As Connecticut doctors take their time converting to an electronic prescription system, Medicare has developed plans to slap them with reimbursement penalties if they don’t sign on within three years.
Between 5 and 7 percent of Connecticut physicians are using e-prescribing, according to Dr. Angelo Carrabba, immediate past president of the Connecticut State Medical Society.
Medicare believes e-prescribing improves efficiency and cuts down on prescription errors, so it has been trying to promote its use.
On Jan. 1, Medicare started giving a 2 percent bonus on top of regular fees to doctors who use e-prescribing. The bonus program will be scaled back to 1 percent in 2011 and 0.5 percent in 2013.
Meanwhile, a 1 percent penalty for doctors not prescribing electronically starts 2012 and climbs to 2 percent in 2014.
E-prescribing is a Web-based secure system that allows physicians to send prescriptions directly to pharmacies.
For many doctors, the financial incentive to move into e-prescribing just hasn’t been enticing enough.
However, the 2 percent Medicare bonus will save participating doctors $1,400 this year, according to the American Academy of Family Physicians. It’s a bit of incentive for doctors to invest in the necessary hardware, which usually costs around $3,000, according to the U.S. Department of Health and Human Services. However, the cost of software and training staff with the new system can raise the final price tag to $25,000.
Slow Start
“At the present time, with regards to either e-prescribing or electronic medical records, we’re sort of slow in getting started,” said Carrabba, also chairman of eHealthConnecticut, the state’s effort to digitize medical records.
Regardless, Carrabba said he believes there needs to be greater government incentives for doctors to invest in the technology, which by all expectations will cut down on costs by boosting prescription accuracy.
“It’s a significant investment,” he said. “Somehow, we have to get some help in funding that reinvestment. We’re working hard to save everyone else money, so then we should be part of that positive cash flow so we can fund further IT projects for our own practices and improve the quality of care.”
Some states have offered varying levels of assistance toward the ultimate goal of getting every doctor logged into a health information exchange.
In New Hampshire, the state and Anthem Blue Cross and Blue Shield launched a program two years ago to provide doctors access to free software and a handheld device. In Nevada, members of the state’s medical association were given e-prescribing software free for two years, though physicians had to pay for the hardware.
Efforts have been much more meager in Connecticut. Two years ago, eHealthConnecticut was given a $300,000 state grant, but program director Scott Cleary told the Hartford Business Journal two months ago that the health information exchange faces a funding crisis.
“This is going to cost millions of dollars over its lifetime,” Cleary said.
Meanwhile, some of the larger physician organizations have been the first to jump on the e-prescribing bandwagon.
Incentives Needed
Saint Francis Physician Hospital Organization (PHO), the group of physicians that work in the hospital, was one of the first groups in the state to use e-prescribing a few years ago.
“Some have been doing it for several years, and some are starting on Jan. 1 because of the incentives from the federal government,” said Jess Kupec, president of the Saint Francis PHO.
Count Kupec among the many in the health care community eagerly awaiting President-elect Barack Obama’s proposed $800 billion economic stimulus package, which is expected to include funding for updating health care information technology.
Without a major federal subsidy, the adoption of advanced technology will stall, Kupec said.
On The Rise
“From a safety and quality perspective, it’s good, but until the economics make sense, it’s not going happen,” he said.
Carrabba said the potential for further expanding the technology’s availability in Connecticut will be closely tied to the success of an operational statewide health information exchange.
Despite slow adoption, the number of electronic prescriptions in Connecticut is on the rise, increasing from 5,996 in 2005 to 592,000 in 2007, according to the latest data from SureScripts, a health information exchange founded by the National Association of Chain Drug Stores and the National Community Pharmacists Association.
With nearly 75 percent of the state’s pharmacies already signed on to the technology, Connecticut is ranked as the 9th most active state for e-prescribing, according to SureScripts.
