Meaningful use of EMRs might be the 'Trojan Horse' of real health reform

I've complained plenty in this space over healthcare reform really only being insurance reform, though I did talk in a recent FierceHealthIT column about some nuggets of true reform contained in the Patient Protection and Affordable Care Act.

Yesterday, I got a nice reminder of where real reform of care--and not just insurance coverage--will come from. "Meaningful use is the Trojan Horse of healthcare reform," Pam Arlotto, president and CEO of Roswell, Ga.-based Maestro Strategies, told me over breakfast in Chicago. If you want the extra Medicare and Medicaid payments for being a meaningful user of an EMR, you're going to have to report quality and outcomes data.

That data will, in part, be used for comparative-effectiveness research at the Agency for Healthcare Research and Quality, per the American Recovery and Reinvestment Act. AHRQ will work with CMS and, presumably, medical specialty boards, to develop best practices for Medicare and Medicaid. This development, Arlotto said, will accelerate the movement toward quality-based reimbursement, a necessary step for true health system improvement.

Then, we'll just have wait for Congress to approve changes in Medicare payment formulas some time in the mid to latter part of this decade and for private insurers to take similar steps. That could be an impossible scenario, but that's another issue for another time.

For now, it's up to you, the EMR community, to serve as the soldiers in this Trojan Horse. - Neil