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ARRA EHR Presentation Austin - GCS Technologies


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Presentation on the EHR Stimulus package (ARRA) in Austin, TX covering the important topics of "meaningful use" and "certified EHR" and how the EHR stimulus will be paid to doctors. …

Presentation on the EHR Stimulus package (ARRA) in Austin, TX covering the important topics of "meaningful use" and "certified EHR" and how the EHR stimulus will be paid to doctors.

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  • Under the Medicaid program, nurse practitioners and nurse mid-wives can file for incentive payments. Additionally, Physician Assistants (PAs) are included but only insofar as the PA is practicing in a rural health clinic that is led by that PA or is practicing in a Federally qualified health center that is so led. Medical Assistants and Physical Therapists are not included. Mid-levels are not included in the Medicare portion of the incentives. Physicians who practice in an area that is designated as a health professional shortage area shall receive an additional 10 percent incentive.
  • If the Secretary finds that less than 75% of eligible healthcare professionals are utilizing EHR beginning in 2018, the Secretary can further reduce the fee schedule to 96% and then 95% in subsequent years but not further.
  • Incentive payments will be based on a calculation that factors the physician’s Medicaid mix in combination with up to $25,000 the first year and $10,000 each subsequent year for five years, all multiplied by 85%. The highest potential for Medicaid payments is $63,750. Additionally, physicians filing under Medicaid must first demonstrate EHR usage by 2015 and will not be eligible for payments after 2021.
  • A lower 20 percent threshold can be used in the case of pediatricians.99% of federally qualified health center (FQHC) physicians.If all qualifying physicians apply for the Medicaid incentives the federal government would invest more than $2.8 billion in healthcare IT.About 45,000 office-based physicians may be eligible for up to $63,750 in ARRA funding over six years
  • Guide for "Meaningful Use" in July
  • Takes Less TimeFinding and Retrieving Notes (milliseconds)Doing Refills (minutes)Faxing Off Prescriptions (seconds)Making Appointments (seconds)Looking Up Results (milliseconds)Doing Calculations (DAS28, Framingham) (seconds)Drug Interactions (seconds)Reporting to Recall Patients (minutes)Reprinting Letters (seconds)Looking Up ICD9s (seconds)Takes More time Documenting an Encounter Level of Documentation Is Now Higher than BeforeEntering Initial Diagnosis List
  • Once a provider starts collecting incentive payments for meaningful use of an EHR (whether in 2011 or beyond), he or she can continue to collect PQRI payments but cannot continue to collect ePrescribing payments.
  • Transcript

    • 1. John lynn
      EMR, EHR and HIPAA Wiki
      EHR Stimulus Money (ARRA)
    • 2. How much EHR Stimulus Money?
      ARRA – HITECH Act – EHR Stimulus
      Estimated $19.5 Billion Spent on Stimulus
      $2 Billion for Office of National Coordinator (ONC)
      $36.3 Billion for Medicare and Medicaid Incentives
      Savings of $18.8 Billion
      Improved Efficiencies
      Tax Revenue
      Reduce Fee Schedule Payments from Penalties
      Medicare or Medicaid Bonuses
    • 3. Medicare EHR Stimulus Incentives
      $44,000 per Provider
    • 4. Actual EHR Stimulus Amount - Medicare
      75% of Medicare Allowable Charges
      $24k Medicare Charges = $18k in EHR Stimulus
      $13.3k Medicare Charges = $10k in EHR Stimulus
      Medicare Penalties
      2015 - 1%
      2016 - 2%
      2017 - 3%
      2018 - 4% (HHS Secretary Option)
      2019 - 5% (HHS Secretary Option)
    • 5. Medicaid EHR Stimulus Incentives
      $63,750 per Provider
    • 6. Medicaid Details
      More Complicated Process
      Reimbursement is Percentage of EHR expenditures
      Extended Time Horizon (through 2021)
      Must Demonstrate 20-30% of Patients are Covered by Medicaid
      Must Show “Meaningful Use”
      GW Study
      15% of Physicians Qualify
      99% of Federally Qualified Health Centers (FQHC)
      45,000 Office Based Physicians
    • 7. Lies EHR Vendors Use
    • 8. EHR Sales Lines
      Move quickly…EHR deployment back-log!
      You won’t be ready to show “meaningful use!”
      The government requires you buy an EMR
      Simply buy a CCHIT-certified product
    • 9. 2 Main Requirements
      “Meaningful Use”
      “Certified EHR”
      Still Only Partially Defined
    • 10. Meaningful Use Matrix
      Improve quality, safety, efficiency and reduce health disparities
      Engage patients and families
      Improve care coordination
      Improve population and public health
      Ensure adequate privacy and security protections for personal health information
      Requirements Increase Over Time
      Provide Patients e-copy of Data (2011)
      Real Time PHR Access (2015)
    • 11. EHR Certification
      Only Current EHR Certification
      Other EHR Certifications?
      “ Many certified EHRs are neither user-friendly nor designed to meet HITECH's ambitious goal of improving quality and efficiency in the health care system.“
      - Dr. David Blumenthal, NEJM April 2009
    • 12. Proposed CCHIT Certification Paths
      EMR Company Certification
      “Module” Certification
      Site Certification
    • 13. Cost of Certified EHR
      EHR Matrix of Prices
      Average for Certified EHR - $30,690.80
      Average for Non-Certified EHR - $17,066.00
      Cost of EHR Certification
      Cost of Extra Development
      One EMR Vendor Estimated $200,000 in Development Costs
      Many Unnecessary Requirements
    • 14. Problems with CCHIT Certification
      More Successful Installs – Where’s the proof?
      De-install Rate is Large
      Stability of Certified EHR Vendors
      Jabba the Hut EMR Companies
    • 15. Timelines
      6/16/09 – Meaningful Use Matrix
      7/16/09 – HIT Policy Committee Presents Next Revision of Meaningful Use
      “Meaningful Use” Implementation Guide in July
      7/21/09 – HIT Standards Committee Presents Standards and Certification Criteria
      Interim Final Rule by December 31st
    • 16. Lessons Learned from Past Incentives
      PQRI, P4P and ePrescribing
      Only 52% of participants got paid
      Only $600 per individual participating
      Only 2 of the 10 made a profit
      Not notified of problems for years
    • 17. Guaranteed EHR Benefits
      Legibility of Notes
      Accessibility of Charts
      No More Lost Charts
      Multiple Users Accessing Chart
      Disaster Recovery
      Drug to Drug and Allergy Interactions
    • 18. EHR Pricing Models
      One Time Cost Plus Annual Maintenance
      Monthly Cost Per Provider
      Cost Per Visit
      Free EMR
    • 19. Online Resources
      EMR Forum
      Selecting an EMR
      My Website
      Regional EHR Training Centers?
    • 20. Counsel and Advice
      Implement EHR That Fits Your Clinic
    • 21. John lynn
      EMR, EHR and HIPAA Wiki