As reported by the National Committee for Quality Assurance, small practices provide about 75% of U.S. ambulatory care, but many lack the resources to implement EHRs, improve care quality, or serve diverse populations. Legislative awareness of this barrier to adoption helped introduce a bill that will encourage small practices to implement health IT technologies. The bill, the Small Business Health Information Technology Financing Act, was introduced by subcommittee Chairwoman Kathy Dahlkemper (D-Pa.) to help providers overcome the financial barriers for HIT adoption. The bill would establish a loan program specifically for small practices who want financing to invest in health IT.

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The government is providing significant financial incentives to qualifying physicians. Specifically, the American Recovery and Reinvestment Act provides $19.2 billion dollars towards Health Information Technology (HIT) to encourage the adoption of EHR systems. 

Under the Stimulus Package, the HITECH Act outlines two types of incentive programs for Medicare and Medicaid. Providers may only submit and receive payment from one program; however, each provider can submit individual claims, maximizing reimbursements specifically within group practices.

Medicare Program
Beginning in 2011, physicians will be eligible for a maximum payout of $44,000 over the course of 5 years. An additional 10% incentive is available for physicians who practice in a “provider shortage area”.

Medicaid Program
The Medicaid program offers up to $64,000 to physicians who see more than 30% of patients paying with Medicaid, (20% for pediatricians).

Eligibility
In order to qualify for the stimulus plan, physicians must implement a certified electronic health record (EHR) system and demonstrate “meaningful use”.

Physicians that do not accept Medicare or those that do not have a payer mix of greater than 30% Medicaid (20% for pediatricians) will not qualify. Physicians who operate solely in a hospital environment, such as anesthesiologists, pathologists, and emergency physicians are not eligible.

Penalties
Providers that fail to implement a certified EHR and demonstrate meaningful use will begin to see a reduction in Medicare fee schedules, with penalties potentially reaching as high as 5%.

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“Meaningful use” is the buzz word within the healthcare industry because the American Recovery and Reinvestment Act (ARRA) of 2009 which is also referred to as the Federal Stimulus Package. The ARRA provides Medicare and Medicaid incentives that are based on the adoption and “meaningful use” of certified EHR technology which is why defining and clarifying the term “meaningful use” is important to healthcare providers.

Although specific requirements for demonstrating “meaningful use” of EHR technology are continuously being defined and evaluated, HIMSS officials urge that CCHIT should be the certifying body for EHR technology. CCHIT has provided a certification process for EHR solutions to accelerate the adoption of health IT, like a “Good Housekeeping” seal of approval. CCHIT Certified® solutions simplify the adoption by reducing purchase risk and allow physicians to take advantage of available HIT incentives. As mandated by ARRA, a final “meaningful use” rule should be published by the end of 2009.

The Health Information and Management Systems Society (HIMSS) recommends the following guidelines:

1. Recognize CCHIT as the certifying body of EHRs.
2. Adopt metrics that can be reasonably captured and reported beginning in FY11/2011,* and then made increasingly stringent using intervals of not less than two years.
3. Coordinate with HITSP and IHE to create new harmonized standards and implementation guides to bridge gaps in interoperability of health information.
4. Reconcile gaps among “certified EHR technologies,” “best of breed,” and “open source” technologies.
*ARRA requires the hospital-focused definition to be effective FY11 (October 1, 2010).  For meaningful users (physicians), the definition must be effective January1, 2011.

Healthcare DPS offers certified EHR products that help physicians take advantage of available incentives, grants and reimbursement. For more information, please visit www.HealthcareDPS.com

Information regarding the HIMSS guidelines: HIMSS Guidelines

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