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Not looking to get into the politics of this...more focused on industry impact...

http://www.healthcareitnews.com/news/house-balks-10-billion-price-tag-va-cerner-ehr-project

With the budget approved, Cerner is to receive 10 billion dollars, 1B/year, for 10 years to provide their EHR application to all VA sites.

This is quite a deal for Cerner and where does that leave the rest of the industry?  How will EPIC fare?  What about the medium sized to small EHR shops?  Allscripts, Athena, eCW, etc.?

My thought is that EPIC and Athena will be fine due to their large contracts across the nation.  Will the others be able to keep up with market trends of costs to provide meaningful healthcare rising, at the same time, insurance/CMMS paying less, larger impact of data/analytics, etc?  I only know of 2 large organizations this past year staying in the black while everyone else was in the red.  Those two being HCA and UHS.  UHS to me is in a different category though because they are primarily behavioral health with only a few true hospitals.   I know of many individual practices that no longer process insurance claims and are cash only and with a 2-3 doctor office that can work if your reputation and bedside manner is on point and schedule stays full.

Can the big players like Ascension, Kaiser, CHI, Tenet, etc. keep purchasing smaller systems?  Or are they just creating a new healthcare bubble based on unstainable debts and loss of profits?

I don't have any answers, but shit is bad right now.  Lot's of bad decisions being made at the highest levels. 

I'll just say that some people are going to get their wish and find out the hard way that you get what you pay for.

Seems like a waste of money.  The V.A. is exempt from CMS reporting mandates and I can't imagine it will improve their collections significantly enough.  I would imagine they will obtain the most limited version possible.  Or it could be great.  

Seems to me the big advantage would be to get more providers on your system to create a standard but Cerner seems to be so different from institution to institution.

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