CMS has taken up the e-prescribing torch. In July, the agency announced a preliminary program to promote widespread adoption of electronic prescribing.
E-prescribing is a natural goal for CMS; it has been proven to improve quality of care, reduce medication errors, increase efficiency, and lower administrative costs. Kerry Weems, the acting CMS administrator, says an all-electronic prescribing system could save Medicare as much as $156 million over five years—largely through improved quality care.
Though details on the e-prescribing plan are not yet decided, CMS has revealed that beginning in 2009 (and for the next four years) it will provide incentive payments to physicians who are “successful electronic prescribers.”
Details to Be Determined
The e-prescribing plan will be included in the Physician Quality Reporting Initiative (PQRI), with guidelines included in the 2009 PQRI. (How the new plan will work with the current PQRI e-prescribing measure is one of the unknown details.)
Weems says CMS will use its standard rule-making process to shape the e-prescribing plan. Therefore, details of the incentives program will not be available until this fall, when Medicare releases its final rule on the 2009 physician fee schedule. According to Weems, the 2009 fee schedule and PQRI will clarify some murkiness. “They will be specific about what constitutes e-prescribing, including the extent and reporting of what needs to be done through PQRI,” he says.
Rewards, Then Possible Punishments
Physicians can start reporting on e-prescribing Jan. 1, and those who do will reap the benefits. Patrick Conway, MD, MSc, a hospitalist, an assistant professor at Cincinnati Children’s Hospital Medical Center, and a 2007-2008 White House Fellow working in the Department of Health and Human Services (HHS), says initial discussions about promoting e-prescribing included talk of an incentive-based plan.
“It’s my opinion that, for physicians, it’s beneficial to start with a reward or carrot rather than a punishment,” he says. “And generally, CMS has approached physician programs with this method—like the PQRI.”