Economic Stimulus Presentation August 2010

571 views
490 views

Published on

0 Comments
0 Likes
Statistics
Notes
  • Be the first to comment

  • Be the first to like this

No Downloads
Views
Total views
571
On SlideShare
0
From Embeds
0
Number of Embeds
2
Actions
Shares
0
Downloads
11
Comments
0
Likes
0
Embeds 0
No embeds

No notes for slide

Economic Stimulus Presentation August 2010

  1. 1. Economic Stimulus Overview We will begin the presentation shortly.
  2. 2. The Obama Stimulus • The American Recovery & Reinvestment Act (ARRA) is a $787 billion stimulus package that became law in February 2009. • The stimulus is not related to healthcare reform legislation. 2
  3. 3. The Obama Stimulus • $20 billion in incentives for meaningful use of certified EMR technology: – Medicare: $44,000 per doctor – Medicaid: $63,750 per doctor • Incentive money is per Doctor; not per Practice. – Incentive money goes directly to the Doctor; there is no aggregator. • There are penalties: – Beginning in 2015, Medicare Physicians not demonstrating meaningful use of EMR technology will have their Medicare fee schedule reduced: • 2015: -1% • 2016: -2% • 2017 and beyond: -3% 3
  4. 4. Medicare/Medicaid Incentive Overview • Providers must select either the Medicare or Medicaid program, they cannot select both. • Providers are allowed to change their program election…but only once. – If changing programs, doctors start at the payment year level that you would have had in your original program. – Can’t change programs after 2014. 4
  5. 5. Medicare/Medicaid Incentive Overview Meaningful Use 2011-2012 • Functional measures have been replaced by Core Objectives and a Menu Set. – Doctors must abide by all Core Objectives. – Doctors must abide by 5 of 10 Menu items. 5
  6. 6. Medicare/Medicaid: “Meaningful Use” Core Objectives 6
  7. 7. Medicare/Medicaid: “Meaningful Use” Menu Set 7
  8. 8. Demonstrating “Meaningful Use” • Medicare – Year 1 – 90 days of continuous, meaningful use – Year 2 – Meaningful use for the entire calendar year • Medicaid – Year 1 – Doctor need only adopt, implement or upgrade – Year 2 – 90 days of continuous, meaningful use – Year 3 – Meaningful use for the entire calendar year • Eligible Professionals must provide an attestation (witness statement) – mechanism TBD. – Doctors must identify which certified EMR they are using. – Doctors must describe their performance on all Core Objectives and Menu Items. 8
  9. 9. Payment • Doctor’s will need to provide: – National Provider Identifier (NPI), business address, phone etc. – Taxpayer identification • The doctor’s participation in the incentive program will be made public. • Payment will come in a single, annual payment from CMS or the State Medicaid agency. • Payments can be re-assigned. 9
  10. 10. Clinical Quality Measures • Part of meaningful use is submitting information on clinical quality measures (reports on care and care outcomes). – Reports on clinical quality measures help the government identify trends and patterns of care, and provide guidance for improving care. • There are now 44 measures – Three measures required of everyone – Choice of 3 others, chosen from a subset • Reporting – 2011: via attestation – 2012: through an electronic means 10
  11. 11. Medicare 11
  12. 12. Medicare: Eligible Professionals • Doctors of medicine • Doctors of osteopathy • Doctors of dental surgery • Doctors of dental medicine • Doctors of podiatric medicine • Doctors of optometry • Chiropractors 12
  13. 13. Medicare Payment Schedule Incen Incen Incen Incen Incent Incen Incen Total 2011 2012 2013 2014 2015 2016 2017 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 $12,000 $8,000 $4,000 - $24,000 2015 -1% -1% MFS 2016 -1% -2% -3% MFS 2017 -1% -2% -3% -6% MFS -Medicare providers who practice in health professional shortage areas (HPSA’s) will have their incentive payments increased 10%. 13
  14. 14. Medicare Payment Schedule • Medicare incentive payments are based on 75% of submitted allowable charges (look to the physicians Medicare fee schedule). – Clinic that charges $24,000 or more is eligible for $18,000 incentive (75% of 24k = $18k). – Clinic that charges $13,300 is eligible for $9,975 (75% of $13,3000 = $9,975). – Only for services furnished by the EP. 14
  15. 15. Medicaid 15
  16. 16. Medicaid: Eligible Professionals • Physicians • Nurse Practitioners • Dentists • Certified Nurse Midwifes • Physician Assistants practicing in federally qualified health centers led by a PA 16
  17. 17. Medicaid: Payment Structure 85% of “Net Average Allowable Costs” Maximum Incentive Payment is $63,750 Year Incentive Year 1 $21,250 (25k) Year 2 $8,500 (10k) Year 3 $8,500 (10k) Year 4 $8,500 (10k) Year 5 $8,500 (10k) Year 6 $8,500 (10k) 17
  18. 18. Medicaid Incentives • Year 1 incentive payments are provided to eligible providers who are adopters / meaningful users of certified EMR technology: – Eligible providers receive up to 85% of net average allowable costs for their EMR (software, implementation, training, etc.). – Last “first” year is 2015 and no payments after 2021. 18
  19. 19. Medicaid: Eligible Professionals • A non-hospital-based professional with at least 30% of their patient volume coming from Medicaid patients. • A non-hospital-based pediatrician with at least 20% of his/her patient volume coming from Medicaid patients. • A professional who practices predominately in a Federally-qualified health center or rural health clinic with at least 30% of the professional’s patient volume coming from Medicaid patients. 19
  20. 20. Pediatrician Incentive • The pediatrician incentive is lower, because the threshold is lower. • Maximum cumulative incentive = $42,500. – $14,167 in Year 1 • ($16,667 x 85% = $14,167). – $5,667 in Years 2-6 • ($6,667 x 85% = $5,667). 20
  21. 21. How is Patient Volume Defined? • “at least 30% of patient volume” means that the physician must be able to attribute 30% of his/her patient encounters over a 90-day period to Medicaid patients. – Numerator: amount of Medicaid patients – Denominator: total amount of all patients • “practice predominantly in a federally qualified health centers” means more than 50% of the time. 21
  22. 22. What Should I Do Today? • Start researching your options. • Consider your technology, maintenance and support options. • Don’t wait! – With nearly 1 million providers going electronic there will be a line. – The plans are front loaded, most of the money is available in the first few years. • The requirements ramp up over time. 22
  23. 23. Questions and Answers 23
  24. 24. Contact • Todd Krieger – Cell: 248-227-9167 – Email: todd@glostream.com 24

×