Governmental Initiatives

On February 17, 2009 the Economic Stimulus also known as the American Recovery and Reinvestment Act 2009 was finalized and signed by President Obama. A large portion of the stimulus focuses specifically on the improvements of the Healthcare Industry. This section within the stimulus is known as the Health Information Technology for Economic and Clinical Health Act (HITECH Act). It discusses the improvements in Healthcare Quality, Safety, and Efficiency; Testing of Health Information Technology; Grants and Loans Funding; and Privacy.

Say goodbye to paper charts.
Say goodbye to illegible prescription notes.
Say hello to the age where medicine meets technology!

The HITECH Act has now provided the Healthcare Industry with the opportunity to reduce medical errors, reduce patient wait time and increase office efficiency by going paperless. This pivotal time within the industry will enable medical practices and hospitals to use a comprehensive Electronic Health Record (EHR) system.

The government is forecasting 90% of physicians and 70% of hospitals will be using a robust system by 2020. To increase the number of EHR adopters, the government is providing financial incentives for medical practitioners to purchase and implement an EHR by 2014. According to the HITECH Act it is completely voluntary to conform, however, beginning 2015 failure to do will result in penalties.

Details of Financial Reimbursements.It has been explicitly stated that there is $19 billion allotted for the HITECH Act. $2 Billion has been allocated to the Department of Health & Human Services (HHS) and the Office of the National Coordinator for Health IT (ONC) to establish Heath Information Exchange (HIE) initiatives. The other $17.2 billion is for all healthcare providers who demonstrate use of Electronic Health Records.

‘Demonstrate use of Electronic Health records’ means:

1. Use of a certified EHR product with ePrescribing capability that meets current HHS standards.
2. Connectivity to other providers to improve access to the full view of a patient’s health history.
3. Ability to report on their use of the technology to HHS.

There are two different options that providers are able to select from, in order to receive the financial incentives: Medicare or Medicaid.

Medicare Option. This program is designed for providers who accept Medicare. Providers have the ability to receive up to $44,000 over the course of five years. Providers who are located in rural environments or other places where there is a shortage of physicians have the ability to receive additional funding.

Medicaid Option. This program is designed for providers that have a Medicaid volume of 30% or greater. For pediatricians, the Medicaid volume is 20% or greater. These providers are eligible to receive up to $64,000 over the course of five years. This incentive program works differently than the Medicare Program because the formula must factor in the exact percentage of Medicaid volume per provider.

The table below illustrates the incentive payments under the Medicare Program:

HITECH Act Physician Reimbursement Schedule under Medicare
Reimbursement¹ or Penalty² for each provider based on their first qualifying year

Medicare Payment Year	Adopt 2011 or earlier5	Adopt 2012	Adopt 2013	Adopt 2014	Adopt 2015	2016	2017	2018	2019	2020	No EHR Adopted
Copyright© 2009 EHR Scope, LLC
2011	$18,000	-	-	-	-	-	-	-	-	-
2012	$12,000	$18,000	-	-	-	-	-	-	-	-
2013	$8,000	$12,000	$15,000	-	-	-	-	-	-	-
2014	$4,000	$12,000	$15,000	-	-	-	-	-	-	-
2015	$2,000	$4,000	$8,000	$0	-	-	-	-	-	-
2016	$0	$2,000	$4,000	$4,000	$0	$0	1%	1%	1%	1%	1%
2017	$0	$0	$0	$0	$0	$0	$0	2%	2%	2%	2%
2018	$0	$0	$0	$0	$0	$0	$0	$0	3%	3%	3%
2019	$0	$0	$0	$0	$0	$0	$0	$0	3%	3-4%	3-4%
2020+	$0	$0	$0	$0	$0	$0	$0	$0	$0	$0	3-5%
Totals4	$44,000	$44,000	$39,000	$24,000	$0	$0	$0	$0	$0	$0
Maximum reimbursement authorized, the actual amount is 75% of charges for professional services under Medicare. ”Penalty” is a reduction in payments for professional services under Medicare, 2% means you get paid 98% earned payment. The Penalty may increase starting in 2019 if the Secretary finds that the proportion of certified EHR. users is less than 75%, however, it can never be greater than 5%. Physicians operating in a “provider shortage area” will be eligible for an incremental increase of 10% in their bonus payments In order to get reimbursed for your EHR in 2011, you will most assuredly need to select, purchase and implement your EHR prior to 2011.

Penalties. Providers that do NOT adopt by the deadline will see a 1% decrease in their Medicare fee schedule in 2015. An additional percentage will be deducted in 2016 and 2017; therefore, providers will see a 3% reduction in their fee schedule. If adoption is less than 75% in 2018, then the Secretary can reduce the fee schedule by 5%, allowing providers to receive only 95%.

Certification.In order to support a rapid adoption of a certified EHR, the Certified Commission for Healthcare Information Technology (CCHIT), has released three certification approaches to replace the current certification method.

The certification approaches are:

• EHR Comprehensive (EHR-C):Certified EHR-C vendors provide comprehensive EHR products that comply with all applicable Federal standards and enable providers to meet all Meaningful Use Objectives.
• EHR Modules (EHR-M):Certified EHR-M modules are applications that comply with applicable Federal standards and enable providers to meet one or more Meaningful Use Objectives (labeling will specify which Objectives and standard are met).
• EHR Sites (EHR-S):Certified EHR-S sites have developed or assembled EHR technologies that comply with Federal standards and enable them to meet all Meaningful Use Objectives.

All of the certification information has been stated by the CCHIT. To read what has been stated please click here.

Although the guidelines are not set in stone, the committees have been making large strides in the right direction. The guidelines will be clearly defined by the National Coordinator for Health Information Technology, David Blumenthal, by December 31, 2009.

To learn more about the HITECH Act visit:
www.recovery.gov
www.cchit.org
www.allscripts.com/thetimeisNOW
www.nextgen.com/stimulus

For more news about the industry visit:
http://http//www.emrconsultant.com/emrconsultantnews.php