If Court Squashes 'Obamacare,' IT May Suffer: HIMSS

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If the Supreme Court rules that the Patient Protection and Affordable Care Act is unconstitutional, a number of health information technology-related provisions of the law will also fall, and that could disrupt health IT implementation plans, according Richard M. Hodge, senior director of Congressional Affairs at the Healthcare Information and Management Systems Society (HIMSS).

But despite these concerns, Hodge told InformationWeek Healthcare, "We will find ways to move forward regardless of the court's decision. That may be through the private sector, [it] may be through other proposals and legislation…we'll just have to see how that unfolds."

In a fact sheet released to coincide with last week's oral arguments before the Supreme Court on the constitutionality of the Affordable Care Act (ACA), HIMSS identified key provisions of the law that are heavily reliant on health IT implementation for their success. Those provisions include health insurance reform, the expansion of Medicaid eligibility, and the creation of health insurance exchanges.

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The ACA includes a number of improvements dependent on or related to health IT capabilities, including electronic health information exchange (HIE); new methods to reimburse expenses based on quality of care, operating rules, and standards; and health IT workforce development, "all of which will be lost [if the ACA falls]," the document states.

The fact sheet also noted that "among the ACA's reimbursement reforms dependent on health information exchange are Health Benefit Exchanges, Accountable Care Organization Demonstration Projects (ACO), extension of the Physician Quality Reporting Initiative (PQRI), the Center for Medicare and Medicaid Innovation (CMMI), and bonus payments to Medicare Advantage Plans."

While the consensus is that many of the federal health IT initiatives under the Health Information Technology for Economic and Clinical Health (HITECH) Act, such as the Medicare and Medicaid Electronic Health Records (EHR) Incentive Programs, will not be affected by the Supreme Court's decision, Hodge pointed out that the ACA further extends the HITECH Act and the way technology will be used in healthcare.

"The ACA built upon the foundation laid by the HITECH Act. The ACA included provisions related to quality reporting, reimbursement based on quality, data collection standards and rules, and health IT workforce development--all of which are important enhancements to the foundation laid by the HITECH Act," Hodge said.

To appreciate how the court's decision might affect telehealth, one needs to understand the role that CMMI, which was established under the ACA, plays in this scenario. CMMI is tasked with encouraging the use of telehealth to improve the care of hospitalized patients through electronic monitoring by specialists located at other facilities. The Center is also developing new models that use remote monitoring systems to coordinate care over time and across settings.

In an interview with InformationWeek Healthcare, Gary Capistrant, American Telemedicine Association's senior director of public policy, said, "The Court's decision will probably have zero bearing on telehealth. It is inconceivable that all of ACA, notably the Medicare provisions such as CMMI, would be repealed and rolled back."

In the meantime, Hodge said that even if the Supreme Court rules the ACA unconstitutional, lawmakers, healthcare delivery organizations, and the private sector recognize that health IT is a driver that can reduce healthcare costs and raise the quality of care, and they are committed to advancing health IT implementation.

The 2012 InformationWeek Healthcare IT Priorities Survey finds that grabbing federal incentive dollars and meeting pay-for-performance mandates are the top issues facing IT execs. Find out more in the new, all-digital Time To Deliver issue of InformationWeek Healthcare. (Free registration required.)