July 8, 2009

ARRA EHR Stimulus Payments Under Medicare

Written by: John
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UPDATE: Many of you will find my presentation on the ARRA EMR Simulus money of interest.

There’s been a lot of talk (including myself) about the EHR stimulus money. It seems like meaningful use has taken the cake with most of the discussion with certified EHR taking a cozy second place. What I haven’t seen very much of is some practical analysis of the EHR stimulus money and the amount of money various practices will receive. So, I’m going to try to do my part to create some of this practical EHR stimulus money content.

I’m sure that most people have seen a chart like this one describing the $44,000 of EHR stimulus money you can receive from ARRA:

Source: http://hitanalyst.files.wordpress.com/2009/02/hitech2.jpg?w=500&h=234

Source: http://hitanalyst.files.wordpress.com/2009/02/hitech2.jpg?w=500&h=234

Basically, the schedule shows you that you can earn UP TO $18,000 in 2011 (assuming of course that you can show “meaningful use” on a “certified EHR”). What hasn’t been discussed is how many doctors will be eligible for the full $18,000 in stimulus money and how many would only be eligible for $10k or $5k in stimulus money and how much allowable Medicare charges you’ll need to have to receive the full reimbursement.

The EHR stimulus Medicare payments will be paid based on 75% of the submitted allowable charges. For example, a doctors office which has allowable Medicare charges totally $24k or more will be eligible to receive the full $18k in EHR stimulus money. A clinic with $13.3k in allowable Medicare charges would only be eligible for $10k in EHR stimulus money. You can do the math for your own clinic.

Maybe this is a non issue for most clinics. I don’t know. I’ve never seen any published average reimbursement rates for a doctor. $24k doesn’t seem like a lot of Medicare reimbursement, but certainly there are some doctors who are under that amount. Later today I’ll post a poll so we can get a better idea of the average reimbursement rates for a doctor.

What’s most important is for people to know that they’ll only be getting 75% of their Medicare allowable charges up to the cap.

Related Articles
  • EHR Stimulus Calculator – Medicare
  • Q&A: ARRA EMR Stimulus Money for Non Medicare Providers
  • Average Medicare Allowable Charges Poll
  • ARRA EHR Stimulus Money Poll Results
  • Problems with ARRA EMR Stimulus Money

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    7 responses to "ARRA EHR Stimulus Payments Under Medicare"

    1. # Brian commented on July 8th, 2009:

      I don’t believe your numbers are correct for Adopt Beginning 2014. From reading the Act, I believe it is 2014 – $12,000, 2015 – $8,000 and 2016 – $4,000.

    2. # John commented on July 8th, 2009:

      Hi Brian,
      I’ve checked 2 sources and they both say the same as what’s listed above. I’ll check on it more later tonight and correct it if I find something more authoritative. Thanks for checking it and please feel free to link me to any other differing details.

      The principle of 75% of medicare reimbursement should apply regardless of the cap.

    3. # Kristen commented on July 9th, 2009:

      The AMA gave the 12, 8, 4 numbers here:
      http://www.ama-assn.org/ama1/pub/upload/mm/399/arra-hit-provisions.pdf

    4. # Brian commented on July 9th, 2009:

      Thanks John,

      After rereading, perhaps I am reading too much into it. ths language is as follows:

      and such year.
      ‘‘(ii) AMOUNT.—Subject to clauses (iii) through (v),
      the applicable amount specified in this subparagraph
      for an eligible professional is as follows:
      ‘‘(I) For the first payment year for such professional,
      $15,000 (or, if the first payment year for
      such eligible professional is 2011 or 2012, $18,000).
      ‘‘(II) For the second payment year for such
      professional, $12,000.
      ‘‘(III) For the third payment year for such
      professional, $8,000.
      ‘‘(IV) For the fourth payment year for such
      professional, $4,000.
      ‘‘(V) For the fifth payment year for such professional,
      $2,000.
      ‘‘(VI) For any succeeding payment year for
      such professional, $0.
      ‘‘(iii) PHASE DOWN FOR ELIGIBLE PROFESSIONALS
      FIRST ADOPTING EHR AFTER 2013.—If the first payment
      year for an eligible professional is after 2013, then
      the amount specified in this subparagraph for a payment year for such professional is the same as the
      amount specified in clause (ii) for such payment year
      for an eligible professional whose first payment year
      is 2013.

      I may have initially read it as (II) vs (ii) (which includes I through VI) so perhaps I am the one who is incorrect.

    5. # John commented on July 12th, 2009:

      Thanks for keeping me honest Brian. I think the chart above is right. Thanks for going directly to what’s in the ARRA HITECH act and copying it here.

      Still is amazing to think you only lose $9k if you wait until 2013 to implement an EHR. Not all that much really to see how things go for the early adopters.

    6. # EHR Stimulus Calculator – Medicare | EMR and HIPAA pingbacked on August 4th, 2009:

      [...] I knew that it was only a matter of time before someone put together an EHR stimulus calculator and I finally found one here. The basic idea is you input your details and then it calculates how much EHR stimulus money you qualify (under the Medicare side of the stimulus money). I think that a calculator like this is important since the amount of EHR stimulus money you get depends on the amount of allowable Medicare charges. [...]

    7. # T.J. Tavares commented on August 5th, 2009:

      John:

      We’ve developed an easy to use Iphone Application that will calculate the stimulus incentives for you. Please note that a Medicare decision support calculator and hospital calculator are in development.

      http://itunes.apple.com/WebObjects/MZStore.woa/wa/viewSoftware?id=322694232&mt=8

      Regards,
      T.J.

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