Ai Stimulus Overview

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An overview of the ARRA / Stimulus and some insights into the potential impact on US physician practices.

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Ai Stimulus Overview

  1. 1. Overview of Funding for Physicians in the 2009 American Recovery and Reinvestment Act March 24th, 2009 9250 Bendix Road Columbia, MD 21045 (301) 560-6999
  2. 2. The American Recovery and Reinvestment Act (ARRA) of 2009 was signed into law on February 17, 2009. The Act, or “stimulus bill” as it has come to be known, included significant funding for health information technology (HIT) infrastructure and HIT adoption incentives. Collectively, the HIT provisions in the ARRA (Title XIII of Division A and Title IV of Division B) are referred to as the Health Information Technology for Economic and Clinical Health (HITECH) Act. 1
  3. 3. Overview of Available Funding $20.8 billion Medicare/Medicaid incentives to doctors and hospitals for “meaningful use” of certified EHRs (net after government projected savings) $4.7 billion For the National Telecommunications and Information Administration's Broadband Technology Opportunities Program $2.5 billion For the U.S. Department of Agriculture's Distance Learning, Telemedicine, and Broadband Program $2 billion For the Office of the National Coordinator, including significant funds for HIT infrastructure $1.1 billion For comparative effectiveness grants from AHRQ, NIH, and HHS Source: HIMSS 1
  4. 4. Overview of Available Funding (cont’d) $1.5 billion For the community health centers through the Health Resources and Services Administration $500 million For the Social Security Administration $85 million For the Indian Health Service $50 million For the Veterans Benefits Administration Source: HIMSS 1
  5. 5. Grant & Loan Programs Loans to Providers: The ARRA allows funds for states to establish loans to providers. Providers may use loans from states to purchase electronic health records (EHRs) and train personnel on their use. Grants to Promote Health Information Technology: $300 million has been appropriated through the Office of the National Coordinator to distribute grants to state and state designated entities for the promotion of health information technology. Funding will largely go to activities that support the establishment and expansion of health information exchange. 1
  6. 6. Medicare Incentives for Providers Providers using certified EHRs in a meaningful manner will be eligible to receive reimbursement incentives through Medicare beginning in fiscal year 2011. Qualifying EHR users must meet the following criteria: 1) Certified EHR technology is used in a meaningful manner, including e-prescribing 2) EHR is connected in a manner that allows for the electronic exchange of health information 3) EHR is used to submit report on clinical and other quality measures 1
  7. 7. Medicare Incentives for Providers (cont’d) • Hospital-based physicians (ex: • Physicians using certified EHR technology anesthesiologist, pathologist, emergency may receive 75% more per Medicare claim, physician) do not qualify for incentive up to a yearly maximum shown in the chart payments below • Payments may come in a single • Incentives begin in 2011 and no incentive consolidated payment or in periodic payments may be made after 2016 installments, as determined by the HHS • Professionals in a health professional Secretary shortage area (HPSA) qualify for a 10% • Physicians receiving Medicare incentives increase to incentive maximums are no longer eligible for MIPPA e- prescribing incentives Payment Year FY11 FY12 FY13 FY14 FY15 FY16 Total First 2011 $18,000 $12,000 $8,000 $4,000 $2,000 0 $44,000 Qualifying 2012 - $18,000 $12,000 $8,000 $4,000 $2,000 $44,000 Year of 2013 - - $15,000 $12,000 $8,000 $4,000 $39,000 Payment 2014 - - - $12,000 $8,000 $4,000 $24,000 1
  8. 8. Medicare Penalties for Providers Providers not using certified EHR technology by 2015 will be subject to penalties in Medicare reimbursement. A chart of these penalties is shown below. Level of Medicare Fiscal Year Reimbursement 2015 99% 2016 98% 2017 97% *After 2017, if overall EHR adoption rate is less than 75%, the Secretary may reduce Medicare payments by 1% in subsequent years, in no case falling below 95%. Source: HIMSS 1
  9. 9. Medicaid Incentives for Providers • Physicians using certified EHR technology • Medicaid incentives must begin no later in a meaningful manner may also qualify for than 2016; it is speculated incentives will Medicaid incentives begin in 2011 • Physicians may not qualify for both • There are no penalties for Medicaid Medicare and Medicaid incentives providers not using certified EHR • Payments may not be made for a period of technology more than 5 years Payment Amount: 1) Incentive payment must not exceed 85% of the net average allowable cost for purchase and maintenance of certified EHR technology 2) The net average allowable cost for EHR implementation in year one must not exceed $25,000 3) The net average allowable cost for EHR maintenance in year two must not exceed $10,000 1
  10. 10. Thank You! Christopher Brandt 9250 Bendix Road Columbia, MD 21045 cbrandt@ainq.com (301) 560-6999 10

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