How will the new rule on EHR pricing and transparency affect you?

One requirement of the 2014 Final Rule on Health Information Technology is for pricing transparency and disclosure. Certified electronic health record (EHR) vendors have been required to disclose any “additional types of cost that an EP (eligible provider), EH (eligible hospital) or CAH (critical access hospital) would pay to implement the Complete EHR’s or EHR Module’s capabilities in order to attempt to meet meaningful use objectives and measures.”

The rule has not required public disclosure of an actual price but instead information about the types of costs that might be incurred: Is there a one-time fee? A recurring cost? Both? For what features or services? Providers and hospitals should not encounter “unfair surprises” that materially affect their ability to meet Meaningful Use. The 2014 pricing transparency rule has only required disclosure of the various types of costs that would be encountered in the process of demonstrating Meaningful Use with a Complete EHR.

This requirement was recently expanded “to require greater and more effective disclosure by health IT developers of certain types of limitations and additional types of costs that could interfere with the ability to implement or use health IT in a manner consistent with its certification.” The revised rule, finalized in October 2015, expands the transparency statement. Costs that must be disclosed are not just those the user “would” pay to try to implement MU. Now, vendors must also address costs the user “may pay” to use the system within the scope of certification, as well as limitations the user might encounter.

The pricing transparency statement is pretty easy to understand, which is good since nobody likes costly surprises. But what are these “certain types of limitations” that the 2015 rule mentions? Shouldn’t the fact that a product is certified be the final word on meeting MU requirements? The final rule contains an example “scenario” that clarifies what sorts of limitations inspired this wording.

In this scenario, just suppose that a vendor of an EHR implements the capability to meet the Transitions of Care objective by sending secure messages with CCDAs attached. And suppose that the health information service provider (HISP) that connects this EHR to others is run by the EHR vendor. And suppose that the vendor chooses to only connect to other hospitals and providers who run that vendor’s EHR – and transmits those messages for free. In this scenario, connecting to another vendor or network is costly, if it is even possible -- and then there is a per-message fee. These types of “limitations” must be disclosed.

It is not surprising that new certification requirements, which drive new software development and associated services, have costs. In the market for certified health information technology? Be sure to look for the “transparency and disclosures” statements that should be posted on vendor web sites. And if you don’t see one, ask where it is!

To learn more about the federal requirements that EHR vendors must comply with, contact us

Learn more by visiting the ONC website

Tom Arnold, MBA, PMP, is Director of Meaningful Use for Medsphere Systems Corporation.

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