Visionary HealthWare’s Stimulus Summary Site
Visionary HealthWare understands how confusing and cumbersome the stimulus funding information, guidelines, and requirements are. In fact, we empathize with anyone trying to grasp the true meaning and intent of this information. We know that this information changes often, only making it more difficult to understand and follow!
Let us break it all down for you guide you on the right path. We have done our best to understand the necessary and pertinent information and will continue to update you as much as we can. Below is VHW’s viewpoint of ARRA and the stimulus funding information. If at any time you would like to speak with us directly, select the link below to complete the contact form and someone from our office will get in touch with you shortly. We will always be happy to assist you.
For a little less overwhelming information, please continue to read below. Happy reading and researching!
Rating: +0 A. HITECH, or the Health Information Technology for Economic and Clinical Health Act, is a portion of the American Recovery and Reinvestment Act (ARRA) of 2009. On February 17, 2009, ARRA (aka the Stimulus Bill) was signed into law by the federal government. Included in this law is $19.2 Billion (of the $787 Billion total) which is intended to be used to increase the use of Electronic Health Records (EHRs) by physicians and hospitals. This portion of the bill is called the HITECH Act. To receive monetary incentives, practices must meet the criteria defined within Meaningful Use. B. Within the Bill, Meaningful Use is defined as: I. Use of a certified product complete with ePrescribing capability as determined appropriate by the Secretary of HHS; II. The EHR technology is connected for the electronic exchange of PHI; and III. Complies with submission of reports on clinical quality measures. Rating: +0 Criteria # Objective Measure 1 Use computer physician order entry (CPOE) CPOE is used for at least 80% of all orders 2 Implement drug-drug, drug-allergy, drug-formulary checks The eligible providers has enabled this functionality 3 Maintain an up-to-date problem list of current and active diagnoses based on ICD-9-CM or SNOMEDCT At least 80% of all unique patients seen by the eligible provider have at least one entry or indication of none recorded as structured data 4 Generate and transmit permissible prescriptions electronically (eRX) At least 75% of all permissible prescriptions written by the eligible provider are transmitted electronically using certified EHR technology 5 Maintain active medication list At least 80% of all unique patients seen by the eligible provider have at least one entry (or an indication “none” if the patient is not currently prescribed any medication) recorded as structured data. 6 Maintain active medication allergy list At least 80% of all unique patients seen by the eligible provider have at least one entry (or an indication “none” if the patient has no medication allergies) recorded as structured data. 7 Record demographics At least 80% of all unique patients seen by the eligible provider or admitted to the eligible hospital have demographics recorded as structured data. 8 Record and chart changes in vital signs For at least 80% of all unique patients age 2 and over seen by the eligible provider, record blood pressure, and BMI; additionally, plot growth chart for children age 2 to 20. 9 Record smoking status for patients 13 years old or older At least 80% of all unique patients 13 years or older seen by the eligible provider “smoking status” recorded. 10 Incorporate clinical lab test results into EHR as structured data At least 50% of all clinical lab tests results ordered by the eligible provider or by an authorized provider of the eligible hospital during the EHR reporting period whose results are in either in a positive/negative or numerical format are incorporated in certified EHR technology as structured data. 11 Generate lists of patients by specific conditions to use for quality improvement, reduction of disparities, research, and outreach Generate at least one report listing patients of the eligible provider with a specific condition. 12 Report ambulatory quality measures to CMS or the States For 2011, an eligible provider would provide the aggregate numerator and denominator through attestation as discussed in section II.A.3 of the proposed rule. For 2012, an eligible provider would electronically submit the measures as discussed in section II.A.3 of the proposed rule. 13 Send reminders to patients per patient preference for preventive/ follow-up care Reminder sent to at least 50% of all unique patients seen by the eligible provider that are 50 and over. 14 Implement five clinical decision support rules relevant to specialty or high clinical priority, including for diagnostic test ordering, along with the ability to track compliance with those rules Implement five clinical decision support rules relevant to the clinical quality metrics the eligible provider is responsible for as described further in section II.A.3 of the proposed rule. 15 Check insurance eligibility electronically from public and private payers Insurance eligibility checked electronically for at least 80% of all unique patients seen by the eligible provider. 16 Submit claims electronically to public and private payers At least 80% of all claims filed electronically by the eligible provider. 17 Provide patients with an electronic copy of their health information (including diagnostic test results, problem list, medication lists, and allergies) upon request At least 80% of all patients who request an electronic copy of their health information are provided it within 48 hours. 18 Provide patients with timely electronic access to their health information (including lab results, problem list, medication lists, allergies) At least 10% of all unique patients seen by the eligible provider are provided timely electronic access to their health information. 19 Provide clinical summaries to patients for each office visit Clinical summaries provided to patients for at least 80% of all office visits. 20 Capability to exchange key clinical information (for example, problem list, medication list, allergies, and diagnostic test results), among providers of care and patient authorized entities electronically Performed at least one test of certified EHR technology’s capacity to electronically exchange key clinical information. 21 Perform medication reconciliation at relevant encounters and each transition of care Perform medication reconciliation for at least 80% of relevant encounters and transitions of care. 22 Provide summary care record for each transition of care and referral Provide summary of care record for at least 80% of transitions of care and referrals. 23 Capability to submit electronic data to immunization registries and actual submission where required and accepted Performed at least one test of certified EHR technology’s capacity to submit electronic data to immunization registries. 24 Capability to provide electronic syndromic surveillance data to public health agencies and actual transmission according to applicable law and practice Performed at least one test of certified EHR technology’s capacity to provide electronic syndromic surveillance data to public health agencies (unless none of the public health agencies to which an eligible provider or eligible hospital submits such information have the capacity to receive the information electronically). 25 Protect electronic health information maintained using certified EHR technology through the implementation of appropriate technical capabilities Conduct or review a security risk analysis in accordance with the requirements under 45 CFR 164.308 (a)(1) and implement security updates as necessary. · To view the 23 criteria for Facility EHRs, click here. Rating: +0 a. Medicare Incentives Eligible in the Year of Year 2011 2012 2013 2014 2015 2011 $18,000 $0 $0 $0 $0 2012 $12,000 $18,000 $0 $0 $0 2013 $8,000 $12,000 $15,000 $0 $0 2014 $4,000 $8,000 $12,000 $12,000 $0 2015 $2,000 $4,000 $8,000 $8,000 $0 2016 $0 $2,000 $4,000 $4,000 $0 TOTAL $44,000 $44,000 $39,000 $24,000 $0 b. Medicaid Incentives Eligible in the Year of Year 2011 2012 2013 2014 2015 2011 $21,000 $0 $0 $0 $0 2012 $8,500 $21,000 $0 $0 $0 2013 $8,500 $8,500 $21,000 $0 $0 2014 $8,500 $8,500 $8,500 $21,000 $0 2015 $8,500 $8,500 $8,500 $8,500 $21,000 2016 $8,500 $8,500 $8,500 $8,500 $8,500 2017 $0 $8,500 $8,500 $8,500 $8,500 2018 $0 $0 $8,500 $8,500 $8,500 2019 $0 $0 $0 $8,500 $8,500 2020 $0 $0 $0 $0 $8,500 TOTAL $63,500 $63,500 $63,500 $63,500 $63,500 Rating: +0 a. Medicare: An “eligible professional” is defined as a doctor of medicine or osteopathy, a doctor of dental surgery or medicine, a doctor of podiatric medicine, a doctor of optometry, or a chiropractor. b. Medicaid: An “eligible professional” is defined as physicians, dentists, certified nurse-midwives, nurse practitioners, and physician assistants practicing in an FQHC or RHC that is so led by a physician assistant. c. Who is NOT eligible? Those not accepting Medicare or those that do not have a patient base that is comprised of more than 30% of Medicaid patients, and those physicians delivering all care in a hospital (i.e. anesthesiologists, pathologists, emergency physicians) do not qualify. d. Pediatricians: Pediatricians can qualify for these incentives. i. Pediatricians must meet a lower threshold of only 20% Medicaid patients within the total patient base; if this is met, pediatricians can receive 66% of the incentive payments. ii. If pediatricians meet the upper threshold of having a patient base comprised of at least 30% of Medicaid patients, they will receive full incentive amounts. e. “Mid-Level” Providers i. Medicare: mid-level providers are NOT eligible for Medicare incentives. ii. Medicaid: Nurse Practitioners and Nurse Midwives can file for incentive payments; Physician Assistants that are the lead practitioner in a rural health clinic or a federally qualified health center are eligible; medical assistants and physical therapists are NOT included. f. Physical Therapists: NOT eligible for Medicare or Medicaid incentives. Rating: +0 a. Outside of the HITECH Act, there are available incentives for those practices utilizing an ePrescribing solution, which is available via the Medicare Improvements for Patients and Providers Acts of 2008 (MIPPA). b. Additionally, PQRI incentives are available, where a qualified provider can earn $6,000 to $8,000 of additional monies. Rating: +0 a. What is the First Step in Showing EHR Meaningful Use? Successful EHR Implementation! · As you look to adopt an Electronic Medical Record System, in order to qualify for the $44,000 in stimulus funds, questions still loom regarding “meaningful use”. The first step towards showing meaningful use is successful implementation of an EHR. Sounds easy, right? Unfortunately, it isn’t as easy as it sounds. Upwards of 50% of EHRs purchased are not implemented at all and an even larger number are not implemented to their fullest extent due to system complexity and negative impact on workflow. The following steps are designed to offer you a guide to a successful EHR implementation. b. Define Your EHR Goals and Objectives · The first, and most important step, is to define your goals for EHR implementation. Goals and objectives should be defined prior to entertaining any EHR vendors and their products. Form a committee consisting of all stakeholders in the EHR decision making process. This committee should include a representative from the front office, the physician team, the laboratory (if applicable), and the billing staff. Once you have your committee formed, the first meeting should consist of each member bringing a list of their most important goals and objectives for EHR implementation. When the committee meets to discuss the list of objectives from each stakeholder, make a prioritized list outlining each objective from most important to least important. The list of objectives that you created will act as your baseline for when you have discussions with EHR vendors discussing their product’s features and functionality. c. Vendor Selection Process · With over 250 EHR vendors to choose from, you cannot possibly look into the offerings of every vendor! So where does one start to look? There are a number of third party organizations that rank EHR vendors (similar to Consumer Reports) but the best place to start is with your peers. Find a practice(s) within your specialty, with similar practice size, and one that had similar EHR goals and objectives to your practice. Ask them about the vendors they engaged in discussions, inquire into the sales process, and ask how they ultimately made their adoption decision. The most important question to ask a peer is, “If you had it to do over again, would you do anything differently?” · Topics to cover with your prospective vendors: o When meeting with vendors, share your list of goals and objectives. While it is important to ask if they can accommodate your goals and objectives, it is more important to have them show you how they will allow you to meet your goals and objectives through a product demonstration. Don’t let a vendor tell you what their system can do; make them show you how their system helps you meet your EHR goals and objectives! o Ask vendors for references. Keep in mind that vendors carefully select who they use as references but a good reference should share the positive aspects of working with the vendor along with any challenges that they faced. o If you are interfacing your EHR to other software applications (i.e. a Laboratory Information System or Practice Management System), it is best to deal with vendors who have successfully interfaced their products in the past. o Ask your vendors how they conduct product training. Does the vendor come onsite for training? How many of your employees will receive training? What type of post-installation training is available? Do they offer web-based training or additional onsite training? Is it free or is there a cost involved? o What hardware is needed in order to implement their software? Is the vendor a supplier of hardware? Is the hardware included in the vendor’s quote? If a third party hardware vendor is needed in order to implement the software, this will add an additional supplier that you will have to manage. d. EHR Implementation Plan · Once you have selected a vendor that you want to move forward with, it is time to create an implementation plan. EHR implementation will have an impact on the practice! Here is some advice on how to successfully implement an EHR. Identify one person in the practice to act as a “Super User”. This individual should be the main contact for the EHR vendor and the other third party vendors that you may be interfacing your EHR to. The Super User should ask the vendor for an implementation schedule which includes deliverables and due dates. If the EHR is being interfaced with other systems, such as a Laboratory Information System or Practice Management System, interface milestones should be included in the implementation schedule. In order to manage all of the vendor relationships, the Super User should schedule regular conference calls with all of the involved parties in order to refrain from becoming a virtual ping-pong ball bouncing between vendors trying to resolve implementation issues. It is a good idea for the Super User to create a trouble-shooting log where issues and resolutions are logged for users to reference. · Decide when you want to implement the EHR. It is best not to implement an EHR during a traditional busy season such as flu season or back to school when your office will be running at full capacity. There are a couple of different ways to go about implementing an EHR in regards to seeing patients. At first, some practices choose to use the EHR with new patients only until the staff is fully up to speed and then transition existing patients to the EHR. Another approach to implementation is to implement specific modules or features of the EHR one at a time. e. Summary · While EHR implementation may seem like a daunting task, having well defined goals and a strong implementation plan will greatly improve your chances for success. Carefully weigh your options and once you select a vendor, wholeheartedly move forward with implementation. You and your entire staff must buy into EHR implementation in order for your practice to be successful. In the end, successful implementation will ensure that you are positioned to take advantage of the Federal Stimulus Plan. Rating: +0 a. What are the incentive options? · There are two incentive payment programs outlined under the HITECH ACT – one through Medicare and another from Medicaid. Providers can only submit for payment of an incentive bonus from one of the programs so each provider will need to analyze their organization’s public payer mix to determine where they stand to benefit most. Both require that a provider prove “meaningful use” of an EHR product to qualify for the incentives, as well. b. As a physician, what if I don’t demonstrate use of an EHR after the incentives are in place? · Beginning in 2015, physicians not demonstrating meaningful use will have their Medicare fee schedule reduced. Reductions will be o 2015: down to 99% of regular fee schedule o 2016: down to 98% o 2017: down to 97% o If the Secretary finds that less than 75% of eligible healthcare professionals are utilizing EHR beginning in 2018, the Secretary can further reduce the fee schedule to 96% and then 95% in subsequent years but not further. c. How is the incentive program structured? Is it based on payment of a flat dollar amount or is it a percentage of Medicare allowables like it is for PQRI? · The utilization bonus payments identified as incentives for physician utilization in the Bill are flat payments that will be the same for all providers who meet the criteria. d. Are groups that do Medicare Advantage also eligible for the stimulus dollars? · Yes, there are provisions of the Bill related to groups accepting Medicare Advantage. Those organizations and their providers are eligible for the incentives as long as the provider delivers a minimum of twenty hours a week of patient care services and the organization furnishes at least 80 percent of the services of the individual professional to clients of their organization. e. What does this mean to current Visionary HealthWare clients? · The answer depends on the client’s current technology utilization patterns. o For those that do not yet use an EHR and meet the criteria for the incentive payments, this program should offer a motivation to adopt so there is sufficient time to implement and learn how to effectively use the software sufficiently enough to comply with the “meaningful use” requirements. o For clients who already use an EHR product, they will be eligible for the utilization incentives assuming they meet the criteria under Medicare or Medicaid and demonstrate meaningful use. f. For how long and when do you have to prove meaningful use to earn the incentives? · You must demonstrate successful use of the EHR for a continuous 90-day period within the payment year in which the eligible provider. The EHR reporting period, therefore, could be any continuous period beginning and ending within the relevant payment year. g. When will physicians actually receive stimulus funding and how will the successful providers be paid? · Payments will be made on a rolling basis, as soon as CMS ascertains that a provider has demonstrated meaningful use for the applicable reporting period (90 days for the first year or a calendar year for subsequent years) and reached the threshold for maximum payment. · Eligible providers will be sent a single, consolidate, annual incentive payment. For Medicare, providers will receive the funds from CMS; for Medicaid, providers will receive payment from either the State Medicaid agency or their designated intermediary (i.e. Medicaid HMO). h. Want more detailed information regarding ARRA, the HITECH Act, and Meaningful Use? · CMS (Centers for Medicare and Medicaid Services): http://www.cms.hhs.gov/. · GPO US Government Printing Office: http://www.gpo.gov/ · American Medical Association: http://www.ama-assn.org/ · Agency for Healthcare Research and Quality: http://www.ahrq.gov/ · Certification Commission for Health Information Technology: http://www.cchit.org/ · Healthcare Information Technology Standards Panel: http://www.hitsp.org/ Rating: +0 a. Visionary HealthWare is guaranteeing that its software solution of their fully integrated Practice Management and Electronic Health Record system will qualify for Meaningful Use before HITECH payments begin January 2011.
1. What is Meaningful Use?
2. Criteria for meeting the terms of Meaningful Use for Provider EHRs
3. Benefits of incorporating an EHR that meets MU standards
4. Who is Eligible?
5. Additional Incentives
6. Are You Ready to Implement an EHR Solution?
7. Frequently Asked Questions
8. Visionary HealthWare's Guarantee
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