As funding ends, Regional Extension Centers adjust business models
The centers were successful in helping providers qualify for EHR incentive funding, and now are finding new ways to meet IT support needs for healthcare organizations.
Although the Regional Extension Center program will officially sunset at the end of 2016, the Office of the National Coordinator for Health IT estimates that 90 percent of the 62 current RECs will continue to operate nationwide,e helping providers to adopt electronic health records and meaningfully use them.
The centers, which operate in all 50 states, have been particularly helpful in assisting providers in rural, underserved healthcare settings to navigate the complex EHR adoption process from vendor selection and practice workflow redesign to implementation and project management, as well as addressing privacy and security issues.
Under the HITECH Act, ONC starting in 2010 invested more than $700 million in the REC program, awarding 62 cooperative agreements to 60 local organizations to provide technical assistance to small primary care practices, community health centers, rural health clinics and critical access hospitals. In fact, the REC network includes 54 percent of all rural providers, 80 percent of all critical access hospitals and 83 percent of all community health centers—healthcare organizations that typically lack the financial and human resources of larger providers.
When the REC program was established, the goal was to support 100,000 such providers to successfully achieve Stage 1 of Meaningful Use. However, according to ONC’s Chief Medical Officer Thomas Mason, MD, RECs easily surpassed that number, enabling more than 120,000 providers around the country to meet Stage 1 MU requirements.
“A measure of success for evaluating the REC program is providers that received incentive payments through the Medicare and Medicaid EHR Incentives Program,” says Mason.
He points to a recently released study of the REC program funded by ONC and conducted by the American Institutes for Research which reported that 68 percent of eligible professionals who received incentive payments under Stage 1 of the MU program were assisted by an REC, compared with just 12 percent of those who were not. “That statistic speaks volumes about the success of the program,” adds Mason.
Similarly, a 2012 Government Accountability Office report revealed that Medicare providers working with RECs were more than twice as likely to receive an incentive payment, according to Mason.
Despite the fact that ONC funding for the RECs has run out, the vast majority of these centers are finding ways to sustain their operations beyond traditional business areas, such as achieving meaningful use of certified EHR systems, he contends.
“Today, the RECs have a varied portfolio,” observes Mason. “Many have partnered or contracted with their state Medicaid offices, helping providers become certified in their state patient-centered medical home program, or similar programs. Many are assisting provider organizations with privacy and security issues. There are RECs working with ACOs in their states or regions. And, they are partnering with health information exchanges to help providers with data exchange to support improved patient care and decreased costs.”
As the American Institutes for Research (AIR) report states “most RECs thought that eligible professionals would be unwilling or unable to pay and thus provided services free of charge” and “some RECs charged a fee because it demonstrated providers’ commitment to reach their health IT goals.”
While in the past these centers operated with no-cost or low-cost fee structures, which were major benefits of the previously subsidized program, Mason says RECs are now charging for their services as a result of ONC funding drying up. Nonetheless, he believes the centers retain tremendous health IT expertise and knowledge they’ve developed over the past six years and will offer significant value to providers as the healthcare industry transitions from fee-for-service to value-based reimbursement.
“We’re very happy that they’re able to continue to work with providers in their regions to advance health IT adoption, health information exchange, and the transition to value-based care models,” concludes Mason. “We see RECs in the trusted advisor role for providers as they look to optimize their systems.”
However, AIR’s assessment is not as rosy as ONC. The firm’s report reveals that RECs anticipate numerous challenges to their sustainability, including generating the revenue needed to support their business operations.
Further, AIR notes that as RECs are winding down their grant programs, they have downsized and scaled back, and that staff have left the centers to work for large hospitals, health systems and vendors. As a result, they “might not have the human capital necessary for sustaining their technical assistance services.”
The centers, which operate in all 50 states, have been particularly helpful in assisting providers in rural, underserved healthcare settings to navigate the complex EHR adoption process from vendor selection and practice workflow redesign to implementation and project management, as well as addressing privacy and security issues.
Under the HITECH Act, ONC starting in 2010 invested more than $700 million in the REC program, awarding 62 cooperative agreements to 60 local organizations to provide technical assistance to small primary care practices, community health centers, rural health clinics and critical access hospitals. In fact, the REC network includes 54 percent of all rural providers, 80 percent of all critical access hospitals and 83 percent of all community health centers—healthcare organizations that typically lack the financial and human resources of larger providers.
When the REC program was established, the goal was to support 100,000 such providers to successfully achieve Stage 1 of Meaningful Use. However, according to ONC’s Chief Medical Officer Thomas Mason, MD, RECs easily surpassed that number, enabling more than 120,000 providers around the country to meet Stage 1 MU requirements.“A measure of success for evaluating the REC program is providers that received incentive payments through the Medicare and Medicaid EHR Incentives Program,” says Mason.
He points to a recently released study of the REC program funded by ONC and conducted by the American Institutes for Research which reported that 68 percent of eligible professionals who received incentive payments under Stage 1 of the MU program were assisted by an REC, compared with just 12 percent of those who were not. “That statistic speaks volumes about the success of the program,” adds Mason.
Similarly, a 2012 Government Accountability Office report revealed that Medicare providers working with RECs were more than twice as likely to receive an incentive payment, according to Mason.
Despite the fact that ONC funding for the RECs has run out, the vast majority of these centers are finding ways to sustain their operations beyond traditional business areas, such as achieving meaningful use of certified EHR systems, he contends.
“Today, the RECs have a varied portfolio,” observes Mason. “Many have partnered or contracted with their state Medicaid offices, helping providers become certified in their state patient-centered medical home program, or similar programs. Many are assisting provider organizations with privacy and security issues. There are RECs working with ACOs in their states or regions. And, they are partnering with health information exchanges to help providers with data exchange to support improved patient care and decreased costs.”
As the American Institutes for Research (AIR) report states “most RECs thought that eligible professionals would be unwilling or unable to pay and thus provided services free of charge” and “some RECs charged a fee because it demonstrated providers’ commitment to reach their health IT goals.”
While in the past these centers operated with no-cost or low-cost fee structures, which were major benefits of the previously subsidized program, Mason says RECs are now charging for their services as a result of ONC funding drying up. Nonetheless, he believes the centers retain tremendous health IT expertise and knowledge they’ve developed over the past six years and will offer significant value to providers as the healthcare industry transitions from fee-for-service to value-based reimbursement.
“We’re very happy that they’re able to continue to work with providers in their regions to advance health IT adoption, health information exchange, and the transition to value-based care models,” concludes Mason. “We see RECs in the trusted advisor role for providers as they look to optimize their systems.”
However, AIR’s assessment is not as rosy as ONC. The firm’s report reveals that RECs anticipate numerous challenges to their sustainability, including generating the revenue needed to support their business operations.
Further, AIR notes that as RECs are winding down their grant programs, they have downsized and scaled back, and that staff have left the centers to work for large hospitals, health systems and vendors. As a result, they “might not have the human capital necessary for sustaining their technical assistance services.”
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