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EMR & EHR - Medical Stimulus Package

The American Recovery and Reinvestment Act of 2009 (ARRA) President Barack Obama on Feb. 17, 2009 signed into law the "American Recovery and Reinvestment Act of 2009" (ARRA), authorizing $20 billion to assist in the development of a robust health information technology (IT) infrastructure. The Health Information Technology for Economic and Clinical Health Act (''HITECH") includes $19 billion for health information technology.

What Does This Mean to You as a Provider?

Physicians can now be paid between $44,000 to $64,000 over five years from Medicare/Medicaid if they are utilizing an EHR in 2011 and beyond

  • Late adopters will receive significantly less
  • Providers may receive incentives under only one of the programs
  • 2015: penalty reductions in Medicare/Medicaid fees for non-EHR users

Medicaid: Physicians who see more than 30% of patients paying with Medicaid (20% for pediatricians) are eligible for payments of up to $64,000 over six years. The incentives will be calculated through a formula that multiplies 85% by amounts ranging from $25,000 in the first year to $10,000 in subsequent years. Additionally, those meeting the 30% threshold can begin earning the incentive payments even as they adopt, implement and upgrade their EHR software; they can begin proving Meaningful Use of the EHR in the second year of their program participation.

Medicare: Physicians who implement a certified solution and become meaningful users between 2010 and 2012 will be eligible for up to $44,000 each in incentive payments. Physicians who wait to become meaningful users between 2012 and 2014 will be eligible for lower payments. Physicians who have not become meaningful users by 2015 will not qualify for any payments and will be subject to increasing penalties. Incentives are based on the lesser of either 75% of the provider's Medicare Part B billings or the maximum allowable incentive.

Annual Incentives Schedule:

Adopt Yr 1
2011

Adopt Yr 2
2012

Adopt Yr 3
2013

Adopt Yr 4
2014

Adopt Yr 5
2015

Adopt Yr 6
2016

Total
2011 $18,000 $12,000 $8,000 $4,000 $2,000 - $44,000
2012 -> $18,000 $12,000 $8,000 $4,000 $2,000 $44,000
2013 -> -> $15,000 $12,000 $8,000 $4,000 $39,000
2014 -> -> -> $15,000 $12,000 $8,000 $35,000
2015 Start Paying Penalties

Payment Reduction

For office-based physicians who do not adopt EHR technology by 2015, Medicare payments will be reduced by:

From Year

Reduction in Medicare Payments

2015 1%
2016 2%
2017+ 3%

In 2018 and beyond, the HHS Secretary may decrease one additional percent per year (maximum of 5%) contingent upon the levels of overall EHR adoption in the market.

Other Valuable Financial Benefits Available

The use of Electronic Health Records and Integrated Practice Management Software is saving practices thousands of dollars in administrative cost. Additionally the providers are saving enormous amounts of time in documenting the patient encounter and the daily notes automatically within seconds. Providers are really enjoying the feeling at the end of the day when all patient charts and notes are done.

What the Law Says About "Meaningful Use"

The law defines a meaningful user as a physician who:

  • Uses a certified EHR in a meaningful manner, which includes the use of electronic prescribing (e-prescribing)
  • Uses a certified EHR that can accommodate the electronic exchange of health information to improve quality
  • Submits information on clinical quality measures, as chosen by the Health and Human Services (HHS) Secretary, for the reporting period

The law also defines a certified EHR technology as that which:

  • Includes patient demographic and clinical health information, including medical history and problem lists
  • Has the ability to provide clinical decision support.
  • Has decision supporting tools that support physician order entry and be able to capture and query quality information.
  • Tools that will also be able to exchange and integrate health information from outside sources.

The Meaningful Use Rule, which was released in a proposed form at the end of 2009 and will be finalized in Spring 2010, outlined in much greater detail what physicians and other participating providers will need to do to quality for the HITECH incentive payments.

  • Providers will need to prove Meaningful Use of their EHR for at least 90 continuous days in 2011 in order to earn an incentive, and then for the entire year each subsequent year.
  • Physicians need to prove that they have met 29 different functional objectives with their use of the EHR product to be considered "meaningful users". These objectives include computerized physician order entry (CPOE), the use of clinical decision alerts, incorporation of lab results into their EHR as discrete data, ePrescribing and electronic information distribution to patients.
  • Clinical quality measures will need to be submitted by a provider on a Core set of measures, as well as a specialty-specific subgroup; providers will be able to file for an exception if none of the 89 proposed measures matches with their specialty.
  • Physicians will be paid on a rolling basis as soon as they have proven to CMS that they have met all the functional objectives of the Meaningful Use requirement and have hit the maximum amount for the year. CMS will then issue a single, annual, consolidated payment.
  • All reporting will be done by attestation in 2011, moving to an electronic form in later years.
  • The requirements related to Meaningful Use will get more challenging beginning in 2013.

HIMSS (Healthcare Information and Management Systems Society) Recommendations

HIMSS defines 'meaningful use' of EMRs for Medicare incentives

To get Medicare incentive payments, it's not enough to simply roll out the technology - hospitals and physicians will have to prove that they've made "meaningful use of certified EHR technology."

This "meaningful use" includes using the technology to exchange electronic health data to improve care quality and submitting care quality measures to HHS. Not only that, hospitals and doctors will need to meet these requirements within a specified time frame.

Suggestions:

  • Rely on CCHIT as the certifying body for EMRs
  • Adopt metrics that can demonstrate meaningful use, and make them increasingly more stringent over two years or so
  • Work with HITSP and IHE to make sure systems are interoperable
  • Close the existing gap between "certified EHR technologies", "best of breed" and "open source" technologies

How We Can Help

  • At 1st Providers Choice we offer integrated Electronic Health Records & Practice Management Software that is affordable both for purchase and ongoing use, can be utilized as an in office (client server) or remotely hosted.
  • We offer a variety of financing options making your EHR / EMR & Practice Manament software affordable.
  • There is a relatively short window of opportunity for a physician to take advantage of these stimulus payments and we can help since it is critical that you move quickly.

Call today to schedule your free demonstration (480) 782-1116.