Are EHRs a barrier to value-based payment models?

Health IT is essential for transitioning to a fee-for-value care payment model, but current IT mandates and requirements are hindering the industry's evolution to value-based care, according to a policy brief from The Brookings Institution.

While EHR adoption has skyrocketed in recent years, interoperability and meaningful use incentives have remained a burden for many providers and hospitals, many of which criticize the program's strict requirements and one-size-fits-all approach.

"In an effort to keep MU and the EHR certification program 'simple,' these programs have relied on a specific set of requirements and process measures for all providers, regardless of specialty or scope of practice," according to the policy brief. "However, this uniform approach does not support the different realities of clinical care, which require varying health IT functionalities and tools across different specialty and scope of practice areas."

Additionally, the policy brief indicates EHRs don't provide clinicians or patients cost and payer information when they need it most — at the point of care. "With the shift to a more value-based care environment, patients and providers are struggling to make informed, shared decisions about testing and treatment in the absence of access to key cost and coverage information where it matters most," according to the brief.

The policy brief offers two overarching principle recommendations by which "MU can achieve its purpose of allowing health IT to be more 'meaningful.'"

  1. Change meaningful use payment incentives to focus on value and outcomes instead of IT processes.
  2. Instead of focusing on promoting interoperability from "process-oriented mandates," focus on real business cases for data exchange that increase value.

"Our policy recommendations should enable more progress in achieving an adaptable health IT infrastructure by helping existing policy transition from one that is too narrow and prescriptive to one that can give MU more practical meaning that resonates with providers and patients by more directly supporting improved outcomes, administrative efficiency and value," the brief concludes.

More articles on EHRs:

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Who are the EHR non-adopters?

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