E-prescribing: Mass. insurer to require e-prescribing for incentive programs

November 14, 2008

The largest health insurer in Massachusetts is aggressively pushing e-prescribing, requiring physicians in the state to prescribe electronically by 2011 or get bounced from its bonus-payment programs.

The largest health insurer in Massachusetts is aggressively pushing e-prescribing, requiring physicians in the state to prescribe electronically by 2011 or get bounced from its bonus-payment programs.

Blue Cross Blue Shield of Massachusetts’ e-prescribing deadline will come a year before the date of a similar penalty to be imposed by the Centers for Medicare & Medicaid Services. Under a Medicare bill passed earlier this year by Congress, CMS in 2012 would cut Medicare reimbursements by 1 percent for physicians who don’t prescribe electronically. The penalty increases in subsequent years.

Blue Cross’ bid to promote e-prescribing could push Massachusetts even further ahead of the rest of the country in e-prescribing. In 2007, more than 13 percent of prescriptions in the state were ordered electronically, according to RxHub, a company that sends prescriptions to mail-order firms. Massachusetts far exceeded the national average of two percent. Rhode Island came in second among the 50 states at about nine percent, according to RxHub.

Previously, e-prescribing was optional for participants in BCBSMA’s incentive programs. The company’s primary care physician incentive program rewards physicians who provide high-quality care, and has paid out more than $124 million in bonuses since its inception in 2001, says Katie Fryman, a spokeswoman for the insurer. The program tracks physicians’ use of appropriate screening tests, use of technology to aid in clinical decisions, and utilization rates of generic drugs, Fryman says.

“Our incentive programs are designed to reward doctors for taking steps to improve the quality of care for patients, and e-prescribing has certainly proven to increase quality of care,” John Fallon, BCBSMA’s chief physician executive, says in a statement.

BCBSMA cited a study by researchers at Dana-Farber Cancer Institute that found that, in 2006, physicians who prescribed electronically chose more cost-efficient drugs and saved five percent on drug costs compared with physicians who didn’t e-prescribe, according to the statement.

BCBSMA plans to help defray e-prescribing costs for physicians who’ve not yet adopted the technology. The insurer plans to provide funding for such physicians to purchase e-prescribing software and hand-held devices, Fryman says. The company hasn’t yet decided on how much funding it’ll provide, she adds.