Health IT

Ohio medical association wants electronic medical record aid to reach individual practioners

Any federal funding for electronic medical records must trickle down to individual physicians to truly help cut their costs, the Ohio State Medical Association senior director of governmental relations said. The association also outlined its top priorities for this legislative session, including the reform of the state’s “prompt pay” law.

Any federal funding for electronic medical records must trickle down to individual physicians to truly help cut their costs, the Ohio State Medical Association senior director of governmental relations said.

Doctors are drowning in paperwork, Director Tim Maglione said. But a three-member medical practice could easily spend $100,000 to upgrade to electronic medical records and then adjust to the new system.

“It takes a while to figure [electronic records] out,” Maglione said. “There’s a cost associated with that.”

President Barack Obama has set aside $19 billion for electronic medical records, while Ohio has budgeted $20 million to fund a transition to electronic records and capture additional federal funding.

Nearly 90 percent of the new federal funding goes to providers through Medicare and Medicaid payments based on who is using certified health IT tools, according to the Ohio Department of Insurance.

The state cannot withhold the money meant for providers, but the state hasn’t seen any figures on how much of that funding would go to hospitals, as opposed to physicians or smaller practices, spokesman Robert Denhard said.

A Congressional Budget Office report (pdf) in mid-2008 said many practitioners would lose money by deploying electronic medical records.

“Some of that [funding] has to come down to the physician level,” Maglione said.

Monitoring the implementation of electronic medical records funding will be one of a handful of key areas for the Ohio State Medical Association. The group’s legislative agenda also includes goals to:

– Revise the state’s prompt pay law — which mandates that a payment from an insurance company to a physician be made within 30 days – to include Medicaid-managed care plans and third-party administrators that manage benefits for large employers.

It’s hard to gauge the severity of this problem, however. Maglione said the OSMA has mostly anecdotal information. Insurance department spokesman Denhard said the data regarding prompt-pay compliance is very small, and the department hopes to increase the information it collects.

The association’s proposal also would cut down the “take back” period in which insurance companies could request refunds from physicians from more than two years now to five months.

“Right now, that law works very well when it comes to state-licensed insurance companies,” Maglione said. “It doesn’t work well for third-party administrators — companies that administer benefits for large employers.”

– Get agreement with insurance companies about the data used in their physician rankings and preferred doctor programs. The Ohio State Medical Association wants Ohio to mirror the model developed in New York, where a series of insurers promised to rank physicians on measures of care quality and not price.

Insurance companies promised in 2007 to implement rankings nationwide that mirrored their agreements in New York. But some states, including Colorado, have opted to regulate the so-called tiered networks. The Ohio State Medical Association has been part of negotiationswith UnitedHealth over its ranking program, as has the Department of Insurance and other relevant state organizations.

“We feel standards are necessary,” Maglione said.