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ARRA EHR Presentation Austin - GCS Technologies

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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

http://healthit.hhs.gov/portal/server.pt/gateway/PTARGS_0_11113_872719_0_0_18/Meaningful%20Use%20Matrix.pdf

http://www.healthimaging.com/index.php?option=com_articles&view=article&id=17532Implementation 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

http://www.emrandhipaa.com/emr-and-hipaa/2009/06/13/regional-ehr-training-centers/

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.

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ARRA EHR Presentation Austin - GCS Technologies - Presentation Transcript

  1. John lynn
    http://www.emrandhipaa.com
    EMR, EHR and HIPAA Wiki
    http://www.emrandhipaa.com/w
    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”
    Challenge
    Still Only Partially Defined
  10. Meaningful Use Matrix
    Measures
    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
    CCHIT
    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
    EHR-C
    EMR Company Certification
    EHR-M
    “Module” Certification
    EHR-S
    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
    $20-30k
    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
    Scenarios
  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
    http://www.emrupdate.com
    Selecting an EMR
    http://www.emrconsultant.com
    My Website
    http://www.emrandhipaa.com
    Regional EHR Training Centers?
  20. Counsel and Advice
    Implement EHR That Fits Your Clinic
  21. John lynn
    http://www.emrandhipaa.com
    EMR, EHR and HIPAA Wiki
    http://www.emrandhipaa.com/w
    john@emrandhipaa.com
    Questions?
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