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Comment by will_brown | Hacker News Reader

>Even the value based programs that CMS has implemented are really fee for service with a look back and adjustments to payments made based on savings that were encountered.

And let’s not forget one of the more troubling aspects of EHRs and Medicare patients is that physicians are now required to turn over all patient EHR data to the government (CMS) every year for a reimbursement bonus and failure to turn over patient records results in a penalty.

Government collecting patient digital health records...what could possibly go wrong?

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The parent comment gets this a little wrong, but there is truth to the data collection aspect.

An increasing number of physicians have to be part of an integrated health network in order to get competitive reimbursement rates. Those networks upload individual patient data to state exchanges which in turn have started to upload to nationwide databases.

The rollout of this is staggered and uneven, as of a couple years ago when I stopped working at a company with its own electronic health record product.

As a sibling comments correctly notes, the CMS bonus (or absence of penalty) does not depend on direct uploading. It does, however, depend on using a system which has the capability of doing that uploading ('sharing').

Finally, I saw over the past 10 years a giant increase in the number of records audited by health insurers. Those audits involve giving the entire patient file to the insurer.

I'm waiting for the day one of these large databases gets compromised and everyone acts shocked that the data was being collected.

Physicians are in no way required to turn over all patient EHR data. CMS collects quality measures in the aggregate, numerators and denominators. There may be vendors in the middle who are collecting the data to calculate the measures, but the patient-level data does not go to CMS. (Obviously, their claims do, they're a payor.)

Was the parent post downvoted because it isn't true, or for some other reason? Explain, please.

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