fail to demonstrate "meaningful use" will take effect. Blumenthal said HHS is setting up listening sessions around the country targeted at small practices to hear how they believe stimulus money can work for them.

Currently, 21 percent of physicians have adopted electronic medical records, but only 13 percent of small providers have done so. For that reason, Congress created grant programs to stand up regional extension centers that would assist and educate providers, with priority given to small practices and those focused on primary care, Blumenthal said.

House Small Business Regulations and Healthcare Subcommittee Chairwoman Kathy Dahlkemper, D-Pa., said the bill she introduced in conjunction with the hearing will build on the stimulus by establishing a Small Business Administration loan program designed specifically for doctors who want to make health IT investments. The starting price tag for such systems is $32,000 per doctor, she noted.

"That's a big investment for any business, and for many physicians it is enough of a hurdle to stop them from purchasing HIT," she said.

Susan Kressly, who testified on behalf of the American Academy of Pediatrics, said her colleagues are deprived by low-payment rates under Medicaid and because of disparities between stimulus requirements for practices paid by Medicaid rather than Medicare. The Academy thinks pediatricians whose caseload consists of 20 percent Medicaid, Children's Health Insurance Program and the uninsured should be eligible for stimulus funds. Pennsylvania Optometric Association Executive Director Charles Stuckey added his group is troubled that a "large and diverse group of providers" could be left behind.