tag:blogger.com,1999:blog-8852684919029181544.post8198316257836800835..comments2024-03-21T22:09:25.626-07:00Comments on Advanced Health Information Exchange Resources: NCVHS Executive Subcommittee Hearing Defining "Meaningful Use"Ahierhttp://www.blogger.com/profile/13398190978662246852noreply@blogger.comBlogger1125tag:blogger.com,1999:blog-8852684919029181544.post-19254209866035321082009-04-29T15:44:00.000-07:002009-04-29T15:44:00.000-07:00The recently enacted Health Information Technology...The recently enacted Health Information Technology for Economic and Clinical Health (HITECH) Act, part of the American Recovery and Reinvestment Act (ARRA), authorized Medicare and Medicaid incentive payments and penalties to encourage physicians and hospitals to adopt and use electronic health records (EHRs). To be eligible for these incentives, physicians and hospitals must demonstrate the “meaningful” use of electronic health record (EHR) technology that is certified as meeting standards of interoperability, clinical functionality, and security. ARRA directs the Secretary to develop and approve EHR standards by the end of 2009 and to establish a program to certify which EHR systems meet these standards. <br /><br />Starting in 2011, physicians who meet the definition of a “meaningful” EHR user (including exchanging electronic health information to improve health care quality and coordination) will be eligible for up to $44,000 in Medicare bonus payments over a five-year period. Physicians who are not meaningful EHR users by 2015 will see their Medicare reimbursement reduced by up to 5 percent in 2019 and subsequent years if the Secretary finds that the proportion of meaningful users is less than 75 percent. Eligible professionals are those that meet the Medicare definition of a physician, i.e., state-licensed doctors of medicine, osteopathy, dentistry, podiatry, and optometry, as well as licensed chiropractors. Eligible professionals are those that meet the Medicare definition of a physician section 1861(r) of the Social Security Act. <br /><br />Beginning in 2011, hospitals who meet the definition of “meaningful” EHR user will also be eligible for bonus payments. For hospitals subject to the inpatient prospective payment system (IPPS), the amount of the payment incentive depends on when the hospital first demonstrates meaningful use of a certified EHR system, the size of the facility, and the hospital’s Medicare share. The incentive payment will phase-out over a four year period, such that hospitals receive 75 percent of the applicable bonus payment in year two; 50 percent in year three; and no incentive payment in subsequent years. Hospitals that are meaningful users beginning in 2011, 2012 or 2013 will receive a full four year of incentive payments based on the aforementioned schedule. Hospitals that become meaningful users in 2014 or 2015 will only receive three or two years of incentive payments, respectively. Starting in 2015, hospitals that do not show meaningful use of a certified EHR system during the prior year will be subject to reductions in the annual IPPS market basket update. <br /><br />Starting in 2011, Critical Access Hospitals (CAHs) who demonstrate meaningful use of EHR will receive expedited and increased payments for health IT costs that would otherwise be subject to depreciation. In 2011 through 2015, CAHs can expense health IT costs that would otherwise be eligible for depreciation, which will allow them to receive Medicare reimbursement for these costs shortly after incurring the expense, rather than over a multi-year depreciation schedule. In addition, Medicare reimbursement to CAHs for health IT costs will be enhanced by providing an additional 20 percentage points in extra depreciation payments in addition to the allowable depreciation amount that is calculated based on the Medicare share formula set forth in the bonus payment policy for IPPS hospitals. Starting in 2015, CAHs that do not show meaningful use of a certified EHR system during the prior year will face a reduction in their payment rate that will phase-up over three years to 1 percent of the currently 101 percent cost-based reimbursement available to CAHs. <br /><br />The HITECH Act also included health IT incentives for eligible professionals and hospitals through the Medicaid program. Beginning in 2011, eligible professionals who treat a high volume of Medicaid patients and demonstrate meaningful use of a certified health IT system are eligible for temporary health IT payments. Payments are not to exceed 85 percent of the cost of purchase, implementation, and maintenance and upkeep of certified systems, subject to an overall cap. Maximum program participation is six years. Eligible professionals include non-hospital professionals (doctors, dentists, nurse practitioners, certified nurse mid-wife, and certain physician assistants) who have at least 30 percent of their patient volume from Medicaid; pediatricians with at least 20 percent of their patient volume from Medicaid; and federally-qualified health centers (FQHCs) or rural health clinics (RHCs) with at least 30 percent of their volume from needy individuals. Eligible providers participating in the Medicaid incentives program are not allowed to participate in the Medicare incentives program described above.Ahierhttps://www.blogger.com/profile/13398190978662246852noreply@blogger.com