Similarly, St. Luke’s Health System in Kansas City is rolling out EMRs to its own medical group and offering the RelayHealth secure messaging system to community doctors. Debe Gash, St. Luke’s CIO, sees hospital gifts to private practices as the exception. It’s tough for them to find the money, she says, “given the reimbursement climate and low operating margins.”

But how much will they pay?

Healthcare systems that are donating EMRs often pay the maximum allowable 85 percent of the software cost. But that still leaves a big investment for you.

Consider Memorial Hermann Health Network Providers, an IPA affiliated with Memorial Hermann Hospital in Houston. Using hospital funds, the IPA plans to help up to 1,300 of its member physicians — all of whom have agreed to participate in a “clinical integration program” — to buy the eClinicalWorks EMR. Scott Fenn, CEO of the network, says that 70 doctors are already implementing or using the EMR, and he expects 400 to be up and running within three years.

The IPA, which hosts the program itself and provides technical support, starts with a needs assessment of each practice. While doctors select their own hardware and get discounts through the IPA, they’re told what the minimum computer requirements are. Some practices have felt taken aback by the equipment cost, which averages $5,000-$7,000 for a soloist, Fenn says.

Because the hospital cannot legally pay for ongoing support, the cost is bundled into the monthly fee of $325 per physician, plus $75 for eClinicalWorks’ practice management component, if a practice chooses to include that. So, participating doctors are paying up to $400 a month.

Plastic surgeon William Riley Jr. of Sugar Land, Texas, an EMR adopter, feels that that’s a reasonable charge. And it’s not atypical for hospital-provided EMRs.

The Butler Health System in Butler, Pa., is charging private-practice doctors $500 a month for hosting and supporting an Allscripts EMR. It’s paying 85 percent of the cost for the software, which is also being rolled out to its 30 employed physicians.

The hospital decided to offer only one product because it believed that would be the best way to improve community health, says Mike Bush, Butler’s vice president and chief strategic officer. He also points out that the system wanted to provide an EMR to doctors before one of its competitors did, and that physician job candidates are increasingly demanding that the hospital give them an EMR.

Payer subsidies

Health plans, like hospitals, are still rather timorous about subsidizing EMRs for doctors. Most of the technology donations from payers have been e-prescribing programs, which promise a faster and surer bang for the payers’ buck via increased generic and in-formulary prescriptions.

Yet there are exceptions. Nine percent of health plans include incentives for EMR adoption in their pay-for-performance programs:

Blue Cross and Blue Shield of Massachusetts offers a maximum incentive of $1 per member, per month to doctors who meet its goals for preventive and chronic care, generic prescribing, and health IT adoption;

The seven plans that belong to the Integrated Healthcare Association P4P program in California have paid groups substantial rewards for EMR adoption, as well as quality improvement;

The Hawaii Medical Service Association, also a Blues plan, has reportedly committed $50 million to subsidize EMRs. But it has given out only $3 million so far, at $20,000 per doctor, because just 150 physicians accepted its offer; and