The American Hospital Association is putting pressure on legislators to change one area of the final ruling on the federal incentives for the meaningful use of EHRs.

The focus of AHA's discontent is the provision that makes hospitals, regardless of how many campuses they have, eligible for only one incentive payment if the multiple facilities share the same Medicare provider number.

What's wrong with this provision? As AHA pointed out, it doesn't take into account the significant cost of implementing and adopting the EHR system across facilities. Other than a potential logistical issue of keeping track of multiple incentive payments for one Medicare provider number, it's hard to fathom the reason for penalizing multi-campus health systems. After all, they are the ones who can really bring speed to market, so why not work with them to bring about that massive change? They will be the ones who reach out to the local physician groups to connect with them, thereby not only helping small physician offices adopt EHRs but aid in health information exchange.

Will not changing the provision keep multi-campus hospital systems from adopting EHRs? I don't think they have a choice, frankly. But not accommodating this huge cost factor could very well drag out adoption, and that's something neither HHS nor ONC want to see happen.

What are the chances of the provision being amended? Well, who's up for re-election? Just kidding. If you look at the high-ranking legislators who are supporting AHA, it holds a clue of what may happen. For one, it's a bipartisan effort.

AHA is supporting a bill that was introduced by Reps. Zack Space (Ohio-D) and Michael Burgess (Texas-R) in the House, and Sen. Charles Schumer (N.Y.-D) sponsored the Senate version. Two high-ranking Democrats who can throw a lot of weight around are supporting the bill - Ways and Means Chairman Sandy Levin (Mich.-D) and Health subpanel Chairman Pete Stark (Calif.-D).

When Congress comes back from recess, expect more pressure and more pressure. It would be interesting to get the reaction of HHS Secretary Kathleen Sebelius and ONC head David Blumenthal, MD, to this requested change.

Photo by Freedom to Marry courtesy of Creative Commons license.