Current data from the AMA shows that less than 20% of physicians have invested in HIT, and less than half of those have fully implemented it into their practice. Some of the most frequently cited barriers to adoption are the financial investment, technical support and time required to acquire and implement these tools. Therefore, I am pleased to announce this evening, with your approval, our own HIT initiative for the coming year to meet these challenges, that will consist of three main components.
First, in partnership with CitiGroup, we are creating specifically designed, low interest loan and lease programs to assist physicians with the purchase of HIT. We will also develop a Preferred HIT vendor program that will require vendors to comply with certain standards of conduct and support when dealing with our members and eliminate some of the psychological barriers to adopting HIT including transparent pricing, guaranteed "go live" time frames, free tech support for the first year, and deferred interest financing.
We must also work to create an environment in which our members can deal successfully with the current challenges of our healthcare system, especially so called "Pay for Performance" programs. Pay for performance is in fact nothing new in the managed care industry. The "performance" metrics for managed care are and have always been about cost and volume, and are rooted in an outdated model of assembly line economics. The medical profession by contrast has always had only one metric: outcomes. Yet, as if by some sudden divine enlightenment, insurance companies and government agencies now also claim that this is the metric which should be used to determine how physicians are reimbursed. Of course it is. Better care leads to better long term outcomes which leads to a more efficient and less costly healthcare system.
But quality healthcare is simply not sustainable when these institutions demand better outcomes with greater efficiency, while at the same time consistently reducing and even denying us the economic means and tools necessary to achieve those goals. It is simply unconscionable that some insurance companies continue to increase premiums and limit coverage blaming "increasing healthcare costs", while at the same time proclaiming record profits to Wall Street shareholders.
In fact, rather than talking about "pay for performance", as if physicians aren't fundamentally and professionally driven to always perform at the highest possible level for their patients, we should be talking about "payer performance." We must not be afraid, embarrassed or ashamed to demand reimbursement that is a reflection of the work we do, the risks we take and the tools we need in order deliver effective, quality healthcare.
Therefore, as a second part of our HIT initiative, I will work with the FMA to support not only our efforts to update Medicare and Medicaid fee schedules that better reflect the economic realities of delivering healthcare in the 21st century, but to also incorporate a more direct way to support physicians who have implemented HIT in their practice than the current complex and limited government grants and pilot projects.
We must speak with absolute clarity and conviction that the only acceptable "pay for performance" initiatives are those which invest in improving quality of care, and do not masquerade as just another scheme to deplete the resources in our healthcare system from the very people who use it and make it work. Continue
