Emr And Economic Stimulus

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Outlines the economic stimulus benefits for meaningful use of an EMR system in medical offices.

Outlines the economic stimulus benefits for meaningful use of an EMR system in medical offices.

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  • 1. Economic Stimulus Overview Provided by gloStream and EMR Specialists, LLC
  • 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.
  • 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%
  • 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.
  • 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    • Functional measures have been replaced by Core Objectives and a Menu Set.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.
  • 6. Medicare/Medicaid: “Meaningful Use” Core Objectives
  • 7. Medicare/Medicaid: “Meaningful Use” Menu Set
  • 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.
  • 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.
  • 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
  • 11. Medicare
  • 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
  • 13. Medicare Payment Schedule -Medicare providers who practice in health professional shortage areas (HPSA’s) will have their incentive payments increased 10%. Incen 2011 Incen 2012 Incen 2013 Incen 2014 Incent 2015 Incen 2016 Incen 2017 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 $12,000 $8,000 $4,000 - $24,000 2015 -1% -1% MFS 2016 -1% -2% -3% MFS 2017 -1% -2% -3% -6% MFS
  • 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.
  • 15. Medicaid
  • 16. Medicaid: Eligible Professionals
    • Physicians
    • Nurse Practitioners
    • Dentists
    • Certified Nurse Midwifes
    • Physician Assistants practicing in federally qualified health centers led by a PA
  • 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)
  • 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.
  • 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.
  • 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).
  • 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.
  • 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.
  • 23. Contact
    • Michael Kanet
      • Cell: 702-279-8603
      • Email: mkanet@emr4drs.com