"With that uncertainty comes paralysis," he says. "If you have a $1.5 million project on the table and you don't know if only $1 million is available at the accelerated reimbursement or $1.4 million is eligible, obviously these small facilities that are already cash-strapped don't want to take a risk of having $400,000 disallowed from the higher reimbursement rates and so they are just not moving forward."
Slabach says he is heartened to see that ONC is plunking down another $30 million to help with meaningful use implementation.
"We will see how that plays out. I am not sure about the details and I'm not sure they are either," he says. "But if they have the resources those would be welcome to address the glaring problems that we are experiencing."
He cautions, however, that the Centers for Medicare & Medicaid Services is ultimately responsible for the meaningful use program, not ONC.
"Obviously we will need to work with CMS as a partner in this to make sure the right hand and the left hand know what is going on," Slabach says. "CMS has made some changes recently that we are encouraged by, for example allowing for lease purchases to be considered part of what is being reimbursed at the higher rate. That was a significant policy change."