Tuesday, August 02, 2005

Employer / Insurance Consortiums

Our multi-faceted effort has now turned to involvement of the business community(s) of the Inland Empire. I welcome those who have chosen to respond to the email invitation that was sent out to all regional Chambers of Commerce in the Inland Empire and Coachella Valley.
As most providers are aware the IT revolution began a decade or so ago with the transformation of reimbursement and managed care. A great deal of the healthcare financial resources was budgeted on IT by healthcare insurers for financial management, utilization review and referral authorizations. The physicians were left to fend for themselves facing diminishing reimbursement, and less capital to convert to electronic medical records. In addition, the product itself was still immature and poorly designed for physician work flow. Physicians were/are reluctant to invest capital in hype marketed by the federal government. This is especially critical for small to medium sized practices. The reasons for this go beyond the purpose of today's posting.

One model for financing EHRs which would benefit the industry as a whole is to form an alliance between employers and insurance carriers for funding some of the EMR costs which will be thrust upon physicians. Each particular physician specialty has it's own needs, and many specialties do not enjoy a high profit margin or large amounts of discretionary income after expenses. Some practices do not interface with CMS (medicare), such as pediatrics, and some primary family practitioners.

Our particular regions enjoys a relatively booming economy with several large employers.
It is my expectation that the business community will begin to see the importance of the RHIO to reduce their health care expenditures, and facilitate safe and efficient care of their employees.
Physician leadership is extremely important in interfacing with the boards of directors, and executive staff of these large, medium and small corporate entities.

I know we cannot depend upon the federal government for funding these ventures despite what we hear about congressional bills. We need a model that will be self sustaining beyond grants.
CMS (Medicare) was originally designed to pay for medical care for seniors.....it has now become rift with programs that merge into public policy making, and addresses issues that are not and should not be its main focus. More on that later.

In several states and regions RHIOs are already functioning.

CALRHIO (California Regional Health Information Organization) will have a summit meeting in mid September. I hope by that time I will have good news to report from the Inland Empire

Our first RHIO meeting will take place in mid September, date and place to be announced.

Gary Levin M.D.


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