Stimulus Q & A

Stay "In-The-Know"

What does this American Recovery and Reinvestment Act (IT legislation) mean to me and my business?
There is a great opportunity for your business under this new legislation to take advantage of grants and financial incentives that come with an electronic health records purchase, while simultaneously putting in place the infrastructure that will allow you to enhance your patient care capabilities with all that electronic health automation offers.

What is the total penetration of electronic health record systems among U.S. physicians?
At most, 17%.

What is the extent of financing available through the IT legislation?
The Bill currently provides approximately $30 billion in funds allocated for the building of health IT infrastructure and incentives to adopt. Beyond this $17 billion slated for incentives, there are other sources of money available, which providers may access. Some of these sources lie in state funding or broadband investment.

Please clarify start date for the incentives, and any additional detail, you referenced?

  • Year 1 (2011) - $18,000
  • Year 2 (2013) - $12,000
  • Year 3 (2014) - $8,000
  • Year 4 (2015) - $4,000
  • Year 5 (2016) - $2,000
  • Penalties for non-adoption start in 2015

Are the stimulus incentives per practice or per provider?
The incentives are determined on a per provider basis.

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I keep hearing the term “meaningful user” pertaining to qualifying for incentives. What qualifies as meaningful?
To qualify for incentives practices must demonstrate that they are meaningful users of EHRs and other health IT solutions. To qualify as such, three criteria must be met:

  • You must perform e-prescribing using your HIT solution
  • You must connect to a health information exchange in your region
  • You must use the EHR to report back quality measures (as yet not finalized but expected to be more advanced than PQRI).

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What steps should be taken next?

What should my first step be?
Begin to make plans to implement a certified system or fine tune an existing implementation immediately. If you have yet to install, begin your research immediately. Stay informed about the stimulus bill, sign up for updates, and attend webinars. Learn what you need to do and when, and how specifically your practice or hospital can take advantage of this opportunity.

Should I wait until all the details are worked and announced out before initiating my process?
You are of course the best judge of what the current status of your practice is, but a clear provision of the stimulus package and the HIT funds to be made available, is that you need to be a “meaningful” user on a certified EHR system. This would imply that your system is fully implemented and ready to meet the reporting provisions required to access the incentive funds. As the actual system search, implementation and training and system fine tuning require a time commitment that is best not rushed, most observers feel that a delay in beginning the process increases the risk that your practice may not be eligible to receive incentive funds at their earliest availability.

Do you suggest that practices hold off on purchasing an EHR until early 2010?
For the reasons detailed in the above answer it is suggested that practices be proactive in this process and begin their software search as soon as is reasonable.

How do I pick the right electronic health record system that acts in such a way that meets governmental demands?
You need to be sure that the EHR is “certified” under the provisions of the bill and that the EHR has the discrete data and reporting capabilities to provide the type of patient documentation and reporting you will need to provide to the government to prove “use” of the system. More details about what those reporting demands will be are forthcoming.

Which EHRs are eligible for funding or reimbursement?
Per wording within the IT legislation (HITECH-provisions), a provider must be using “certified EHR technology” that meets specific standards outlined in the bill. Those standards will be available shortly; we anticipate using the Certification Commission on Health Information Technology (CCHIT) standards as a starting point.

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Will doctor's records in paper format from pre-2011 periods need to be converted to electronic records?
At this point, no. The determining factor will be “meaningful use” and while convert prior paper records may help make the data available to support a claim of “meaningful use” it is not a requirement.

What about those of us who already have implemented EMR….is there anything in the stimulus for us?
Yes as the legislation is currently understood. If you have implemented an EHR that meets the certification requirements you will be eligible for incentive reimbursements beginning in 2010/2011. The bill does not distinguish between currently installed and yet-to-be installed systems. Stay tuned to our webinars as more information becomes available. One critical element appears the need to install a “certified” EHR and while the final certification standards are yet to be established and released, it is thought that the current 2008 Certification Commission on Health Information Technology (CCHIT) standards will be adopted in full or will serve as the basis for certification standards. Installing a 2008 CCHIT certified EHR is your current safest course of action.

Am I able to earn incentive payments immediately if I currently qualify as a meaningful user of EHR?
Physicians and hospitals are required to wait until 2011 to submit for bonus payments. However, immediate incentives are available from PQRI bonuses and e-Prescription utilization.

I work within a single practice, yet am affiliated with a health enterprise. As governmental monies will be given to both sectors, could I potentially become eligible to receive incentives through both areas?
While this is a detail of the American Recovery and Reimbursement Act that has not yet been fully defined, it seems unlikely that smaller physician practices with a larger affiliate partner will be able to “double dip” and receive monies from both incentives.

What will happen to physicians if they are not EHR-active and using the technology to report clinical quality measures in time? What will happen to hospitals?
Physician practices will begin to be penalized starting January 2015, by reductions in their Medicare fee schedule if they are not actively utilizing and reporting with a certified EHR solution. Hospitals will also be penalized for not being active users starting October 2014.

Which EHRs are eligible for funding or reimbursement?
Per wording within the IT legislation (HITECH-provisions), a provider must be using “certified EHR technology” that meets specific standards outlined in the bill. Those standards will be available shortly using the Certification Commission on Health Information Technology (CCHIT) standards as a starting point. ITMed, LLC will only suggest CCHIT and enventually ONCHIT certified software vendors!

The last year that incentives will be paid is 2015, correct? So if a practice starts in 2014 they will only be paid for two years which is $24,000?
Correct. This reinforces the statement above that suggests that the course of action that will yield the best possible financial results from the stimulus package is to begin their software selection process as soon as is reasonable.

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