If the Supreme Court strikes down all or part of healthcare reform, it would stall a number of national health IT projects and initiatives, including health information exchanges, Richard M. Hodge, senior director of congressional affairs at the Healthcare Information and Management Systems Society (HIMSS), tells InformationWeek.
A HIMSS information sheet outlines some of the repercussions if the Supreme Court rules against the individual mandate and also rules that the mandate is inextricably linked to the rest of the Patient Protection and Affordable Care Act, which would mean that the entire Act--not just the individual mandate--would fall.
"If the entire ACA is ruled unconstitutional, a number of health IT related provisions of the law will be nullified," the HIMSS paper says. "In addition to health insurance reforms, expansion of Medicaid eligibility, and the creation of health insurance exchanges, the ACA includes a number of improvements dependent on or related to health IT capabilities including electronic health information exchange [HIE]; new methods to reimburse expenses based on quality of care, operating rules and standards; and health IT workforce development, all of which will be lost."
HIE is a key piece of the ACA, HIMSS notes--without it, ACA reforms at risk include the Accountable Care Organization Demonstration Projects, extension of the Physician Quality Reporting Initiative (PQRI) and the Center for Medicare and Medicaid Innovation (CMMI).
That's just the beginning, FierceHealthIT editor Ken Terry notes in a recent commentary.
"The business model for accountable care organizations is based partly on the Medicare shared savings program authorized by the law--and ACOs cannot exist without a robust IT infrastructure," he writes. "The ACA also authorizes a bundled payment pilot that depends on coordination of care between hospitals and post-acute-care facilities. And another ACA provision requires Medicare to levy penalties for excessive readmissions, forcing hospitals to bolster their ability to communicate with other providers and patients."
The HIMSS paper does end on an upbeat note--listing alternatives, such as new legislation, to support some aspects of ACA that already have "significant momentum" and aren't so controversial.
"We will find ways to move forward regardless of the court's decision," Hodge told InformationWeek. "That may be through the private sector, [it] may be through other proposals and legislation ... we'll just have to see how that unfolds."
Additionally, a newly-released report from the Senate Committee of Health Education Labor and Pensions says that if the Supreme Court strikes down ACA in its entirety, it would have a negative impact on the Meaningful Use EHR incentive program, according to FierceEMR.