Managed care and big business continue to step up to the plate in driving IT adoption to improve healthcare quality and lower costs.   This is natural since doctors certainly can’t be relied upon to do so, and payors and employers feel the economic pinch most.  Payors are granting technology to providers to improve revenue management. Pay-for-performance will force adoption by doctors interested in avoiding salary cuts. 

Examples: Aetna is making PHRs powered by ActiveHealth Management available to their 15 million members. In Massachusetts, the Blue Cross Blue Shield Foundation awarded $50 million to almost 100 small and medium sized medical practices for EMRs. Stark Law reform will help accelerate these efforts.

Business interests continue to come together to encourage reform. This month two more coalitions have formed.  The Business Roundtable has joined the AARP and the Service Employees International Union to campaign Congress for better legislation for healthcare and retirement issues.  A second expansive group unites the U.S. Chamber of Commerce, insurance companies, and advocacy groups including Families USA.

High on the agenda is healthcare for the uninsured. One in six Americans doesn’t have health insurance.  Not all of these are poor – according to the Census Bureau, 70% live in a family with one worker, and a fifth are in families with household incomes above $40,000. The problem is many small and medium sized employers are doing away with healthcare benefits due to cost, or passing along the prohibitive cost to employees.

States have lost patience with Federal inaction and Massachusetts, Vermont, Maine, California and most recently Pennsylvania have moved forward with their own universal healthcare plans.  Most big insurers, facing dwindling medical plan enrollment, favor such state plans.

It will be interesting to see if more coalitions have deeper impact. Leapfrog Group has had limited success. A more receptive Democrat administration will likely help.


By Shawn Whalen, SVP & Director, Healthcare IT Practice, Schwartz Communications