Stark talk from the new boss

You probably think of Rep. Pete Stark (D-CA) as the guy who imposed all those scary self-referral rules on doctors. But, before the Republicans took over Congress in 1994, he had significant influence on all healthcare legislation. And now, with the Democrats back in power, he's set to take the reins of the health subcommittee of the House Ways and Means Committee.

Stark talked about the Democratic healthcare agenda at a recent pay-for-performance conference in Washington. While he didn't see big changes coming in the next couple of years, he did make some sweeping observations about what needs to be done to jump-start health IT adoption.

Recalling that government regulation had helped establish a single standard for ATM machines, Stark said that something similar would be required to spur the widespread use of standardized EHRs. "We'll have to say to providers that in five years, you're going to have to use an interoperable EHR…After five years, you won't get paid [by Medicare if you don't have one]."

After hitting the audience with that stick, Stark offered a carrot, saying the government should help subsidize the acquisition of health IT by physicians and other providers. "Then it'll get done. If we don't do this, we won't have a universal IT system that's interoperable." And without that, he added, performance and outcomes measurement will be impossible.