Incentives At Work: E-Prescriptions On the Rise

E-prescribing is one of those no-brainers that has nevertheless taken forever to attain any sort of momentum in U.S. healthcare. But there finally appears to be some good news on that front, thanks to new Medicare incentives that appear to have pushed many doctors to climb on the bandwagon.

According to SureScripts-RxHub, which manages an e-prescription network for many pharmacies, the number of U.S. doctors writing at least some e-prescriptions has likely doubled in 2008 to more than 70,000, up from 35,000 last year. Perhaps more significant, the volume of filled e-prescriptions -- purely electronic drug authorizations, that is -- has risen roughly 15 percent a month since August, a significant boost over the five to eight percent increases recorded earlier in the year.

Although it's too soon to be absolutely sure, the primary reason for the shift appears to be a classic carrot-and-stick incentive courtesy of Medicare. Starting next year, the federal program will offer doctors who e-prescribe a two percent reimbursement bonus. That drops to one percent in 2011 and again to half a percent in 2013. Meanwhile, those who stick to their paper pads will see reimbursement cuts starting in 2012.

E-prescribing makes sense for all the same reasons that electronic medical records do: They reduce the opporutnity for error and give doctors and pharmacists a chance to catch potentially dangerous drug interactions before it's too late. There are still shortcomings, of course, particularly the fact that the Drug Enforcement Agency won't allow various narcotic painkillers to be e-prescribed (although the DEA insists it's working on the problem). That said, the upside to e-prescribing is clear. The only problem is that doctors haven't wanted to pay for the systems that would make it possible, and until now, no one was offering them much incentive to do so either.

The prospect of bonuses -- or cuts -- in Medicare payments, however, may well have kick-started a move toward e-prescribing that common sense and pharmacy-industry exhortation couldn't. Of course, even the recent improvements are so far is still pretty minimal, as there are more than 300,000 doctors of all sorts in the U.S. But hey -- it's a start.

Photo via Flickr user Mark Sadowski, CC 2.0