Archive for March, 2009
-
0 Health Care Stimulus – Who is eligible?
Mar 31, 2009. Today.One major goal of The American Recovery and Reinvestment Act of 2009 is to encourage physicians to adopt Electronic Medical Records (EMRs). The act does that by paying incentives up to $44,000 to physicians that adopt EMRs. In addition, the act penalizes physicians without an EMR by decreasing their Medicare reimbursements.
How can physicians qualify for the incentives and avoid the penalties? According to the legislation, they must be an “eligible professional” who uses a “certified EMR” in a “meaningful way.” In my last article we talked about certified EMR systems. This time we will examine the “eligible professional” requirement.
The “eligible professional” requirement has four main components. First, the “professional” must be a healthcare provider such as a physician, physician’s assistant, or nurse practitioner. Second, the provider must receive Medicare reimbursement payments.
Third, the provider must not work in a hospital-based environment. For example, anesthesiologists, pathologists, and emergency room physicians would not qualify. Hospitals are reimbursed as a corporate entity according to a separate schedule, and not on a per-provider basis. Fourth, labs and skilled nursing facilities are not required to adopt an EMR, so it is possible that providers working at these facilities may not qualify.One drawback of the stimulus program is that unqualified providers may feel that they do not need an EMR. Good EMR systems offer many benefits – not just money from the government. EMR systems can help a practice cut costs – especially those associated with managing paper charts and outsourced dictation. EMR systems can improve patient care by requiring providers to complete more comprehensive exams and reviews. EMR systems can help increase revenue since providers will no longer have to under-code because their current paper charts do not meet CMS requirements.
Although many things are uncertain at this point, geriatric and long-term care providers that work primarily in nursing homes may not qualify for the program. This does not mean that geriatric or any other physicians should not adopt an EMR. On the contrary, a lean, mobile EMR can greatly benefit any practice, especially geriatric/long term care practices.
Currently unqualified providers should also keep in mind that the stimulus act is still in its infancy and will probably undergo several revisions. Congress may decide that labs, skilled nursing facilities, and similar practices need to adopt an EMR so they can benefit from information sharing and contribute to the goal of universal electronic medical records. Therefore, providers should not delay or cancel their plans to adopt an EMR, rather they should move forward so they have plenty of time to implement their systems and learn to use it in a meaningful way.
Continue Reading...
Ryan Ricks Security Officer
-
1 To PHR or Not to PHR. That is Today’s Question
Mar 24, 2009. PHR.During your lifetime you will see dozens of physicians each of whom specializes in a different field, and each of whom compiles a separate file of information about your health and medical conditions, including thoughts about their decision making processes. The electronic version of these files, called an EHR, or Electronic Health Record, can help physicians keep track of the examinations they perform, the prescriptions they provide, and the course of recommended treatment for an ailment.
Just like an EHR, Personal Health Records, also known as PHRs, can be extremely beneficial to your health and to the health of those around you. Every time you or a family member sees a doctor, has a new medication prescribed, or develops a known allergy, you can enter this information into one of the online databases that PHR companies provide. Keeping an updated, complete PHR helps you play an active role in your healthcare, and gives physicians and other healthcare professionals a more accurate presentation of your health history.
Continue Reading... -
4 Health Care Stimulus – What is a Certified EMR?
Mar 23, 2009. Today.The American Recovery and Reinvestment Act of 2009, otherwise known as the Stimulus Act, authorizes the government to pay incentives totaling $44,000 per physician to encourage the adoption of Electronic Medical Records (EMRs). The incentives are coupled with penalties; physicians that don’t adopt an EMR will be penalized by a reduction in Medicare reimbursements. In order to qualify for the incentives and avoid the penalties, an “eligible professional” must use a “certified EMR” in a “meaningful way.”
The big question on everyone’s mind is “What is a certified EMR?” Physicians currently using EMRs want to be sure their systems are certified. Likewise, physicians shopping for an EMR don’t want to risk purchasing something that won’t meet the stimulus criteria. Unfortunately, the legislation did not specify certification criteria. We will have to wait for congress, various offices, and committees created by the legislation to agree on the requirements.
Right now, many people point to CCHIT as the certification criteria. However, only 8% of EMR vendors were CCHIT-certified in 2008. Does this mean that 92% of all the EMR systems on the market are garbage? Hardly. CCHIT is a hugely expensive endeavor that costs about $40,000 to complete, including registration and maintenance fees. This effectively locks out many smaller vendors that can’t afford to apply. In addition, many of the CCHIT requirements pertain to software with relational databases, or are otherwise unnecessary for a functional EMR system. Finally, CCHIT does not consider things like usability or ability to generate return on investment.
The government has a history of creating EMR standards that have suffered from poor participation. The now-defunct Doctor’s Office Quality – Information Technology (DOQ-IT) program was intended to promote EMR adoption and implement a pay-for-performance program. Since only a few EMR vendors were DOQ-IT certified, and only one vendor was able to submit regular production data, the government scrapped it in favor of PQRI. The Physicians Quality Reporting Initiative (PQRI) program was similar, but with less-stringent requirements. In 2007, only about 10% of physicians successfully received their 1.5% bonus.
Whatever the government decides will constitute a “certified,” EMR system, we can be sure that decision will go through a few revisions. It would not make sense for the government to adopt standards that rule out 92% of the EMR industry. Physicians contemplating an EMR purchase should not wait until the lengthy decision process is over. Purchase and install an EMR system now, that way your practice will have plenty of time to learn your system and use it in a “meaningful way.”
Continue Reading...
Ryan Ricks Security Officer
-
2 Stimulus Payments – Are they Worth it?
Mar 3, 2009. Today.The American Recovery and Reinvestment Act of 2009, signed into law on February 17th, allocates $44,000 in payments to medical practices that adopt a certified Electronic Medical Record (EMR) system. This legislation is supposed to provide an incentive for physicians to switch from paper records. Although the promise of free money is alluring, is the $44,000 actually an efficient way to promote EMR adoption?
First, let’s take a closer look at the expected revenues. Physicians will need to implement and use a certified EMR in a meaningful way before January 1, 2011. Assuming they qualify, payments will arrive over five years. The first-year payment is $18,000, followed by $12,000, $8,000, $4,000, and finally $2000.
On the other hand, physicians that do not adopt certified EMR systems will be penalized. CMS will reduce Medicare payments by a one-percent for the first year, followed by two and three percent reductions in subsequent years. Since penalties are based on a percentage, it’s hard to say how much this would affect any given practice.
Is the $44,000 incentive payment worthwhile? The answer depends largely on the total cost of “certified” systems. While not explicitly stated in the act, “certified” is understood to mean CCHIT certified. The problem with CCHIT systems is that they are often quite expensive. The certification process costs vendors $34,000 just to get started, not to mention maintenance and development costs. These costs are passed onto consumers, resulting in very expensive EMRs, some of which cost as much as $100,000.
In addition to the purchase price, there are other hidden costs, such as maintenance fees from the EMR vendor. These are usually about 20% of the purchase price and are due annually. Training and implementation may also cost money, either through vendor charges or lost revenue because your staff is busy training instead of seeing patients. Certified systems are notorious for being complex and confusing, so training time is usually substantial. If you don’t currently have computers or networking gear at your office, you will have to figure that in as well.
Considering the total cost of owning a CCHIT-certified systems, your practice would probably be better off forgoing the stimulus. $44,000 probably will not cover the costs associated with implementing a CCHIT-certified EMR, especially since the payment is spread out over five years. There are many less-expensive, less-complicated EMR systems that offer the functionality you need without the drawbacks of CCHIT-certified systems.
Read the article.
Continue Reading...
Ryan RicksSecurity Officer
