A shot in the arm for EMR

Computerworld - Pay-for-performance incentives aimed at getting doctors to adopt electronic medical records systems have been tested by only a handful of health care insurers, but they have made a big difference in physician adoption rates in regions where they have been applied.

For example, while just 18% of physicians around the U.S. are using one or more components of an EMR system, a solid 48% of doctors in Massachusetts have adopted the systems, according to John Halamka, CIO at Beth Israel Deaconess Medical Center in Boston and a Computerworld columnist. Pay-for-performance incentives offered by Blue Cross and Blue Shield of Massachusetts (BCBSMA) “have made a difference,” he says.

In 2004, BCBSMA began offering grants and financial incentives for physician groups to install EMR systems, says Steve Fox, senior director for provider relations, communications and e-health at the Boston company. The incentives are tied to achieving quality and efficiency goals. For example, physicians can participate in the health insurer’s measurement system for testing patients for diabetes. Doctors can also use their EMR systems to report on patients’ hemoglobin and low-density lipoprotein (bad cholesterol) levels and can earn $1.50 for each BCBSMA member they test.

The average payment per physician for this measurement alone was $3,500 last year, says Fox. “So if you’re in a group of five physicians, you can see the return on the technology investment.” The average payment per doctor in BCBSMA’s overall incentive program is $6,000 per year, he says.

Pay-for-performance incentives have also been tested by WellPoint Health Networks Inc. and the Hawaii Medical Service Association.