RECs Won't Finish Mission Without More Funding

Scott Mace, for HealthLeaders Media , March 18, 2014

For one thing, the RECs did not suddenly snap to life in Year One of the program. "They spent the first year letting contracts," says Bobby Gladd, author of the independently-published HHS Regional Extension Center Blog. "The second year was going out and recruiting. They've really only done boots-on-the-ground for two years, and the phrase was 'one and done'" meaning, just enough time and resources to help providers implement Year 1 of meaningful use Stage 1.

For those providers who attested early, say in 2011, had collected 70 percent of the money they were eligible to obtain through the Meaningful Use incentive program, by the end of that milestone, Gladd says.

A Long and Rocky Trail

Yet, that still left Year Two of Stage 1; and all the challenges of implementing Meaningful Use Stage 2, with all its disruptive changes to healthcare's workflows in order to effectively implement such objectives as coordination of care, patient engagement and health information exchange.

Without the help of the RECs, small and rural providers would be even more dependent on pricey consultants or EHR software vendors who might see such an opportunity as a sure way to lock in and lock up providers in their technology.

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2 comments on "RECs Won't Finish Mission Without More Funding"

Sherry Reynolds (3/18/2014 at 4:11 PM)
The program was always set up with sustainability built in - in fact none of the REC's got any funding without a plan to survived. They were also supposed to be partially vs fully funded at 80/20 then 20/80 but ONC let them become dependent on govt funding. Providers can easily get a "free" EHR and get up to $64k over the first few years of using one and they could use that to pay for the consulting services. There are also many many rural health programs that provide additional funding for rural hospitals that ONC and rural health have put together. ONC and HITECH were supposed to be startup capital and the RECs had four years to figure out that they could have charged for their services.. Even if only at 20% it would have given them an extra year.

PJC (3/18/2014 at 3:49 PM)
The article notes an important point. The government's role in accelerating the adoption of EHR technology has been 3-fold, though almost all the press has been around incentives. The 3 elements have been: incentives (to help defray the cost of EHR acquisition and implementation), technical assistance (to provide low cost or even free expert technical consulting during the migration), and oversight (to establish standards through certification and to coordinate efforts among stakeholders). Because these were the three major obstacles raised by physicians when polled 5 years ago - a lack of working capital, knowhow and standardized EHR products. Now, with only about half of all providers having ever achieved MU at all, what's changed for those who haven't yet started? Not much. MU certification certainly helps, (and I'd even say, fewer vendors is actually advantageous), but the other two problems remain - and impending penalties make the capital pinch worse, while declining REC assistance leaves providers with huge challenges. But now that we've spent nearly $20B on incentives, how costly is it to lose a player who, having once achieve MU, decides to quit because they still can't afford the game? I'd say it's even worse to lose someone who has received incentives than it is to fail to help someone migrate in the first place. It's like a bridge halfway across the river. 2014 will be a watershed. ICD-10 will occupy all the "change agent" resources available form most practices. MU participation will fall off, before we can really prove whether the migration is working. And Congress will either wake up and realize the job isn't finished and needs more time, and yes, more money, or they will declare the whole thing a failure and waste precious time laying blame on this side or that side of the aisle. I hope fervently for the former.




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