Who Should Pay For the EHR?

The AMA reports that:

The Massachusetts Blues believes that the return on physicians' investment doesn't warrant buying the technology as part of its bonus programs.

...so BCBS of MA is no longer going to pay for its docs to get an EHR. Meanwhile, Vermont's own VITL project has done an about face regarding the funding of EHRs and has asked that the state provide the funding, "with money raised by a fee or surcharge on medical claims."

Does anyone on this planet actually think this cost simply won't be passed back to the doctors and patients? Does anyone imagine that Aetna/CIGNA/MVP simply won't lower reimbursements by the amount required to offset the $$? This doesn't even pass the laugh test.

Sadly, the $16-30m the proposed tax would raise can only be spent on a list of five pre-chosen vendors, none of whom have a particular understanding of pediatrics. I've spoken about this before.

Ironically, no one locally has remarked on the Allscripts sale to Mysis, which is officially being pegged as a layoff opportunity. Allscripts, you see, has a big office a few miles from here (right within the IDX/GE campus - I've never understood the relationship) and the jobs of hundreds of locals are threatened. It's no surprise that the local media haven't figured this out, yet. I wonder if any of the VT docs who choose Allscripts with the vision of it being a local product realize what's going on?

A proper blogger would take the time to indicate whom he thinks should be paying for EMRs. To be honest, I don't know - we are all going to pay if we don't do it. And nearly all of the payment schemes I see make the patients and docs pay for it, directly or indirectly. I don't like the gov't paying for it (the effect of its intrusion in the form of CCHIT certification has been negative so far, imo). Where does that leave us?

I'll never know. More about SOAPM, merging practices, etc., tomorrow.