As part of the American Recovery and Reinvestment Act (ARRA) signed this month, approximately $30 billion within the Bill is allocated toward the improvement of health care in some form. Title XIII of the Act, also known as HITECH, focuses on HIT and quality, with $19 billion in grants and loans set aside for infrastructure and incentive payments under Medicare and Medicaid for providers who adopt certified EHR technology. The grants and loans include $17 billion in provider incentives and $2 billion allotted to jump-start health IT adoption.
What Are the Goals for HITECH?
- Build a health information technology structure for interoperability to be in place.
- Create standards building upon Certification Commission for Health Information Technology.
- Save the federal government $12 billion.
- Strengthen federal privacy and security law.
What Are the Physician Incentives?
Physicians can earn $44,000 over five (5) years from Medicare/Medicaid if they are utilizing an EHR in 2011. Thirty thousand dollars ($30,000), or close to 70%, comes in the first two years. Late adopters will receive significantly less. In 2015, there will be reductions in Medicare/Medicaid fees for non-EHR users. These incentives are specifically designed for use of HIT in the ambulatory (clinic) setting. There are separate incentives for the use of HIT in the acute care (hospital) setting.
These incentives are in addition to the current CMS incentives that are in place for ePrescribing and PQRI, which can each add up to $10,000 per physician per year during 2009 and 2010.
How Do I Collect the Money?
Physicians need to become “meaningful” EHR users. The definition is still being further defined, but clearly simply having an EHR is not enough. The EHR must be certified and have the ability to share required data elements.
If you already have an EHR, you must demonstrate meaningful utilization. Purchase and implementation are not enough. If you don’t yet have an EHR, you need to start the acquisition process immediately. Funding starts in 2011, decreases over time and goes away after 2015. Penalties begin in 2015.
What Are My Next Steps?
You need to develop a strategic, collaborative plan before rushing out to spend your share of the HITECH stimulus money. Although the timetable encourages quick adoption, that goal has never been easy. It’s estimated only 5% of physicians currently use an EHR for a significant part of their workflow!
If you haven’t yet purchased an EHR, you need to evaluate your workflows, develop your selection criterion, select a vendor, develop your implementation plan, install your EHR, connect to other providers and have your physicians fully functional. If you already have purchased an EHR, you’ll need to have a plan to make sure the EHR is fully deployed, connectivity to other systems is in place and the EHR users are trained to be “meaningful” users. You need to demonstrate Meaningful Utilization. Current physician practices that have already invested in EHR technology have the best opportunity to take full advantage of the significant new incentives.
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