You can't get there from here: Misplaced incentives can undermine the goals of health care reform in the NICU setting

摘要

There is an old saying used for circumstances in which the path from a traveler's present location to the final destination is necessarily so circuitous and non-intuitive that making the trip becomes absurd. The start and finish points may, in fact, be very close in distance, but there is no navigable direct path. 'You can't get there from here' implies that either the direct route is fraught with insurmountable hazards or the traveler has strayed so far off the correct path that backtracking is unavoidable. The United States is fast approaching this point in achieving some of the Health Information Technology (HIT) goals set forth in the American Reinvestment and Recovery Act (ARRA),1 and the incentives set forth in the act may, indeed, undermine specific goals set forth in the Affordable Care Act (ACA).2 Specifically, the goal of decreasing health disparities is undermined when identifiable patient populations are excluded from incentives programs and real meaningful use standards. This article examines the disparity created by excluding babies <2 years old from the benefits that meaningful use standards and incentives afford other Americans.