The Centers for Medicare and Medicaid (CMS) has announced that starting January 2010, healthcare providers will have the option to use electronic health record systems to report Medicare quality and electronic prescribing measures to CMS in some of its pay-for-performance programs. The revisions are designed “to promote adoption and use of electronic health records and to provide both eligible professionals and CMS with experience on EHR-based reporting,” said CMS.

 The new revisions support the efforts of the Office of the National Coordinator for Health IT to set up additional incentives for providers to measure and submit data measuring the quality of their treatments. Providers could use EHRs to submit information for the CMS’s Physician Quality Reporting Initiative (PQRI) program, which pays an incentive to eligible physicians and other healthcare professionals who report on specific quality measures for care for Medicare patients.

Providers also will be able to report e-prescribing usage through qualified EHR systems or registries. Under the fee schedule rule, providers- for the first time- will be able to count quality data submitted through electronic health record systems toward their eligibility for a PQRI incentive payment. Next year, those payments will be equal to 2 percent of their total estimated allowed charges for the reporting periods. 

The rule also streamlines reporting of e-prescribing and focuses on the actual use of e-prescribing by the provider. In 2010, providers will use one code for e-prescribing, but they “need to report this code at least 25 times during the reporting period to be considered a successful electronic prescriber,” CMS said. 

The Medicare fee schedule puts into practice provisions of the Medicare Improvement for Patients and Providers Act of 2008, which established a program for incentive payments for e-prescribing over five years. In 2012, CMS will impose penalties on providers who are not “successful e-prescribers.”

It is evident that the federal government is pushing hard for the advancement of health IT and EHRs. As in this case, the government conveys the “pay now or pay later” theme: those who are not “successful e-prescribers” by 2012 will be penalized. Adopt an EHR or else…