Friday, May 31, 2013


So the other day, I'm corresponding with the practice manager of one of my physician group clients. This particular PM is extremely professional and knowledgeable, to the point that I rarely hear from her unless I instigate the conversation. I had emailed her regarding the upcoming ObamaTax compliance issue we wrote about earlier this week.

I really just wanted to know if she had any questions, or would like to meet for a mid-year plan review. She politely declined, but what got my attention was her reason: she was knee-deep in implementing new EHR (Electronic Health Record) tech, and that it was proving to be a massive challenge for her - she simply couldn't spare the time for anything else.

This is an obvious problem with such a massive new requirement. But inherent in that challenge is an even greater one: how can smaller practices afford this kind of investment? It is, in fact, one of the most egregious (intended?) consequences of the ObamaTax:

"[F]or those who don’t meet the electronic medical records deadline for implementation, the government has laid out a series of penalties. The message to doctors is clear: implement electronic records or pay a price."

But if you're a small(er) practice, how do you afford this implementation? As Nate pointed out last Fall, "the move to electronic health records may be contributing to billions of dollars in higher costs for Medicare, private insurers and patients ... hospitals that received government incentives to adopt electronic records showed a 47 percent rise in Medicare payments at higher levels from 2006 to 2010"

Which brings me to my real question: doesn't (expensive) EHR implementation actually encourage smaller providers to seek refuge in (ie be bought out by) larger ones? In the long run, economy of scale will always trump the little guy.
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