STILL ANOTHER SNAFU VIA THE AFFORDABLE CARE ACT (ACA)

The federal mandate that all health care providers who treat Medicare patients must use Electronic Health Records (EHRs) is stipulated in the ACA after originating in the federal government’s Stimulus Bill of 2009.  Granted, it sounds good, but in actual practice many physicians and dentists have expressed the opinion that the use of EHRs in a busy health care practice is a negative. 

One major concern---those doctors who treat Medicare patients but do not comply with the EHR requirement will have their already-low Medicare reimbursement rate cut by 1% beginning this year, increasing to a 5% cut by 2020.  Further, a 2014 survey by Medical Economics discovered that 67% of physicians are “dissatisfied with EHR functionality.”  Doctors reported wasting almost an hour per day dealing with EHRs.

Surveys show that three out of four physicians think EHRs add to health care costs for three reasons:

• Doctors cannot see as many patients as they once did because they are focusing on the collection of formatted, required data on each patient and in-putting that information into the exam-room computer.  Using valuable doctor time to collect superfluous data and entering it into the computer results in their charging higher fees for the fewer patients they can see in order to maintain productivity.

• EHRs cost an average of $162,000 for implementation in a typical office, followed by approximately $85,000 per year service and maintenance costs.

• Because many solo private practices cannot afford such costs, physicians are being forced to sell their practice to area hospitals.  Studies reported in 2014 in the AMA Journal and in Health Affairs have found that this leads to most hospitals charging higher fees which increases costs for patients.

While much of the information in this blog concerns medical practices, one wonders if dental practices are not far behind in perceiving DHRs as a cumbersome, expensive intrusion impacting the way a provider would choose to maintain his/her patient records.  Question: Will increased numbers of dental solo practitioners follow the pattern mentioned above, selling their practice to dental service management companies which may, in turn, force an increase in dental fees?

If dentists think they can avoid the EHRs mandate because they do not file Medicare for routine dental care, see my blog, Medicare Provider Sign-Up Deadline Approaching, in the Practicon archives for May 2015.  Dentists may, in fact, file Medicare claims for some dental surgeries and for certain medicaments prescribed for Medicare patients.  The blog explains why dentists must opt in or opt out of being a Medicare provider by filing proper documentation by the deadline, June 1, 2015.  If he/she chooses to opt in to be a Medicare provider in order to satisfy the needs and demands of current patients receiving Medicare benefits, a dentist will be restricted to the use of DHRs, just as his/her medical colleagues are.