Know how to get $44,000+ for using an EHR?

The Time is Now. The Stimulus Center will help to prepare you to implement an EHR. Great incentives are coming. Be ready.

On February 17, 2009, President Barack Obama signed into law the American Recovery & Reinvestment Act. The health IT component of the Bill is the HITECH Act, which appropriates a net $19.5 billion dollars to encourage healthcare organizations to adopt and effectively utilize Electronic Health Records (EHR) and establish health information exchange networks at a regional level, all while ensuring that the systems deployed protect and safeguard the critical patient data at the core of the system.

The opportunity presented by the Bill is enormous. After literally decades of slow but steady progress towards converting our paper-based record system into an electronic one, we now stand poised for a monumental leap forward. The Congressional Budget Office predicts 90% of physicians and 70% of hospitals will be using a comprehensive, robust Electronic Health Record over the next few years. As a result, the country will save billions of dollars on the provision of healthcare, and our citizens will receive coordinated, informed care from their entire network of providers.

Navigating the language of the Bill is time consuming and onerous, so following is a plain language summary of the health IT provisions within the Stimulus Bill. More documents can be found under the Stimulus Center tab on the right.

Stimulus Details

There are two portions of the HITECH Act – one providing $2 billion immediately to the Department of Health & Human Services (HHS) and its sub-agency, the Office of the National Coordinator for Health IT (ONC), and directs creation of standards and policy committees; a second that allocates $36 billion that will be paid to healthcare providers who demonstrate use of Electronic Health Records. The net cost to the Federal government is anticipated to be $19.5 billion after savings are achieved through efficiencies, tax revenue and Medicare fee reductions for non-adopters.

$36 Billion in Incentive Payments to Physicians and Hospitals

The government is focused on two primary goals in this legislation: moving physicians who have been slow to adopt Electronic Health Records to a computerized environment, and ensuring that patient data no longer sits in silos within individual provider organizations but instead is actively and securely exchanged between healthcare professionals. Therefore, the vast majority of the funds within the HITECH Act are assigned to payments that will reward physicians and hospitals for effectively using a robust, connected EHR system. There is a program designed for those that see large volumes of Medicaid patients, and another for those that accept Medicare, and in order to qualify for the incentive payments, both physicians and hospitals have to demonstrate three things:

1. Use of a certified EHR product with ePrescribing capability that meets current HHS standards.
2. Connectivity to other providers to improve access to the full view of a patient’s health history
3. Ability to report on their use of the technology to HHS

Additionally, because the government wants to spur quick movement in this area, all of the incentives include payments for up to five years but provide the largest payments early in the program, and those that don’t demonstrate meaningful use of an EHR under the Medicare component of the program will eventually be penalized through lower payments. The incentive payments begin in 2011 to ensure the providers have time to adopt and learn to use the EHR; penalties begin in 2015.

Specifics of the Physician Opportunity

As stated, there are two incentive programs for physicians: Medicare and Medicaid. Physicians will choose program participation.

Medicaid:

Physicians who see more than 30% of patients paying with Medicaid (20% for pediatricians) are eligible for payments of up to $64,000 over five years. The incentives will be calculated through a formula that multiplies 85% by amounts ranging from $35,000 in the first year to $10,000 in subsequent years.

Medicare:

Physicians who do not have a large Medicaid volume but do accept Medicare can receive up to $44,000 over the five years. Additionally, physicians operating in a "health provider shortage area" will be eligible for an incremental increase of 10%, and those delivering care entirely in a hospital environment, such as anesthesiologists, pathologists and ED physicians, are ineligible.

Fee reductions

Providers who do not demonstrate meaningful use in 2014 will see, in their 2015 fee schedules from Medicare, a decrease of 1%. An additional decrease will be affected in 2016 and 2017 down to a total of 97% of the regular fee schedule; it can further be reduced to 95% if the Secretary determines that total adoption is below 75% in 2018.

Additional Incentives for Physicians Currently Available

Even before the incentive payments or grants become available to qualifying healthcare organizations through the HITECH Act, there are already programs in place that will reward physicians who adopt technology now. By maximizing the ePrescribing incentives currently available through the Medicare Improvements for Patients and Providers Acts of 2008 and PQRI incentives, a qualified provider can earn between $6,000 and $8,000 prior to beginning participation in the Stimulus incentives programs.