This offers much greater incentives to adopt electronic transactions than currently exist. However, health care providers should not be required by health plans to use any of the standards during the first year after adoption of the standards, and a health plan should give its health care providers at least 6 months notice before requiring them to use a given standard. These recommendations offer a realistic and functional approach to management of the 2-year implementation schedule and, most importantly, this approach would remove many of the disincentives to early implementation. However, if the data elements are necessary, timely updates will be important. Obviously, design and establishment of a registry without funding makes for some very difficult choices.
Tradeoffs are inherent.
Nonetheless, selection of Option 2 may represent a false economy. Option 2 is a complicated mix of Federal and State programs made more complicated by the mixing of enumeration and enrollment functions. If funding were not an issue, Option 1, which involves a single registry for enumeration of all health care providers, would be clearly superior to Option 2 for both the industry and the Government. The costs for the registry could be further reduced by the elimination of non-essential data elements, as suggested in the principles above. However, the fact that no funding source is available for the enumeration function dictates a more parsimonious strategy.