EMR Stimulus Incentive

After the signing of American Recovery and Reinvestment Act (ARRA) by President Barack Obama physician practices have a question in mind, ‘howdoes this affect me?’

The stimulus package announced for the year 2009 promised $19 billion for the medical industry to help implement technology that makes healthcare safer and more connected. One’s who proves to be meaningful users of EMR/EHR can receive an incentive reimbursement of up to $64,000 over a period of 6 years. Hospitals can qualify for $2-8 million in funding. It must be kept in mind that 70% of the incentive is received within the first 2 years. So you need to start early in order to receive the maximum reimbursement.

The US Dept of Health and Human Services (HHS) outlined these criteria for Meaningful Use of EMR:

•  Improve quality, safety, efficiency, and reduce health disparities
  
•  Engage patients and families
  
•  Improve care coordination
  
•  Improve population and public health
  
•  Ensure adequate privacy and security protections for personal
  

2011 qualification criteria include the following:

• 90 day reporting period to prove meaningful use through required measures
  
• At least one clinical decision support rule relevant to a specialty or a high clinical priority
  
• Electronic claim submission to payers
  
• Electronically check insurance eligibility (when possible)
  
• Provide patients with timely electronic access to their health information;
  
• Provide patients, upon request, with an electronic copy of their discharge instructions and procedures at the time of discharge; and
  
• Require the capability to exchange health information where possible in 2011, with participation in a national health information exchange by 2015
  

*By 2013, it is also expected that criteria will extend to include the ability to provide patients with access to their personal health records populated in real time.

Physicians qualifying under the Medicaid provision can receive up to $63,750 over a period of 6 years and they can receive their incentive payments starting from January of 2011. Payment is calculated as 85% of the EHR cost (up to $25,000 for the first year), and 85% of annual cost (up to $10,000) over the following five years. If you are to qualify for the Medicaid provision, at least 30% of your cases must be attributable to Medicaid. The minimum percentage of Medicaid patients is reduced to 20% for pediatricians. However, office-based pediatricians are only eligible to receive up to two thirds of the maximum payment.

Physicians qualifying under the Medicare provision can receive up to $44,000 over a period of 5 years and they can receive their incentive payments starting from January of 2011. The total amount that you receive is based on how early you adopt and your Medicare Part B billings. (You must submit Medicare Part B claims to qualify.) You will receive the lesser amount of either 75% of your Medicare Part B charges or $44,000 over a five year period from 2011 to 2015.

The total amount that you receive is based on how early you adopt and your Medicare Part B billings. (You must submit Medicare Part B claims to qualify.) You will receive the lesser amount of either 75% of your Medicare Part B charges or $44,000 over a five year period from 2011 to 2015. You can also qualify for an early adopter incentive of $3,000 (if you qualify for either 2011 or 2012.) MAXIMUM incentives (including $3,000 bonus) will be paid as follows:

• $18,000 for the 1st year
  
• $12,000 for the 2nd year
  
• $8,000 for the 3rd year
  
• $4,000 for the 4th year
  
• $2,000 for the 5th year
  

Physicians who do not implement EHR technology by 2015 will suffer from a 1% reduction in Medicare Payments (reductions will continue to increase after 2015 up to 5%). if they fail to implement the EMR/EHR technology by 2015.

Remember, to receive your maximum payment, you must start NOW!

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