Keeping Score on eHealth Savings

You have to hand it to former Speaker Newt Gingrich.  This year he's been tireless in his push for transforming health care towards a 21st model with electronic health care records and a national health information network (check out his Center for Health Transformation).  And, while he tosses out the headline grabbing slogans like "Paper Kills" like few others, Gingrich is also never afraid to get down and geeky and fight at the level where only wonks dare tread.  He does this because as a former master of Congressional process, Newt knows that this where most of his former colleagues glaze over in boredom -- leaving only those who understand the complexities of the Hill to spur real change.

Case in point, Gingrich has an op-ed in the Washington Times today about an all-time, epically unsexy topic:  How the Congressional Budget Office scores the potential cost of legislation.   Here's how Gingrich frames it:

In the coming months Congress will appoint a new director to the Congressional Budget Office. It is not a small decision.  Congress has a unique opportunity to fundamentally transform the way government weighs the financial costs of policy decisions. Nowhere can transforming the CBO have a greater impact than in the area of health and health care. Doing so can literally save thousands of American lives and billions of their tax dollars.

Specific to eHealth, consider what the former Speaker has to say about how the CBO has scored a key piece of legislation that is critical to moving the country forward effective modern health care practices:

The way the CBO scored Senate bill 1418, the Wired for Health Care Quality Act, is another example of how bad scoring methods can hurt good policies. The bill contains grant funding for connecting physicians and creating community networks, which the CBO scored to cost $652 million from 2006 through 2010. There is overwhelming evidence that proves health-information technology dramatically improves the quality of care. There are hundreds of case studies that show how health IT saves money through efficiency gains and automation. Yet the CBO mentioned no benefit of the macroeconomic savings in its scoring analysis. Instead, the CBO provided a four-page overview of the federal dollars that would be spent, but not a word on the anticipated savings.

Ignoring the savings and outcomes from capital investments is foolish, much like trying to save money by refusing to change the oil in your car. Nearly every member of Congress will vote for a bill if it improves the lives of their constituents and saves money at the same time, but they are unlikely to vote for a bill that is simply scored as costing the millions of dollars. This backward approach is a significant barrier to passing legislation that will dramatically improve patient safety and drive down health care costs.

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