CSC survey reveals hospitals' focus on meaningful use and challenges in meeting incentive requirements
According to a survey of U.S. hospital executives released today by CSC (NYSE: CSC), steps to meet meaningful use requirements were already a priority for hospitals before the final rules to establish an incentive program for electronic health records were announced by the United States Department of Health and Human Services (HHS) on July 12. Titled, “Health Reform: Priorities and Challenges for Hospital Executives,” the survey conducted in June and July concludes that 90 percent of participating hospital executives report that achieving meaningful use of an inpatient EHR is one of their top two priorities, and 67 percent say it is their highest priority. For 42 percent of the respondents, helping owned and/or affiliated physicians’ practices achieve meaningful use of an ambulatory EHR ranked second on the business agenda.
Under the American Recovery and Reinvestment Act of 2009 (ARRA), hospitals can apply for incentive payments from Medicare and Medicaid starting in October 2010 for the successful implementation and effective use of EHRs. The incentive payments are substantial: a typical 275-bed hospital would be eligible for approximately $6 million. Hospitals that do not meet federal guidelines by 2015 face reductions in Medicare reimbursement.
The survey reveals that work to achieve meaningful use is well underway: 67 percent of hospital executives have already implemented or are in the process of implementing new capabilities in order to meet the federal requirements, and 51 percent are targeting fiscal year 2011 to qualify for meaningful use. Roughly one-third (34 percent) are looking at fiscal year 2012.
The biggest barrier for hospitals to move forward in preparing for meaningful use, as indicated in the survey results, was the absence of final rules (reported by 60 percent when the survey was conducted). Given that the final rules were released on July 13, that barrier has been removed, but other barriers remain, including insufficient IT staff (40 percent), other priorities taking precedence (32 percent) and limited capital (28 percent). Only a small number of hospitals (5 percent) have not taken any actions to prepare for meaningful use requirements.
The survey also reveals a clear recognition of challenges in meeting meaningful use incentive requirements. The three biggest challenges based on the proposed requirements are use of electronic physician documentation functionality (48 percent), capturing and reporting designated quality measures (44 percent), and data exchange with other entities (44 percent).
“Achieving meaningful use is clearly top of mind among hospital executives, but the CSC survey also reveals there are many competing priorities, including changes to payment models, that are slowing the progress,” said David Hampshire, senior partner and managing director of Health Delivery for CSC's Global Healthcare Services Group. “The next few years are filled with opportunities and challenges for hospitals, and success will depend on starting early and building the right infrastructure.”
Additional findings from the survey of hospital executives include:
• 11 percent currently participate in a statewide health information exchange (HIE) while 26 percent have established a private hospital-sponsored HIE. However, 66 percent are planning to participate in a state HIE.
• When more than 30 million newly insured people enter the healthcare system in 2014, one-quarter predict that their organization will experience a significant strain on capacity to provide care, and an additional 43 percent expect to experience a slight strain on capacity.
• Hospital executives anticipate the biggest impact will be on outpatient primary care (36 percent) followed by demand in the emergency department (33 percent).
• More than 50 percent of operational executives cite preparing for new models of care as their first or second priority for 2011 and 2012.
• 49 percent see the ability to form accountable care organizations and share savings with Medicare and Medicaid as a future opportunity, although almost as many (44 percent) see this as both an opportunity and a threat.
• About one-quarter are planning on participating in a bundled payment or accountable care pilot, but less than 10 percent have already decided not to and 67 percent have not yet made a decision.
Of the 60 U.S. executives participating in the survey, 33 respondents represented multiple hospitals or health systems with a total of at least 225 hospitals, 15 responded for a single academic medical center, and 12 responses were for a single hospital that was not an academic medical center. In total, the survey included more than 250 hospitals. The respondents were almost equally divided between IT executives and operational executives, including chief executive officers, chief financial officers and chief operating officers.
CSC’s Global Healthcare Services Group, which serves healthcare providers, health plans, pharmaceutical and medical device manufacturers, and allied industries around the world, is a global leader in transforming the healthcare industry through the effective use of information to improve healthcare outcomes, decision-making and operating efficiency.