November 12, 2012

EMR Implementation May Be Bad for Your Health (PLAN)!

Health care costs are supposed to be contained by more efficient coordination of health care tests and treatments.  Much of this is supposed to be connected to the EMR, which is intended to bind together the process of diagnosis and treatment methodologies and assist practitioners in the attainment of “best practices.”  However, now there is evidence that the EMR and “best practices” are being coupled to generate coding which may result in higher charges to the final consumer – in the case of a self-insured employer, this could mean that while the technology might have an impact on health care efficiency it may also result in a cost transfer from providers in your network.

The report has been covered by any number of publications.  One of the more cogent treatments is by the NY Times writers, Reed Abelson and Julie Creswell, in which they outline the meaning behind the text of a letter that CMS has forwarded to five major hospital systems.  In their article, they outline the observations that the CMS has regarding the “cloning” of material from patient-to-patient and the apparent up-coding that might be taking place in the application of electronic medical records processes in health care systems.

If CMS is catching this as an issue, you can bet that there are implications for self-funded programs and for employers.  Have you checked on your claims and the average bundled price of services that you are experiencing?  Who is watching the impact of what is being reported on by CMS?  This is one of the real issues that the health care reform act, with its emphasis on EMRs, may create as an unintended consequence.  The bottom line is that there should be  no problem with better billing unless they are for tests and processes that are related to rote orders or cloned records and unrelated to quality and patient outcomes.

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