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The Healthcare Penalties Are Coming!!

Posted on April 3, 2015 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

We all know about the Meaningful Use penalties. The PQRS penalties. The Value Based Modifier penalties. Individually, they’d all be annoying, but I don’t think most healthcare organizations have understood what these penalties will be in aggregate.

This hit home to me when I was reading a smartly titled post by Jim Tate called “What you don’t do in 2015 will cause 9% CMS penalties in 2017” Here’s how he describes the penalties that are in store for healthcare:

MU: Failing to achieve MU in 2014 will bring a 2% penalty beginning in 2016 with a 1% annual increase up to 5%.

Physician Quality Reporting System (PQRS): Non-participation brings a Medicare reimbursement reduction of 2.0% in 2016 based on 2014 data.

Value-Based Modifier(VBM): The VBM, which many providers are not aware of, is linked to PQRS. Beginning in 2016, eligible providers (EPs) in groups with 10 or more EPs will be subject to a penalty based on performance. In 2017, this will include all EPs, not just those in larger groups.

Taken together, this adds up to a 9% penalty in 2017 based on 2015 participation.
To avoid these penalties, immediately assess your current participation in the MU, PQRS, and VBM programs. If you are not on track you must take steps to mitigate your risk as soon as possible.

Risk mitigation is the right way to describe it. As I mentioned in the beginning, I don’t think that many providers are planning ahead to avoid these penalties. I also don’t think they realize the long term consequences of the choices they make today.

Thanks Jim for waking us up to the reality.

4 Great Healthcare IT Bloggers

Posted on March 9, 2015 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

This post was inspired by Dave Newman’s post which listed his 4 favorite health IT bloggers. In his list, I’m in great company alongside Marsha Tatt, Shahid Shah and Ed Marx. What I loved about Dave’s description of each is that you knew he actually read each of the sites regularly since he summed us each up very well.

Also to answer his question “Does he [John Lynn] ever sleep?” Yes, I do sleep. My favorite response is “Sleep is for the weak…and sometimes I’m weak.”

I think the reason I loved Dave’s post so much is that it hearkened me back to my early days of blogging where people would do posts like this all the time. This was pre social media. Twitter didn’t exist and Facebook was for college campuses. The idea of a healthcare IT blogging “community” has kind of gone away in a lot of respects. There are a bunch of bloggers, but not much of a blogging community.

I miss those days, but I’m not sure it’s an awful thing. The reason there was a blogging community before was that the blog was the only format people had to share their ideas and thoughts about what was happening. So, the blogs and the comments of blog posts was this amazing way to connect with people who had common interests. That blogging community has now moved to social media where we have Twitter communities. Many people who were blogging and who would blog are now just sharing their thoughts on Twitter and other social media. In many ways that’s a lot easier than starting a blog. Plus, those communities are really strong.

What’s clear to me is that people’s desire to connect with other people in a community and people’s desire to share their ideas and thoughts will never end. It’s just the format that will change.

With all of that said, I still have a friendly affection for bloggers. Particularly bloggers that can slay the content beast and regularly publish thoughtful content. While I like many of you don’t follow that many bloggers fanatically like I might have done before (I use social media to bubble up the interesting content), I still am fond of some really exceptional healthcare IT bloggers who I do read regularly. Here are 4 of the many I could highlight.

Life After Epic – Epic is the Apple of Healthcare IT. They have such tremendous fan following on each side. Plus, they are incredibly secretive about many of their business practices. Everyone likes to know a secret, so it’s always fun to read some of the behind the scenes insights that Life After Epic provides. I hope he/she brings on some other former Epic people to contribute content to the site so that the site is always updated on the latest perspectives. In fact, they need a button that lets someone submit info to them to be published. They should continue to publish it anonymously, but not accept anonymous submissions.

EMR Advocate (Jim Tate) – If you care about meaningful use, then Jim is a must follow. He’s deep in the meaningful use attestation and audit world. Plus, he’s just a fantastic individual. While he doesn’t post as regular as some, whenever he posts it’s interesting.

HIStalk – When I first found HIStalk 10 years ago, it wasn’t that interesting to me since I wasn’t deeply entrenched in the industry. However, as I dug in and understood many of the inner workings of healthcare IT, I started to appreciate HIStalk so much more. I can’t imagine the number of hours Mr. H spends and has spent creating all of the content he creates. He deserves a lot of credit for the work he’s done. If you’re entrenched in healthcare IT like me, you’ll enjoy and appreciate the work they do on HIStalk.

HealthSystemCIO (Anthony Guerra) – Ever since Anthony and I first battled it out on a “Meet the Bloggers” panel at HIMSS (we have very different views on how to approach content), I’ve respected the work he’s done. He has a very ardent view of how to approach content and I respect him for sticking with it all these years later. Although, his work I love the most is when he writes about his personal experiences. I always love a good story and Anthony’s great at telling stories.

There you go. 4 great healthcare IT bloggers. Notice that I didn’t say “favorite” since it’s impossible for me to choose a favorite, or a top, or a greatest. Plus, the comparison doesn’t matter to me. Variety is the spice of life, so I love mixing in a variety of great bloggers.

Which bloggers do you read regularly? Which bloggers are your favorite? Which social media personalities do you wish were blogging?

Meaningful Use Audits and Appeals

Posted on February 11, 2014 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

Meaningful Use Expert, Jim Tate, has a really interesting post up on his Meaningful Use Audits website that shares some of the details CMS offered on the EHR incentive audits and appeals process. I know many of my readers are worried about the meaningful use audits and are interested in these details.

You can go and read Jim’s full post for all the details, but I wanted to highlight a few of the items he mentions.

First, CMS said that 5-10% of providers will be subject to pre/post-payment EHR incentive audits. Jim calls this casting a “wide net” for the MU audits. Considering meaningful use stage 1, it makes some sense why the MU audit net would be cast wide. I’m sure many who read this have a friend who’s been through the audit.

I was really intrigued that CMS said “If a provider continues to exhibit suspicious/anomalous data, could be subject to successive audits.” This reminded me of something my brother said about the military. He said that if you got your uniform inspection right the first couple times, then the officers would stop looking at you quite as much. However, if you had something wrong at first, be ready to be scrutinized. It seems like CMS is taking a similar approach. As in most things in life, it’s just better to be honest and accurate. Then, you don’t have to look over your shoulder.

Jim also notes that CMS said that no risk profile will be made public. Basically, we aren’t going to get any clue into how they chose who to audit. Plus, Jim notes that the only next step if you fail an meaningful use audit is to file an appeal.

As long as we have meaningful use tied to EHR incentive money and payment adjustments, I don’t see these MU audits going anywhere. So, if you’re attesting to meaningful use, make sure you’re prepared for an MU audit if it comes.

EHR Certification Results Published – Meaningful Use Monday

Posted on September 17, 2012 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

We haven’t done many posts recently about EHR certification which is an integral part of getting to the Meaningful Use promised land. Although, when I read this post by EHR certification expert, Jim Tate, I thought it was worthy of pointing out and starting some discussion on the EHR certification requirements. Here’s a quote from the post that I found quite interesting:

Please allow me to report one final nuance to all this… A vendor can apply for 2011 Edition certification after 10/04/2012 but they will pay a price. They will be exposed to new ONC certification requirements: ”We also require that test results used for EHR technology certification be made publicly available” and “we require that ONC-ACBs ensure that EHR technology developers include in their marketing materials and communications notification to potential purchasers any additional types of costs that an EP, EH, or CAH would pay to implement their certified Complete EHR or certified EHR Module in order to attempt to meet MU objectives and measures”.

I find the idea that the ONC-ACBs have to publish the EHR certification test results quite interesting. What I’m not sure is whether this will really provide much value to those evaluating an EHR company. I know Jim Tate reads this blog and so hopefully he can chime in with any knowledge he has about the subject. Although, I wonder if the results that an ONC-ACB posts about an EHR will provide little value. Will the report essentially be a pass/fail report or will it provide more detailed information about what was found during the EHR certification process? Do we know what these reports will look like?

The later comment that requires an EHR company to disclose additional types of costs is quite intriguing. No doubt there are many EHR companies that have hid behind their hidden EHR costs in the past, so I love the requirement. I’m just not sure what enforcement mechanisms are available to ensure that EHR companies are following this requirement. Are their penalties for not doing this? Is there a reporting mechanism to report marketing that doesn’t follow this? As we all know, a rule without enforcement and penalties isn’t much of a rule at all.

EMR and Meaningful Use Books

Posted on July 27, 2011 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

I must admit that I’m not much of a book guy. Especially since there’s so much free information available on the internet about just about any subject you could want. However, I’ve been quite intrigued by the number of healthcare IT related books that I’ve seen coming out of late. Here’s a quick roundup of some of the ones I’ve seen.

Getting to Meaningful Use and Beyond: A Guide for IT Staff in Health Care by Fred Trotter and David Uhlman – I’ve been a big fan of Fred Trotter for a while. So, I’m glad he’s working on this book. Turns out the book isn’t even published, but in Fred Trotter open source style fashion, the book is available for free online right now. Of course, they’re hoping you’ll provide feedback.

The HITECH Act Made Easy: A Simple Guide to the Federal EHR Incentive Programs – I had this book sent to me. It’s a short book which I think is good. It tries to tackle not only the details of the Medicaid and Medicare stimulus program, but also has a number of sections on EHR selection and implementation as well. I love it’s question format where many of the chapters are a question and the chapter offers the answer.

Health Information Exchange Formation Guide: The Authoritative Guide for Planning and Forming an HIE in Your State, Region or Community – I haven’t really had a chance to dig into this book yet. It’s brought to you by HIMSS. It’s a pretty thick book which I think describes well the challenge that is forming an HIE. Without reading the book, I’m a little torn just by the subtitle of the book, “The Authoritative Guide for Planning and Forming an HIE in your State, Region or Community.” I guess it’s hard for me to imagine it being the “authoritative guide” when I think we’re still trying to figure out the right HIE business model. I don’t think we’ve found it yet. I guess I should read the book to find out.

Jim Tate’s EHR Incentive Roadmap – Ok, this is an e-Book, but I think it’s as good a value as any hard cover book. So, it’s worth mentioning. I wrote a whole post on Jim Tate’s EHR Incentive book before.

Any other books about EMR, Meaningful Use, and/or healthcare IT that are out that we should know about?

UPDATE: User EHR and Meaningful Use Recommendations from the comments below:
Electronic Health Records For Dummies – Recommended by Nate Osit

Electronic Health Records: Transforming Your Medical Practice, second edition – “This is a book from MGMA and was recommended to me by a coordinator from the REC (Ohio) that I have been shadowing.” – Mary Ellen Weber

Jim Tate’s EHR Incentive Roadmap Resource

Posted on June 29, 2011 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.


HITECH Answers has just released the 3rd edition of Jim Tate’s The Incentive Roadmap® The Meaningful Use of Certified Technology: Stage 1 A Manual for Medical Practices. Version 3.0 of the manual that has been helping practices, consultants and vendors across the country understand the step-by-step process of achieving meaningful use is now available. Written by Jim Tate, a nationally recognized expert on the CMS EHR Incentive Program, certified technology and Meaningful Use objectives,The Incentive Roadmap® looks at what steps are needed to get ready for meaningful use and is downloaded immediately upon purchase.

I consider Jim Tate one of the foremost experts on meaningful use and certified EHR. So, I was excited when he decided to publish a resource on the details of the EHR incentive program.

In The Incentive Roadmap®, Jim Tate covers all of the details that you need to know if you’re considering participation in the EHR incentive program.

The first section is actually incredibly valuable since it covers who is eligible for the EHR incentive money and also includes a comparison of the various EHR incentive programs. Plus, it walks a clinic through the process of determining which program it is eligible for. Certainly many people have already gone through this process, but for the rest of you this is a great resource that will guide you through the EHR incentive options.

The next section of the The Incentive Roadmap® covers the details of the meaningful use criteria. This is the section that I think most people will be interested in having now. Certainly many of these details can be found on the CMS website and we’ve covered a lot of them in our Meaningful Use Monday series. However, if you want to get all of the meaningful use details in one place without all the legalese that CMS loves to provide, then check out the The Incentive Roadmap®.

I also love a later section of the The Incentive Roadmap® where Jim Tate provides some practical strategy advice on how a clinic should approach meaningful use.

I know I’ll be keeping my copy of The Incentive Roadmap® close by as a reference. It’s a lot easier to go through than the HHS/CMS/ONC websites.

EHR Certification Testing Dates Scheduled into November

Posted on September 14, 2010 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

I can’t remember when or where I saw it, but at some point I saw someone reference Jim Tate from EMR Advocate as the expert on EHR certification. I’d known Jim electronically for quite a while having followed his writings online and on Twitter. I even haphazardly bumped into Jim where we both looked at it each other and recognized our pictures from Twitter.

After Jim stopped by to comment on my previous EHR certification post, I emailed Jim to ask him if he wanted to do a guest blog post for EMR and HIPAA. He is busy with 3 stage 1 EHR certifications this week, but did send the following info which I found interesting and useful. I’m also looking forward to taking a look at his manual on meaningful use. I hear it’s highly targeted at doctors and clinical practices which fits in line with my style too.

The HHS/ONC Authorized Certification Program has really broken loose. We were in the eye of the storm, but the eye has passed and the windows are being blown out. Vendors are desperately trying to get a testing date in October and not Novemenber or later. The ability to get Stage 1 Certified and listed on the ONC website is now a giant business issue. A two month’s delay in being able to market and sell certified technology is a handicap. We will see the effect that decisions made over the past year by vendors will play out in the market. Those that applied for the CCHIT Preliminary IFR Stage 1 test are sitting pretty as their can choose test dates based on their application date. Those vendors that elected to wait may pay a price in delayed certifications. Of coursethere are presently 2 organizations authorized to test and certify and I expect maybe 2 more in coming weeks. That may help the crunch. The Drummond Group is charging $23,500 for all Stage 1 testing for EPs and has begun accepting applications for testing. Information about their program is available at: http://www.drummondgroup.com/pdfs/EHR_Testing_and_Certification_Guide_Rev_A.pdf (PDF). A number of my vendor clients have applied and have been given test dates in mid to late November. CCHIT will hold a Town Call next Monday at 1 PM ET: http://www.cchit.org/about/towncalls/CCHIT-Town-Call-Authorized-HHS-certification-program. The fees for their Stage 1 testing will be announced at that time and applications will begin to be accepted that date. Vendors who had already applied for CCHIT’s Preliminary Stage 1 Testing will begin testing against the CMS Final Rule next week. By the end of this month we will Certified Technology listed on the ONC website.

Due to the complexities of the CMS EHR Incentive Program for EPs I have written a manual, The Incentive Roadmap, to help guide medical practices through the process. It is being updated continually to reflect the changes in the incentive program. It is being sold at HITECHAnswers.