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CloudView blog

Ideas and insights to help health care providers stay informed and profitable in today's challenging health care environment.

Our Goals in DC

by Jonathan Bush, President & CEO

Thanks for reading my last post. I’m following up with this one because clearly many of you took me up on the offer to explain the benefits of going to Capitol Hill. The thing most worrisome about blogs is wondering if anybody, anywhere, is ever going to read them…hence the “hanging chad” (to use a Washington phrase) ending to my last post.

So you did read it, you commented here and elsewhere and you want to know two things:

1. Why did I not meet with more Democrats?

2. What do I think we (athenahealth and the members of our network) will get out of our DC visits?

The D-spot:

So far, I have met four Democrats and six Republicans. At this point, I’m eager to get to anyone I can…but I’m looking for folks who will give the entrepreneurial sector more room to do good inside of health care. This means less regulation and, generally, this is more an R thing than a D thing. THAT SAID, on this last trip, I think I found a small nook for deregulation that both D & R will be excited about.

The Democrats I met with last time loved the idea of making it explicitly LEGAL (weird that it is not, but that’s another story) for receivers of electronic health information to PAY those who sent it to them. Our senior policy advisor Lauren Fifield has been working with members from both sides of the aisle that could be sympathetic to such an effort…So I think you will see much more from the left side of the aisle in future trips now that we are onto something we think everyone can like. 

What we want:

Our biggest goal for going to Washington is kind of funny but also scary: We go there so that we don’t accidently get wiped out of existence by some law that might seem like a good idea if you didn’t know that there is such a thing in health care as a cloud-based service!

For example, the government of my dear old cousin Dub-ya made really thoughtful changes in the Stark law and the anti-kick-back statute several years ago to allow hospitals to pay for doctors’ EMRs that they don’t use. The problem was that the lettering of the law included words like “licenses” and “servers” and “training”…three things that OUR clients don’t need.

We were ALMOST excluded from the regulatory safe harbor all together! Luckily, we got down there and former Congresswoman Nancy Johnson, R-Conn., added the words “or information services” to the law, and we were included!!! Yeesh.

Our SECOND biggest goal is longer term and more subtle. At athenahealth, we believe that if you don’t first DO GOOD that you can measure each year and then REGULATE YOURSELF to keep doing that good, the government will come in and crush you someday in a fit of jealous rage. The government did this with hospital companies in the early ’90s. They did it with HMOs in the late ’90s. They did it with drug companies in the early ’00s. I don’t want them doing that to us. 

SOOOO… we need to make sure that:

1. We are able to align our profits with an outcome that society wants, and

2. We do it in a way that allows OTHER COMPETITORS to come in and play the game we are playing--against us.

You read that right. If we don’t make it easy for competitors to play against us, our monopoly-like status will draw suspicion and rage over time. I’m sure of it.

HENCE, we are changing the pricing of our athenaClinicals and athenaCoordinator services to be CONTINGENT on SUCCESSFUL coordination of care! This means that when a doctor orders something for a patient, but the info order doesn’t get there and the results don’t come back, athenahealth doesn’t get paid.

This change is good for the world but has never been seen before and it might scare folks in government if they don’t understand it first. Also, we’d like to see other folks start to build products that work this way so we aren’t the only “purple poodle” in the dog park!

Make sense?

Jonathan Bush is the President and CEO of athenahealth.

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