CMS Attestation Calls in May

Posted by AMS at 28 APR 4:32 pm

A message from our HHS partner

Sign Up for CMS’ National Provider Calls about Attestation

CMS is holding conference calls for eligible professionals (EPs), eligible hospitals, and critical access hospitals (CAHs) participating in the Medicare Electronic Health Record (EHR) Incentive Program to provide information on the attestation process. These calls will take place next week. Mark your calendars for one of the calls below.

* Tuesday, May 3, 2:00 – 3:30 p.m. ET – Register to join this call if you are an eligible hospital or CAH who wants to learn more about the attestation process for the Medicare EHR Incentive Program.
* Thursday, May 5, 1:30 – 3:00 p.m. ET- Register to join this call if you are an EP who wants to learn more about the attestation process for the Medicare EHR Incentive Program.

What the Calls Will Cover

* Path to Payment – Highlighting the steps you need to take to receive your incentive payment
* Walkthrough of the Attestation Process – Guiding you through CMS’ web-based attestation system
* Troubleshooting – Helping you successfully attest through CMS’ system
* Helpful Resources – Reviewing CMS’ resources available on the EHR website
* Q&A – Answering your questions about the attestation process

Instructions on How to Register for a Call

To register for these calls, take the following steps:

1. Visit either:

o The registration site for the Tuesday, May 3 eligible hospital and CAH call.

(Registration closes Monday, May 2, 2:00 p.m. ET)

o The registration site for the Thursday, May 5 EP call.

(Registration closes Wednesday, May 4, 1:30 p.m. ET)

2. Fill in all required information and click “Register.”

3. You will be taken to the “Thank you for registering” page and will receive a confirmation email shortly thereafter. Please save this page in case your server blocks the confirmation email. (If you do not receive the confirmation email, check your spam/junk mail filter as it may have been directed there.)

4. If assistance for hearing impaired services is needed, please email medicare.ttt@palmettogba.com no later than three business days before the call.

Prior to each call, presentation materials will be available in the Upcoming Events section of the Spotlight Page on the CMS EHR website.

Registration closes when all available space has been filled, or 24 hours before each call; no exceptions will be made, so please register early.

Want more information about the EHR Incentive Programs?
Make sure to visit the CMS EHR Incentive Programs website for the latest news and updates on the EHR Incentive Programs.

Sixty-two Regional Extension Centers (RECs) across the nation are prepared to offer customized, on-the-ground assistance for eligible professionals and hospitals registering for the CMS EHR Incentive Programs. To locate an REC near you, visit http://www.healthit.gov/rec.

Electronic Medical Records Poised To Cut Costs, Improve Patient Care

Posted by AMS at 26 APR 7:58 am

Federal stimulus dollars provide incentive for doctors, hospitals to adopt digital system

Jennifer Gomez sat at her doctor’s office in Evanston after her appointment, waiting for a handwritten prescription. Minutes later, her doctor wondered why Gomez was still in the office.

What the 20-year-old Loyola University Chicago student didn’t know was that not only had the prescription been sent to the pharmacy, it also was ready to be filled.

“The prescription was at my pharmacy before I even walked out of the office, because everything is computerized,” Gomez said of her experience at a clinic run by NorthShore University HealthSystem. “I was surprised, expecting to wait.”

Gomez is among the first patients to experience the benefits of electronic medical records, as the nation’s health care industry moves from paper files to computerized records. The momentum is expected to pick up this year as federal stimulus money to help with the transition is starting to arrive at doctor offices and hospitals across the U.S.

Already, hundreds of hospital operators nationwide, including the largest ones in the Chicago area such as NorthShore, have entered the digital age, allowing patients to access email alerts to remind them of appointments, request medical test results or easily connect with insurance companies, pharmacies and other key players of the health care system.

Industry observers project the digitizing of medical records could save the nation’s health care system hundreds of millions of dollars because it would reduce or eliminate redundant testing and the occurrence of errors in patients’ files, among other benefits.

“If you are an emergency room doctor and you are trying to figure out what to do next, an electronic medical record may prevent you from having to do another” test, Dave Seaman, chief executive of Pronger Smith Medical Care, said of expensive procedures such as MRIs and other diagnostic imaging that can cost hundreds or thousands of dollars.

About 90 percent of the medical care providers at Pronger Smith, which has more than 60 doctors, physician’s assistants and nurse practitioners in Tinley Park and Blue Island and handles about 50,000 patients each year, have implemented electronic medical records, Seaman said.

As more health care systems adopt electronic records, consumers also should benefit from the efficient sharing of medical information.

“Most physicians will tell you that if you give me your prescriptions that you are on and show me your lab tests, that tells a pretty good snapshot of a patient,” Seaman said. “(Without electronic records), you’d have all these lab test results, and you would have them in 50 to 100 sheets of paper, if the patient even had them.”

The shift to electronic medical records has been in the works for years, but obstacles such as the cost of digitizing files and concerns about patient privacy have held back many hospitals and physician practices.

A key hurdle has been the doctors themselves. The physician community is highly fragmented, numbering in the hundreds of thousands, with more than 60 percent of office-based physicians in single or a small practice of four doctors or fewer, according to the American Medical Association. So coordinating implementation has been a battle.

These doctors also have been concerned about the affordability of information systems, which can cost tens of thousands of dollars for a small practice. The doctors also worry whether the systems will work and whether they can communicate with other computerized medical systems.

NorthShore digitally connected health records to its three hospitals in Evanston, Glenview and Highland Park, along with its medical group offices, in 2003 at a cost of $35 million. In 2009, its hospital in Skokie, which it purchased in 1999, “went live for an additional cost of approximately $5 million,” NorthShore said.

In 2009, Congress passed and President Barack Obama signed into law the Health Information Technology for Economic and Clinical Health Act, which was part of the federal stimulus legislation known as the American Reinvestment and Recovery Act. The legislation aims to provide more than $20 billion to get doctors and hospitals to use electronic medical records, computerized prescription systems and other health information technology.

And doctors for the first time are eligible to begin getting more than $40,000 in extra Medicare payments this year if they upgrade their health information technology. If doctors can’t demonstrate the “meaningful use” of certified electronic health record system by 2015, they face reduced Medicare payments, federal health officials say.

In Illinois, the state received more than $18 million in federal stimulus dollars to support a statewide health information exchange that will allow medical care providers to share data electronically in a collaborative, secure system, Gov. Pat Quinn’s office said. That, analysts say, should eliminate another hurdle that doctors have said prevented their practices from buying a system: the fear it might not work with a system made by another company.

The financial support is paying off, the nation’s top health official said.

“In the last two years, the share of primary care providers using a basic electronic health record has gone from under 20 percent to nearly 30 percent,” Kathleen Sebelius, secretary of Health and Human Services, told hospitals and health systems in February at the Health Information and Management Systems Society annual meeting in Orlando, Fla.

“When President Obama came into office, only two in 10 doctors … used even a basic electronic health record system. Over the last two years, we’ve created unprecedented momentum behind health information technology.”

But challenges are expected to remain for smaller and solo doctor offices, analysts say.

“The initial startup and transition is difficult,” said Dr. Stephen Sproul, a family physician at Advocate Lutheran General Hospital in Park Ridge.

“You have to learn a whole new way of documenting your patient care and managing your patient interactions, and that change is difficult,” Sproul said. “You start to see a light at the end of the tunnel after about a year. Physicians have to be patient, but they will see results.”

Source: www.latimes.com

E-Prescribing Penalties Affect Payments

Posted by AMS at 19 APR 7:39 am

In November, the Centers for Medicare & Medicaid Services announced that beginning in 2012, eligible professionals who are not successful electronic prescribers may be subject to a payment adjustment. Section 132 of the Medicare Improvements for Patients and Providers Act of 2008 (MIPPA) authorizes CMS to apply this payment adjustment whether or not the eligible professional is planning to participate in the eRx Incentive Program.

The payment adjustment in 2012, with regard to all of the eligible professionals’ Part B- covered professional services, will result in the eligible professional or group practice receiving 99% of the Physician Fee Schedule (PFS) amount that would otherwise apply to such services. In 2013, the eligible professional will receive 98.5% of their covered Part B- eligible charges if they aren’t a successful electronic prescriber. In 2014, the penalty for not being a successful electronic prescriber is 2% resulting in eligible professionals receiving 98% of their covered Part B charges.

For purposes of determining which eligible professionals or group practices are subject to the payment adjustment in 2012, CMS will analyze claims data from January 1, 2011- June 30, 2011 to determine if the eligible professional has submitted at least 10 electronic prescriptions during the first six months of calendar year 2011. Group practices reporting as a GPRO I or GPRO II in 2011must report all of their required electronic prescribing events in the first six months of 2011 to avoid the payment adjustment in 2012.

Please see the “Getting Started” webpage at http://www.cms.gov/erxincentive on the CMS website for more information; or download the Medicare’s Practical Guide to the Electronic Prescribing (eRx) Incentive Program under Educational Resources.

If an eligible professional or selected group practice wishes to request an exemption to the eRx Incentive Program and the payment adjustment, there are two “hardship codes” that can be reported via claims should one of the following situations apply:

• G8642 – The eligible professional practices in a rural area without sufficient high speed internet access and requests a hardship exemption from the application of the payment adjustment under section 1848(a)(5)(A) of the Social Security Act.

• G8643 – The eligible professional practices in an area without sufficient available pharmacies for electronic prescribing and requests a hardship exemption from the application of the payment adjustment under section 1848(a)(5)(A) of the Social Security Act.

Additionally, there will be a G code which can be used by eligible professionals to indicate that they do not have prescribing privileges. Reporting this G code will prevent the eligible professional from being subjected to a payment adjustment in 2012.

Source: www.cms.gov

EHR: What Does it Mean and Do We Have to Go There?

Posted by AMS at 12 APR 7:29 am

Ambulatory Surgery Centers will be required to implement Electronic Health Record systems (EHR) within the next few years. Participation in Medicare/Medicaid will depend on it. This article will explore the definition of EHR, what the prime driving forces are behind mandated EHR systems, and how we can heed the warning and plan ahead for successful implementation of EHR systems in our centers.

Definition

EHR = EMR + HIS + CIS + CPR (Electronic Health Record = Electronic Medical Record + Health Information System+ Clinical Information System+ Computerized Patient Record). All the acronyms that have been used in the last four decades to define the electronic storage of patient information have now been rolled into one. The term EHR used to mean an office-based patient documentation system. The Federal government has usurped the EHR label and has given it back to the healthcare industry as the final acronym for describing any of these electronic patient data systems.

Quoting the Centers for Medicare and Medicaid Services: An Electronic Health Record (EHR) is an electronic version of a patient(‘)s medical history, that is maintained by the provider over time, and may include all of the key administrative clinical data relevant to that person’s care under a particular provider, including demographics, progress notes, problems, medications, vital signs, past medical history, immunizations, laboratory data and radiology reports The EHR automates access to information and has the potential to streamline the clinician’s workflow. The EHR also has the ability to support other care-related activities directly or indirectly through various interfaces, including evidence-based decision support, quality management, and outcomes reporting.

Simplified definition: Capture and/or storage of patient specific medical information in a digital format, which is queriable and transferable to and from other computer systems.

Driving forces

On Feb. 17, 2009, President Obama signed into legislation the American Recovery and Reinvestment Act of 2009 (ARRA), aka the “Stimulus Bill”. Lesser known is that, embedded in ARRA, the Health Information Technology for Economic and Clinical Health Act (HITECH) was created. ARRA also made permanent the Office of the National Coordinator for Healthcare Information Technology (ONC) to set policy and standards, as well as direct, oversee, and measure success of the implementation of EHRs.

ONC established the first set of policies and standards for these systems later in 2009, defining mandated Meaningful Use criteria and Certified EHR requirements (HITECH phrases). EHRs must meet strict conditions for data documentation, clinical decision support, data management, and sharing of data. The legislation allows for Meaningful Use criteria to be expanded by ONC every two years during the initial six year roll-out, making it increasingly challenging for EHR systems to be compliant. The second set of requirements is currently in the final stages of development.

The HITECH Act was pushed into place by CMS without forewarning. CMS maintains a vision for a national health record for patients. The goal is to be able to create lifetime individual medical records that are accessible by any provider, anywhere. Our military health system has a similar goal and is on the way to achieving it. CMS expects utilization and quality reports to eventually be submitted from provider EHR systems directly to CMS. CMS is also expecting EHRs to help decrease healthcare costs. Because CMS reimburses big dollars to these entities, acute care hospitals and physicians’ offices are the targets in the first round of mandates for nationwide providers to implement fully integrated EHR systems. The second round will no doubt target ambulatory surgery centers.

EHRs are not an unfunded mandate. There is some ARRA money available to a facility once a properly implemented system is in use. The HITECH act provides for different levels of compensation based on the percentage of Medicare patients served, the facility designation, and the timeliness of implementation. Providers can instead opt to be compensated based on their Medicaid population through funds given to each state. Meeting Certified EHR and Meaningful Use requirements are a prerequisite to any funding. Those affected by the current mandate are required to implement EHR systems by this year (2011) in order to receive full credit. Compensation decreases with delays in EHR installation. If these facilities do not implement EHRs they not only lose out on payment for installation of EHRs, they will also be penalized through decreased Medicare reimbursement for patient care. These penalties are scheduled to increase each year until CMS certification is jeopardized. Acute care hospitals and physician offices must have EHR systems in place, meeting Meaningful Use criteria, by the end of 2014 and 2015 respectively to avoid CMS penalties.

Planning ahead

The bad news is ASCs will be federally mandated to implement EHRs. The good news is EHRs can bring benefits to our business processes, our patients, and our owners. EHRs, when properly implemented, are actually strategic investments, helping facilities gain efficiencies and improve the quality of services provided. It is important to realize that even a small EHR project takes 1-2 years to implement successfully. Implementing an effective EHR system before the mandate arrives will bring maximum benefit to a center. Leadership needs to start that process now. EHR projects are costly in money and other resources. Due diligence in planning is key to effective stewardship during project execution.

Below is a brief description of a recipe for success with an EHR project:
•    Define the project goals
•    Calculate the budget and return on investment based on those goals
•    Identify the stakeholders and project champions.
•    Create a selection committee with pre-determined structure and purpose
•    Select the EHR system

Once the EHR system is selected, disband the selection committee and form an implementation team, again with a pre-defined structure and purpose. This group will take the project through EHR go-live, and some team members will continue in EHR supporting roles after the system is in use. Thoughtfully detailed project organization will smooth the transition from conception through go-live.

Future articles will discuss in more depth the ROI and the steps required for successful EHR projects. For now, remember ASCs are better positioned to address implementation of EHR systems than most acute care hospitals and physician practices were when the HITECH act became law. Let’s take advantage of this opportunity to learn from others’ experience by planning ahead and acting sooner. (A helpful page with many links to resources regarding EHRs is on the Health Information Systems Society’s website at www.himss.org/EconomicStimulus.)

Source: www.beckersasc.com

Health Providers Sign eRecords Pact

Posted by AMS at 5 APR 7:53 am

Five Boulder County health-care providers have signed agreements to share electronic medical records through a Colorado Regional Health Information Organization program.

Alpine Urology, Boulder Community Hospital, Gastroenterology of the Rockies, Longmont United Hospital and Spruce Street Internal Medicine have signed agreements, CORHIO said in a press statement. The nonprofit group is supported by state and federal grants.

Boulder Community Hospital is the first health-care provider affiliated with a state nonprofit group to go “live” in the program, CORHIO said. The other four Boulder County health providers are expected to start sharing medical data electronically early this summer.

“Boulder Community Hospital is very excited to be the first hospital in Colorado to begin sending patient data to CORHIO,” Valerie Lipetz, chief medical officer for the hospital’s affiliated physician clinics, said in the statement. “We will soon be joined by hospitals and physicians around the state who are working cooperatively to provide Colorado citizens with safer and more cost-effective patient care through our statewide Health Information Exchange.”

Patients’ lab tests, pathology results, X-rays, MRIs and other imaging reports and physician transcription reports will be made available on the CORHIO network as a result of the agreement. Later this year, the network will be upgraded to include patient medication lists, allergies and immunizations and lab and imaging orders, the group said in the statement.

Across the state, a total of seven hospitals, eight medical practices and four community mental-health centers have signed agreements to electronically exchange health information, the group said.

While no specific costs are available, general costs for each health-care provider are expected to be in the millions of dollars. The health-care industry’s move to electronic medical records systems is part of a federal push to ultimately reduce medical costs and improve health care.

Source: www.bcbr.com