A sales rep from Allscripts has sent around the following information about what the stimulus plan will do to incentivize the deployment of electronic health records.  I’ve long been of the opinion that they will only happen if the Center for Medicare and Medicaid Services (CMS) mandates them. That’s what happened with electronic claims processing. So here’s what has happened:

“In addition to its other components focused on economic stimulus, the law provides $20 billion in health information technology funding.  The total includes $2 billion in discretionary funds and $18 billion for investments and incentives through Medicare and Medicaid to ensure widespread adoption and use of interoperable healthcare IT systems such as the Electronic Health Record.  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.

“With the stimulus, the Centers for Medicare and Medicaid Services (CMS) will pay physicians between $44,000 and $64,000 over five years, beginning in 2011, for deploying and using a certified Electronic Health Record to care for patients.  The stimulus package is expected to ignite significant job growth in the information technology sector and, according to a Congressional Budget Office review of the legislation’s impact, drive up to 90 percent of US physicians to adopt Electronic Health Records in the next decade.

“Once a provider starts collecting incentive payments for meaningful use of an EHR (whether in 2011 or beyond), he or she can continue to collect PQRI payments but cannot continue to collect ePrescribing payments.

Under the Medicaid incentives, nurse practitioners and nurse mid-wives are eligible for incentive payments if they demonstrate meaningful use and meet the minimum threshold required of the Medicaid incentives. Under the Medicare incentives, the payments are not available to mid-levels; they are available only to MDs, dentists, podiatrists, optometrists and chiropractors.”

Health Affairs released its projection for health care spending in the U.S. over the next ten years, and in another study showed where we are going to spend it.

During the projection period (2008-2018), average annual growth in national health spending is projected to be 6.2 percent–2.1 percentage points faster than average annual growth in gross domestic product (GDP). The health share of GDP is anticipated to rise rapidly from 16.2 percent in 2007 to 17.6 percent in 2009, largely as a result of the recession, and then climb to 20.3 percent by 2018. Public payers are expected to become the largest source of funding for health care in 2016 and are projected to pay for more than half of all national health spending in 2018. [Health Affairs 28, no. 2 (2009): w346-w357 (published online 24 February 2009; 10.1377/hlthaff.28.2.w346)]

This study responds to recent calls for information about how personal health expenditures from the National Health Expenditure Accounts are distributed across medical conditions. It provides annual estimates from 1996 through 2005 for thirty-two conditions mapped into thirteen all-inclusive diagnostic categories. Circulatory system spending was highest among the diagnostic categories, accounting for 17 percent of spending in 2005. The most costly conditions were mental disorders and heart conditions. Spending growth rates were lowest for lung cancer, chronic obstructive pulmonary disease, pneumonia, coronary heart disease, and stroke, perhaps reflecting benefits of preventive care. [Health Affairs 28, no. 2 (2009): w358-w367 (published online 24 February 2009; 10.1377/hlthaff.28.2.358)]