What is the American Recovery & Reinvestment Act of 2009?
- On February 17, 2009, President Obama signed into law the American Recovery and Reinvestment Act of 2009, otherwise known as H.R. 1 or the ARRA.
- $787 billion spending bill aimed at stimulating the economy via tax cuts, expansion of unemployment benefits, social welfare programs and domestic spending on education, energy and healthcare
- Title IV – Medicare & Medicaid Incentives
- $30 billion in incentives for meaningful use of certified EHR technology
- Medicare - $44k per doctor; Medicaid - $64k 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, physicians not demonstrating meaningful use of EHR technology will have their Medicare fee schedule reduced:
- 2015: -1%
- 2016: -2%
- 2017 and beyond: -3%
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What governmental departments/positions were established to oversee HIT standards development and rollout of the incentives?
There are three bodies established in the new law and all fall under the direction of the Secretary of Health and Human Services (HHS):
- Office of the National Coordinator (ONC). The ONC is headed by a National Coordinator appointed by the Secretary of HHS, serves as a leading member of the HIT policy and HIT standards committees and is responsible for:
- Endorsing standards and certification criteria;
- Coordinating health IT policy and programs; and
- Updating the federal health IT strategic plan.
- HIT Policy Committee. This committee is a federal advisory committee established to make recommendations to the National Coordinator about the implementation of a nationwide health IT infrastructure, including implementation of the strategic plan. The committee also is responsible for recommending areas in which standards, implementation specifications and certification criteria are needed for the electronic exchange and use of health information.
- HIT Standards Committee. The HIT Standards Committee was established to recommend to the National Coordinator standards, implementation specifications and certification criteria for the electronic exchange and use of health information, which have been developed, harmonized or recognized by the HIT standards Committee.
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How are the Medicare Incentives paid out?
Eligible professionals who are meaningful users of certified EHR technology will receive incentive payments according to the following schedule:
| YFF |
Incent.
2011 |
Incent.
2012 |
Incent.
2013 |
Incent.
2014 |
Incent.
2015 |
Incent.
2016 |
Incent.
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 |
*YFF – Year First File
*For eligible professionals in a health professional shortage area (HPSA) the incentive payment amounts will be increased by 10%.
*Payments are not available to hospital-based professionals such as a pathologist, emergency room physician or anesthesiologist.
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Who is eligible to receive the Stimulus money?
- Doctors of medicine
- Doctors of osteopathy
- Doctors of dental surgery
- Doctors of dental medicine
- Doctors of podiatric medicine
- Doctors of optometry
- Chiropractors
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Who qualifies as a “meaningful user?”
A meaningful user is an eligible professional who demonstrates:
- Use of electronic prescribing functionality,
- Their EHR is connected in a manner that provides for the electronic exchange of health information to improve the quality of healthcare, and
- Submits information on clinical quality measures.
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How do doctors demonstrate “meaningful use?”
- An attestation (witness statement)
- Submission of claims with appropriate coding (such as a code indicating that the patient was seen using a certified EHR)
- A survey response
- A report
- Other means specified by the Secretary of HHS
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What is CCHIT?
The Certification Commission for Healthcare Information Technology (CCHIT). The Certification Commission is an officially “recognized certification body” in the United States for EHR products. The Commission is the official agency to apply standards, test products, and award a “seal of compliance: to EHR software.
Click here for more information: http://www.cchit.org/choose/ambulatory/2007/gloEMR.asp
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What does a CCHIT Certified EHR product mean?
It means that the product has met basic requirements for –
- Functionality - Ability to create and manage electronic records for all your patients and to automate the office workflow
- Interoperability - Ability to send and receive electronic health data to and from other entities such as pharmacies and laboratories
- Security and Privacy - Ability to safeguard patients’ personal health information
Beware of products that are “CCHIT compliant.” Only the CCHIT Certified seal guarantees that products have undergone the rigorous testing required for certification by the Commission.
CCHIT.org click here for more
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Why should I purchase a product that is CCHIT certified?
- CCHIT certified product helps you narrow the initial field of vendors. It’s a great start!
- Helps you reduce your risk
- So you can receive stimulus money
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How much money in incentives is being offered through Medicaid?
Medicaid payments are meant to cover costs for the purchase and initial implementation or upgrade of EHR technology and support services including training that is for, or is necessary for, the adoption and initial operation of such technology. First year payment (not to be made later than 2016) goes up to $25,000 and then five additional years of payments equal to $10,000 are included, but cannot exceed $64,000. Payments will stop after 2021.
Payment structure:
| Year |
Incentive
|
| Year 1 |
No more than $25k |
| Year 2 |
No more than $10k |
| Year 3 |
No more than $10k |
| Year 4 |
No more than $10k |
| Year 5 |
No more than $10k |
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Are any incentives provided through Medicaid and who is eligible?
- 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.
- An eligible 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.
- A children’s hospital, or an acute-care hospital, that has at least 10% of the hospital’s patient volume coming from Medicaid patients.
*Professionals in the first three bullets include: physicians, dentists, certified nurse midwives, and physicians assistants practicing in rural health clinics or federally-qualified health centers led by a physician assistant.
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Are doctors eligible for both Medicare and Medicaid incentives?
No, they can only submit for one or the other – not both.
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Why should I purchase an EHR product today?
- If you delay your decision, you are also delaying your eligibility for pay-for-performance and other programs. Waiting could cause you to miss several years to potential incentive payments, liability insurance discounts and other benefits.
- A good EHR product will help your practice improve quality, increase efficiency and provide higher level of service to your patients.
- It is becoming a more notable benefit in attempting to recruit new physicians
- Avoid making a rushed decision when you will be under a time crunch
- Beat the rush!
- Get a good deal now. Prices will go up when the rush hits next year.
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Do I Need Local Support?
Your EMR is a mission critical application. So be sure that your investment is protected with local, round the clock support from a company who understands your network, your unique needs and customer service. Don’t settle for an 800 number that takes you takes you to a customer service agent who is not familiar with your EMR. Most importantly, you need superior support past the moment of live implementation.
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What should I do today?
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How do I get started?
- Look for an EHR product that is CCHIT certified.
- Evaluate and Rate each EHR demo you schedule. Which product meets your needs and has a good local IT support team?
- Call Atmosphere Solutions at (602) 324-34889. Our team is dedicated to your success. Our passion is contagious. We are ready to serve you.
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