Published on July 16, 2009
EMR, EHR and HIPAA Wiki
EHR Stimulus Money (ARRA)
How much EHR Stimulus Money? ARRA – HITECH Act – EHR Stimulus Estimated $19.5 Billion Spent on Stimulus $2 Billion for Office of National Coordinator (ONC) $36.3 Billion for Medicare and Medicaid Incentives Savings of $18.8 Billion Improved Efficiencies Tax Revenue Reduce Fee Schedule Payments from Penalties Medicare or Medicaid Bonuses
Medicare EHR Stimulus Incentives $44,000 per Provider
Actual EHR Stimulus Amount - Medicare 75% of Medicare Allowable Charges $24k Medicare Charges = $18k in EHR Stimulus $13.3k Medicare Charges = $10k in EHR Stimulus Medicare Penalties 2015 - 1% 2016 - 2% 2017 - 3% 2018 - 4% (HHS Secretary Option) 2019 - 5% (HHS Secretary Option)
Medicaid EHR Stimulus Incentives $63,750 per Provider
Medicaid Details More Complicated Process Reimbursement is Percentage of EHR expenditures Extended Time Horizon (through 2021) Must Demonstrate 20-30% of Patients are Covered by Medicaid Must Show “Meaningful Use” GW Study 15% of Physicians Qualify 99% of Federally Qualified Health Centers (FQHC) 45,000 Office Based Physicians
Lies EHR Vendors Use
EHR Sales Lines Move quickly…EHR deployment back-log! You won’t be ready to show “meaningful use!” The government requires you buy an EMR Simply buy a CCHIT-certified product
2 Main Requirements “Meaningful Use” “Certified EHR” Challenge Still Only Partially Defined
Meaningful Use Matrix Measures Improve quality, safety, efficiency and reduce health disparities Engage patients and families Improve care coordination Improve population and public health Ensure adequate privacy and security protections for personal health information Requirements Increase Over Time Provide Patients e-copy of Data (2011) Real Time PHR Access (2015)
EHR Certification CCHIT Only Current EHR Certification Other EHR Certifications? “ Many certified EHRs are neither user-friendly nor designed to meet HITECH's ambitious goal of improving quality and efficiency in the health care system.“ - Dr. David Blumenthal, NEJM April 2009
Proposed CCHIT Certification Paths EHR-C EMR Company Certification EHR-M “Module” Certification EHR-S Site Certification
Cost of Certified EHR EHR Matrix of Prices Average for Certified EHR - $30,690.80 Average for Non-Certified EHR - $17,066.00 Cost of EHR Certification $20-30k Cost of Extra Development One EMR Vendor Estimated $200,000 in Development Costs Many Unnecessary Requirements
Problems with CCHIT Certification More Successful Installs – Where’s the proof? De-install Rate is Large Stability of Certified EHR Vendors Jabba the Hut EMR Companies
Timelines 6/16/09 – Meaningful Use Matrix 7/16/09 – HIT Policy Committee Presents Next Revision of Meaningful Use “Meaningful Use” Implementation Guide in July 7/21/09 – HIT Standards Committee Presents Standards and Certification Criteria Interim Final Rule by December 31st
Lessons Learned from Past Incentives PQRI, P4P and ePrescribing Only 52% of participants got paid Only $600 per individual participating Only 2 of the 10 made a profit Not notified of problems for years Scenarios
Guaranteed EHR Benefits Legibility of Notes Accessibility of Charts No More Lost Charts Multiple Users Accessing Chart Disaster Recovery Drug to Drug and Allergy Interactions
EHR Pricing Models One Time Cost Plus Annual Maintenance Monthly Cost Per Provider Cost Per Visit Free EMR
Online Resources EMR Forum http://www.emrupdate.com Selecting an EMR http://www.emrconsultant.com My Website http://www.emrandhipaa.com Regional EHR Training Centers?
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Calcification Inhibitors in CKD and Dialysis Patients
ARRA EHR Presentation Austin - GCS Technologies Text-only Preview. John lynn http://www.emrandhipaa.com EMR, EHR and ... (ARRA) How much EHR Stimulus Money?
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