Betting Electronic Medical Records Can Improve Care

Posted by AMS at 18 MAY 6:38 am

Government, With Billions In Loans, Bets Electronic Medical Records Can Improve Care

The New York Times reports that electronic health records hold potential for major improvements in health outcomes for patients as the federal government puts a renewed emphasis on implementing and digitizing patients’ information. “President Obama’s economic stimulus included $19.2 billion for health information technology, and a number of hospital systems around the country are taking advantage of this financial incentive and investing their own money to foster the creation and use of electronic records that are expected to improve the quality, efficiency and safety of medical care.” Digital records avoid duplication of tests, reduce errors, make surgery safer and encourage better self-care but privacy concerns remain (Brody, 2/22).

The Washington Post reports that two District of Columbia health care organizations and the District’s government will receive $15.4 million in stimulus funds as part of the effort to improve patient records through digitization. “The grants, announced by federal officials last week, are part of a $750 million effort by the Obama administration to improve the nation’s medical records database and enable ‘widespread meaningful use’ of health information technology. … Starting in 2015, health-care providers are expected to be actively using electronic records under the ‘meaningful use’ definition or be subject to financial penalties under Medicare.” The term, “meaningful use,” means using electronic health records to increase “efficiency, coordinate patient care, improve patient safety, reduce racial disparities in treatment and improve the overall health of Americans,” The Post reports. The D.C. Department of Health Care will get $5.1 million while the D.C. Primary Care Association will receive $5.4 million for digitization and the Providence Health Foundation of Providence Hospital will get $4.9 million for job training (Fears, 2/23).

Las Vegas Business Press: The adoption of electronic records has lenders in Nevada courting doctors who “have been slow to move” on electronic records. “The Bank of Nevada placed a focus on electronic medical records in just the last couple of months. … The bank has been prequalifying doctors for electronic medical record systems purchases, much like homebuyers line up mortgage financing ahead of a purchase, on the expectation that deals will increase in the second quarter.” Cost remains prohibitive for some doctors, however, and personal loan “guarantees (from doctors themselves) have become more difficult because of falling home values in Las Vegas. Homes often form a large part of the collateral base for a personal guarantee. Further, many doctors have seen their incomes drop in the wake of rising unemployment and the concurrent loss of medical insurance for tens of thousands of people, she said” (O’Reiley, 2/22).

San Diego Business Journal: Doctors in San Diego are saying they also are likely to begin digitizing records because it provides better care. “Several local physicians, who already use electronic medical records systems, find electronic record-keeping offers major advantages. Among them, convenience, efficiency, elimination of duplicate procedures and reduction of medical and billing errors” (Webb, 2/22).

San Diego Business Journal, in a separate story: The financial incentives from the federal government are encouraging more doctors and hospitals than ever to update their records electronically, though the incentives won’t cover the cost of the changes completely. “In the United States, about 38 percent of office-based physicians reported using fully or partially electronic medical records systems in 2008, according to the National Center for Health Statistics. Electronic medical records, or EMRs, have been around for decades, said Ed Daniels, a health care technology consultant based in Denver. Recently, the Obama administration supported financial incentives, motivating hospitals to increase EMR sophistication. In the end, everyone will win, Daniels stressed” (Pierce, 2/22).

This information was reprinted from kaiserhealthnews.org

Article Date: 24 Feb 2010 – 5:00 PDT

Biden Announces $220 Million in Health-Technology Grants

Posted by AMS at 11 MAY 6:30 am

May 4 (Bloomberg) — The Obama administration plans to announce today the selection of 15 communities that will share in $220 million worth of grants for pilot projects to test health-care information technology.

The money comes from the economic stimulus legislation passed last year and is intended to encourage development and use of systems to connect doctors, hospitals and patients, according to a White House official speaking on the condition of anonymity before the announcement.

Vice President Joe Biden and Health and Human Services Secretary Kathleen Sebelius will announce the locations for the grants at an event scheduled for 1 p.m. Washington time today, the official said.

The grants will create as many as 1,100 jobs, each paying an average of $70,000 per year, the official said.

The $862 billion economic stimulus measure included as much as $27 billion for doctors and hospitals to adopt electronic medical records and committed $2 billion to develop technology so every American can have electronic records by 2014.

The Obama administration announced $975 million in government grants on Feb. 12 to encourage the use of health-care technology at hospitals to help share medical information and train medical professionals to use the new systems.

By Nicholas Johnston

–Editors: Joe Sobczyk, Robin Meszoly

To contact the reporter on this story: Nicholas Johnston in Washington at njohnston3@bloomberg.net

To contact the editor responsible for this story: Jim Kirk at jkirk12@bloomberg.net

EHR Stimulus and Incentives

Posted by AMS at 23 MAR 4:06 pm

On Feb. 17, 2009, President Obama signed the American Recovery and Reinvestment Act of 2009 (Recovery Act), a critical measure to stimulate the economy.  Among other provisions, the new law provides major opportunities for the Department of Health and Human Services (DHHS), its partner agencies, and the States to improve the nation’s health care through health information technology (HIT) by promoting the meaningful use of electronic health records (EHR) via incentives.

Funding

Funding is available to certain eligible professionals (EPs) and hospitals, as described below.  Funds will be distributed through Medicare and Medicaid incentive payments to EPs, physicians, and hospitals who are “meaningful EHR users.” In addition, with regard to the Medicaid program, federal matching funds are also available to States to support their administrative costs associated with these provisions.

Criteria for Qualifying for an Incentive

The qualification criteria for incentives (i.e., meeting specified HIT standards, policies, implementation specifications, timeframes, and certification requirements) are still in development, and will be defined through regulation and additional guidance materials.  However, CMS generally expects that under Medicare, “meaningful EHR users” would demonstrate each of the following: meaningful use of a certified EHR, the electronic exchange of health information to improve the quality of health care, and reporting on clinical quality and other measures using certified EHR technology.  Medicaid programs will determine their own requirements in line with the Medicaid-related provisions of the Recovery Act. Funds will be distributed through Medicare and Medicaid incentive payments to EPs and hospitals who are “meaningful EHR users.”  CMS intends to publish a proposed rule in late 2009 to propose a definition of meaningful use of certified Electronic Health Records (EHR) technology and establish criteria for the incentives programs.  CMS is working extensively with the Office of the National Coordinator for Health Information Technology (ONC) to identify the proposed criteria.

Medicare Payment Incentives for Eligible Professionals

The Recovery Act establishes financial incentives beginning in January 2011 for eligible professionals (EPs) who are meaningful EHR users.  Beginning in 2015, payment adjustments will be imposed on EPs who are not meaningful EHR users. Hospital-based physicians who substantially furnish their services in a hospital setting are not eligible.

Incentive Payments

The incentive payment is equal to 75 percent of Medicare allowable charges for covered services furnished by the EP in a year, subject to a maximum payment in the first, second, third, fourth, and fifth years of $15,000; $12,000; $8,000; $4000; and $2,000, respectively.  For early adopters whose first payment year is 2011, the maximum payment is $18,000 in the first year. There will be no payments for meaningful EHR use after 2016. There would be no payments to EPs who first become meaningful EHR users in 2015 or thereafter.  For EPs who predominantly furnish services in a health professional shortage area (HPSA), incentive payments would be increased by 10 percent.

Payment Adjustments

The Medicare fee schedule amount for professional services provided by an EP who was not a meaningful EHR user for the year would be reduced by 1 percent in 2015, by 2 percent in 2016, by 3 percent for 2017 and by between 3 to 5 percent in subsequent years. For 2018 and thereafter, if the Secretary finds that the proportion of EPs who are meaningful EHR users is less than 75 percent, then the reductions will be increased by 1 percentage point each year, but by not more than 5 percent overall.

Medicaid Payment Incentives

The Recovery Act establishes 100 percent Federal Financial Participation (FFP) for States to provide incentive payments to eligible Medicaid providers to purchase, implement, and operate (including support services and training for staff) certified EHR technology.  It also establishes 90 percent FFP for State administrative expenses related to carrying out this provision.

Incentive Payments to Providers

Certain classes of Medicaid professionals and hospitals are eligible for incentive payments to encourage the adoption and use of certified EHR technology.  Eligible professionals include physicians, dentists, certified nurse-midwives, nurse practitioners, and physician assistants who are practicing in Federally Qualified Health Centers (FQHCs) or Rural Health Clinics (RHCs) led by a physician assistant.
Eligible professionals must meet minimum Medicaid patient volume percentages, and must waive rights to duplicative Medicare EHR incentive payments.  Eligible professionals may receive up to 85 percent of the net average allowable costs for certified EHR technology, including support and training (determined on the basis of studies that the Secretary will undertake), up to a maximum level, and incentive payments are available for no more than a 6-year period.
Acute care hospitals with at least 10 percent Medicaid patient volume would also be eligible for payments, as would children’s hospitals of any patient volume. Entities that promote the adoption of certified EHR technology, as designated by the State, are also eligible to receive incentive payments through arrangements with eligible professionals under certain conditions.

Medicaid Incentive Program Qualifications

To be eligible for incentive payments not associated with the initial adoption/implementation/upgrade of EHR technology, the provider must demonstrate meaningful use of the EHR technology through a means approved by the State and acceptable to the Secretary.  In determining what is “meaningful use,” a State must ensure that populations with unique needs, such as children, are addressed.  A State may also require providers to report clinical quality measures as part of the meaningful use demonstration.  In addition, to the extent specified by the Secretary, the EHR technology must be compatible with State or Federal administrative management systems.

EPs may not receive an incentive under both Medicare and Medicaid in a given year.  CMS and the States will develop means to prevent such duplicate payments.  CMS expects that the prevention of duplicative payments will be addressed more fully through notice and comment rulemaking.

Health Care Changes By The Calendar

Posted by AMS at 11 FEB 9:57 pm

Infographic by HealthInsuranceProviders.com