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Hospital Must Pay Back $31 Million in Meaningful Use Money

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The news just came out that Health Management Associates, Inc. (“HMA”) did not meet the meaningful use requirements necessary to receive the EHR incentive money and so they’ll have to pay back all of the money they’ve been paid by CMS. Here’s a portion of the article that details the amount they have to pay back:

The Company estimates that, between July 1, 2011 and September 30, 2013, it recognized as income HCIT incentive payments totaling approximately $31.0 million for the hospitals that did not meet the “meaningful use” criteria. Of these payments, the Company recognized as income approximately $8.3 million in 2011, approximately $17.3 million in 2012 and approximately $5.4 million in the first six months of 2013. On October 30, 2013, the Company withdrew the 11 hospitals from the HCIT programs and has repaid the majority of the funds to CMS. The Company is in the process of repaying the balance of the funds to the relevant state programs. The Company expects to re-enroll the hospitals in the HCIT programs and may be able to recoup some portion of the amounts repaid.

$31 million is a lot of meaningful use money to pay back. I’m still waiting for the details of why they failed their meaningful use attestation to come out. Although, I believe I read that the top management at HMA are gone from the company as well. So, it’s hard to say if this was a simple meaningful use mistake or if it was an intentional effort to game the EHR incentive and meaningful use system. In meaningful use stage 1 this is particularly easy to game since it was self-attestation.

I’m sad to say that I wrote about the potential of having to payback EHR incentive money previously. Plus, as I mention in that article, HMA will now be subject to the EHR penalties as well if they don’t get things corrected before those go in place. Of course, in my post I discuss organizations that make a good faith effort to attest to meaningful use. We’ll see if HMA made a good faith effort or not. Either way, this is an important warning for those organizations that aren’t doing everything they can do meet the meaningful use guidelines.

One EHR expert I spoke with about this situation said, “It’s not the last of such announcements I expect to come out in the next few months.” I’d only modify that to say “in the next few years.” If organizations had problems with meaningful use stage 1, you can be sure the problems will be multiplied with MU stage 2 and 3.

The problem is that if too many more stories like this come out it’s going to take a program that was suppose to incentivize EHR and make it into a weight around the neck of EHR implementations.

November 7, 2013 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 5000 articles with John having written over 2000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 9.3 million times. John also recently launched two new companies: InfluentialNetworks.com and Physia.com, and is an advisor to docBeat. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and Google Plus. Healthcare Scene can be found on Google+ as well.

Will The Government Shutdown Lead to the Meaningful Use Stage 2 Delay?

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It seems like every healthcare organization that exists has called for a delay to meaningful use stage 2. I’ve predicted before that I think that meaningful use stage 2 will have some sort of delay. I feel even more confident in that prediction thanks to the government shutdown.

With so many people not working at ONC, I think there’s a practical question of whether they can really be ready for MU stage 2. However, maybe even more powerful is that the government shutdown now gives ONC an excuse for why the delay should happen. They can blame the delay on the government shutdown and not on something else. Let’s call it the straw that broke the camel’s back.

Although, Farzad Mostashari at CHIME 2013 disagreed. Here’s the tweet I sent during his keynote presentation:

It was nice of Farzad to retweet it as well. I think he really believes this statement. I was sad he didn’t reply or retweet my other tweet:

If I were a betting man (which I’m not despite living in Vegas), I’d bet on a MU stage 2 delay. However, Farzad did place that seed of doubt in my prediction. Farzad made a good case for why some parts of meaningful use stage 2 we can’t wait on anymore. However, with him no longer as leader we’ll see if they can hold the course with no delays.

October 10, 2013 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 5000 articles with John having written over 2000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 9.3 million times. John also recently launched two new companies: InfluentialNetworks.com and Physia.com, and is an advisor to docBeat. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and Google Plus. Healthcare Scene can be found on Google+ as well.

Are State Health Agencies Ready for Meaningful Use Stage 2?

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As part of its public health objectives, Meaningful Use 2 requires doctors and hospitals to report sizable amounts of information.

The idea is that when significant patterns are forming — an outbreak of a certain disease, for example, or a peculiar cluster of symptoms — they’ll be apparent right away.

But someone has to be in position to receive the data.

The responsibility falls to local and public health departments. Agencies around the country should, theoretically, be preparing for the immunization records, laboratory results and other information they’ll soon be getting.

Just how many will be ready, though, remains to be seen. Many cash-strapped departments lack the IT infrastructure for what’s being asked of them — and the money allocated by the government hasn’t amounted to much, according to a 2012 American Journal of Public Health article by Drs. Leslie Lenert and David Sundwall.

In fact, the authors wrote, the federal effort “has created unfunded mandates that worsen financial strains” on health departments.

There’s a caveat, though: The mandates aren’t really mandates.

“Nothing compels them to do it” except the desire to do the right thing, said Frieda du Toit, owner of Lakeside, Calif.-based Advanced Business Software. “Some directors are interested, some are not. The lack of money is the main thing.”

In our recent interview, du Toit, whose company specializes in information management solutions for health departments, added: “One customer asked me: ‘Am I going to be punished in any way, form or fashion if I don’t support the efforts of my hospitals and care providers?”

Her firm’s Web-based Public Health Information Management System serves cities and counties throughout the United States, including in California, Texas and Connecticut.

The federal government’s goal is for public health agencies to be involved in four administrative tasks to support MU2, according to the Stage 2 Meaningful Use Public Health Reporting Task Force. The task force is a collaboration between the U.S. Centers for Disease Control and Prevention, nonprofit public health associations and public health practitioners.

The first step is to take place before the start of MU2 — that’s Oct. 1, 2013, for hospitals and Jan. 1, 2014, for individual providers.

The tasks:

  • Declaration of readiness. Public health agencies tell the Centers for Medicare & Medicaid Services what public health initiatives they can support.
  • Registration of intent. Hospitals and providers notify public health agencies in writing what objectives they seek to meet.
  • On-boarding. Medical providers work with health departments work to achieve ongoing Meaningful Use data submission.
  • Acknowledgement. Public health agencies inform providers that reportable data has been received.

For doctors and other eligible professionals, MU2 calls for ongoing submission of electronic data for immunizations. Hospitals are to submit not only immunizations but also reportable laboratory results and syndromic surveillance data.

Health care providers whose local public health departments lack the resources to support MU2 are exempt from the reporting requirements.

In Meaningful Use Stage 3, which health IT journalist Neil Versel wrote is likely to begin in 2017, “electronic health records systems with new capabilities, such as the ability to work with public health alerting systems and on-screen ‘buttons’ for submitting case reports to public health, are envisioned,” according to Lenert and Sundwall.

The authors noted: “Public health departments will be required not just to upgrade their systems once, but also to keep up with evolving changes in the clinical care system” prompted by the regulations.

They proposed cloud computing as a better way. Shared systems and remote hosting, Lenert and Sundwall suggested, could get the work done efficiently and affordably, albeit at a cost to individual jurisdictions’ autonomy.

As EMR adoption grows, it would be a shame not to take advantage of the opportunities for public health. The entire health IT effort being pushed by the federal government is, after all, geared toward improving the health of populations.

Without money for the job, though, public health agencies’ ability to support Meaningful Use will likely always be limited. It looks like a good time to think about committing significant funds, embracing cloud-based solutions or both.

September 23, 2013 I Written By

James Ritchie is a freelance writer with a focus on health care. His experience includes eight years as a staff writer with the Cincinnati Business Courier, part of the American City Business Journals network. Twitter @HCwriterJames.

They Do Listen: Stage 2 Proposal Includes Some Changes to Stage 1 – Meaningful Use Monday

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Lynn Scheps is Vice President, Government Affairs at EHR vendor SRSsoft. In this role, Lynn has been a Voice of Physicians and SRSsoft users in Washington during the formulation of the meaningful use criteria. Lynn is currently working to assist SRSsoft users interested in showing meaningful use and receiving the EHR incentive money. Check out Lynn’s previous Meaningful Use Monday posts.

Included in the Proposed Rule for Meaningful Use Stage 2 are several modifications to the requirements for Meaningful Use Stage 1—likely in response to a barrage of comments from providers. 

The MU Stage 1 measure requiring a test of the ability to exchange clinical data would be removed effective 2013. Apparently, the concept of a test created a great deal of confusion. This change, however, should not be interpreted as reduced interest in interoperability. In fact, Stage 2 is all about the sharing of data. The measure would be replaced in Stage 2 by numerous other measures that require the sharing of clinical information—both between providers and with patients. 

The “all 3 vital signs dilemma”, (described in a previous Meaningful Use Monday post), would be resolved by a change to the vital signs measure. Separating height and weight from blood pressure, the revised measure would allow a provider to meet the threshold for recording height and weight, while claiming an exclusion for blood pressure, (or vice-versa). This is good news for specialists like orthopaedists who may routinely document height and weight but who rarely document blood pressure unless it is relevant to a specific patient’s problem. This change would be available as an option in 2013, and formalized in 2014. (The vital signs measure would also increase the minimum age requiring blood pressure documentation from 2-year olds to 3-year olds.) 

Many providers reported a problem in meeting the CPOE measure because of the way the calculation was defined—particularly those providers whose treatment does not frequently include prescribing medication. Now, providers would be able to define the denominator as the number of medications ordered, rather than the “number of unique patients with at least one medication in the patient’s medication list”, (since that list often includes medications downloaded from Surescripts and prescribed by other providers.) There is already a CMS FAQ (#10369) that allows providers to use this alternate definition even in 2012.

The government is listening, so make your voice heard. Use your experience in Meaningful Use Stage 1 to influence Meaningful Use Stage 2. Submit your comments on the Proposed Rule for Stage 2.

April 9, 2012 I Written By

Lynn Scheps is Vice President, Government Affairs at EHR vendor SRSsoft. In this role, Lynn has been a Voice of Physicians and SRSsoft users in Washington during the formulation of the meaningful use criteria. Lynn is currently working to assist SRSsoft users interested in showing meaningful use and receiving the EHR incentive money.

Switching EHRs Mid-Stream – Meaningful Use Monday

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Lynn Scheps is Vice President, Government Affairs at EHR vendor SRSsoft. In this role, Lynn has been a Voice of Physicians and SRSsoft users in Washington during the formulation of the meaningful use criteria. Lynn is currently working to assist SRSsoft users interested in showing meaningful use and receiving the EHR incentive money. Check out Lynn’s previous Meaningful Use Monday posts.

With all the attention that meaningful use Stage 2 has received in the last 2 weeks, it’s easy to forget that most providers are just ramping up for meaningful use stage 1 and are still trying to understand the requirements they must satisfy for the next 2 years. So I’m going to let the dust settle a bit on the Stage 2 proposal and go back to addressing lingering questions about Stage 1.

Last week’s post talked about the increased frequency with which providers are switching EHRs. Some are replacing legacy EHRs that are not ONC-certified in order to qualify for meaningful use incentives, while others are switching from one certified EHR to another to better meet their practice needs. An EMR and HIPAA reader who is changing EHRs in mid (meaningful use) stream submitted the following question:

Q:  “If we attest for 2011, then 3-4 months into 2012 we change to another software vendor, is there a way to attest using both software vendors since we have to combine or run reports to attest for the whole year of 2012?”

A: Yes, you can attest using both EHRs—in fact, you must report from both EHRs. First, enter both certified complete EHRs into the Certified Health IT Product List (CHPL) website to generate a new EHR Certification ID number to use for 2012 attestation. You will need to combine the results, measure by measure including clinical quality measures, from the two sets of reports that you run. For measures that require a count of actions, this is fairly easy—you simply add the numerators and denominators. Where this becomes somewhat challenging is in reporting measures where the denominator is “unique patients.” According to a CMS FAQ regarding a similar situation, (i.e., providers who see patients in multiple locations with different certified EHRs), “…it is the responsibility of the EP….to reconcile information from multiple certified EHR systems in order to ensure that each unique patient is counted only once for each objective.”  No further guidance is provided on how to accomplish that.

March 12, 2012 I Written By

Lynn Scheps is Vice President, Government Affairs at EHR vendor SRSsoft. In this role, Lynn has been a Voice of Physicians and SRSsoft users in Washington during the formulation of the meaningful use criteria. Lynn is currently working to assist SRSsoft users interested in showing meaningful use and receiving the EHR incentive money.

Meaningful Use Stage 2 Commentary and Resources – Meaningful Use Monday

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For this week’s Meaningful Use Monday, I decided I’d go through the large list of meaningful use stage 2 commentary that’s been put out over the past week. I’ll do my best to link to some of the most interesting commentary, summaries, etc of meaningful use stage 2 and point out some resources that I’ve found useful.

John Halamka on Meaningful Use Stage 2
First up is the blog post by John Halamka about MU stage 2. I really like his recommendation to read pages 156-163 of the MU rule (PDF here). Sure, the rule is 455 pages, but many of those pages are a recap of things we already know or legalese that is required in a government document. Halamka also created a meaningful use stage 2 powerpoint that people can reuse without attribution. Worth looking at if you’re not familiar with MU stage 2 or if you have to make a presentation on it.

Health Affairs on MU Stage 2
Health Affairs has a nice blog post covering meaningful use stage 2. They offer “3 highlights that seem particularly important:”

  1. The bar for meeting use requirements for computerized provider order entry (CPOE), arguably the most difficult but potentially the most important EHR functionality, has been raised: now a majority of the orders that providers write will have to be done electronically.
  2. There is a major move to tie quality reporting to Meaningful Use. We knew this was coming, but CMS has laid out a host of quality measures that may become requirements for reporting through the EHR.
  3. Health Information Exchange moves from the “can do it” to the “did do it” phase. In Stage 1, providers had to show that they were capable of electronically exchanging clinical data. As expected, in Stage 2, providers have to demonstrate that they have done it.

Health Affairs also talks about the timeline for this rule and the feedback that CMS is likely to get on MU stage 2. I’m sure they’re going to get a lot of feedback and while they suggest that the rule will look quite similar to the proposed rule, I expect CMS will make a couple strong changes to the rule. If nothing else to show that they listened (and I think they really do listen).

Stage 2 Meaningful Use by The Advisory Board Company
The Advisory Board Company has a good blog post listing the 10 key takeaways on stage 2 of meaningful use. Below you’ll find the 10 points, but it’s worth visiting the link to read their descriptions as well.
1. Centers for Medicare & Medicaid Services (CMS) affirms a delay for 2011 attesters.
2. Stage 1 requirements will be updated come 2013.
3. Medicaid definitions are loosened; more providers are eligible.
4. While the total number of objectives does not grow, Stage 2 measure complexity increases significantly.
5. Information exchange will be key, but a health information exchange (HIE) will not be necessary.
6. Patients will need to act for providers to succeed.
7. Sharing of health data will force real-time, high-quality data capture.
8. More quality measures; CMS’ long term goals—electronic reporting and alignment with other reporting programs—remain intact.
9. The Office of the National Coordinator’s (ONC) sister rule proposes a more flexible certification process and greater utilization of standards.
10. Payment adjustments begin in 2015.

AMA MU Stage 2
The American Medical News (done by the AMA) has a blog post up which does a good job doing an overall summary of where meaningful use is at today (post MU stage 2). Meaningful Use experts will be bored, but many doctors will appreciate it.

Justin Barnes on Meaningful Use Stage 2
Justin Barnes provides his view on meaningful use stage 2 in this HealthData Magement article. It seems that Justin (and a few other of his colleagues at other EHR vendors) have made DC their second home as they’ve been intimately involved in everything meaningful use. I found his prediction that the meaningful use stage 2 “thresholds and percentages will remain largely in place come the Final Rule targeted for August, and should not be decreased via the broader public comment phase next underway like we saw with Stage 1.” Plus, he adds that the 10 percent of patients accessing their health information online will be a widely discussed topic. Many don’t feel that a physician’s EHR incentive shouldn’t be tied to patients’ actions. Add this to the electronic exchange of care summaries for more than 10 percent of patients and the healthcare data is slowly starting flow.

Meaningful Use Stage 2 and Release of Information
Steve Emery from HealthPort has a guest post on HIT Consultant that talks about how meaningful use stage 2 affects ROI. This paragraph summarizes the changes really well:

The bottom line for providers is that Stage 2 MU changes with regards to these specific criteria will drive organizations to implement a patient portal or personal health record application; and connect their EHR systems to these systems. Through these efforts it is expected that patient requests to the HIM department for medical records will decrease; as patients will be able to obtain records themselves, online and at any time.

e-Patients and Meaningful Use Stage 2
e-Patient Dave got together with Adrian Gropper MD, to put together a post on meaningful use stage 2 from an e-Patient perspective. This line sums up Adrian Gropper MD’s perspective, “My preliminary conclusion is that Stage 2 is a huge leap toward coordinated, patient-centered care and makes unprecedented efforts toward patient engagement.”

Meaningful Use Stage 2 Standards
Those standards geeks out there will love Keith Boone’s initial review and crosswalks from this rule to the Incentives rule here.

Shahid Shah on Meaningful Use Stage 2
I like Shahid Shah’s (the Healthcare IT Guy) overview and impressions as well. He’s always great at giving a high level view of what’s happening in healthcare IT.

Are there any other meaningful use stage 2 resources out there that you’ve found particularly useful or interesting?

March 5, 2012 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 5000 articles with John having written over 2000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 9.3 million times. John also recently launched two new companies: InfluentialNetworks.com and Physia.com, and is an advisor to docBeat. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and Google Plus. Healthcare Scene can be found on Google+ as well.

The Meaningful Use Stage 2 Proposed Rule: Highlights for Providers – Meaningful Use Monday

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Lynn Scheps is Vice President, Government Affairs at EHR vendor SRSsoft. In this role, Lynn has been a Voice of Physicians and SRSsoft users in Washington during the formulation of the meaningful use criteria. Lynn is currently working to assist SRSsoft users interested in showing meaningful use and receiving the EHR incentive money. Check out Lynn’s previous Meaningful Use Monday posts.

Although I cannot claim to have read through the entire 455-page Proposed Rule on Stage 2 Meaningful Use, the fact that it is shorter than the 864-page rule that defined Stage 1 does not mean that it is simpler—it just requires less explanation since the basic structure of the program has not changed.

Rather than trying to summarize the Rule at this point, I am just going to point out some highlights gleaned from the presentations at HIMSS last week and from my quick skim through the document:

  • The meaningful use bar has been raised significantly for Stage 2.
  • The earliest that any providers will be subject to Stage 2 requirements is 2014; all EPs operate under Stage 1 requirements for their first 2 years of participation, regardless of when they first enter the program.
  • Most measures have higher thresholds, some have increased complexity, and new measures have been added.
  • Providers have fewer choices—there are 17 Core Measures that all providers must meet (subject to the same types of exclusions as Stage 1), all Stage 1 Menu Measures except syndromic surveillance become Core Measures, and providers will have to meet 3 of the 5 Stage 2 Menu Measures.
  • True interoperability is required—Stage 2 no longer asks providers to test their ability to exchange clinical data, but rather requires them to successfully exchange information on an ongoing basis across organizational and EHR vendor boundaries.
  • Providers will be accountable, to some degree, for actions by patients. For example, it will no longer be sufficient to make clinical information available to patients online—in Stage 2, a percentage of patients will have to actually access this information.
  • Providers will have the flexibility to purchase just the capabilities that they need to meet meaningful use—e.g., a chiropractor who does not prescribe will not have to have an EHR with ePrescribing capabilities, and a provider who is still at Stage 1 will not have to possess the meaningful use capabilities relevant to Stage 2 (until he gets to Stage 2).
  • Providers will report on 12 clinical quality measures, and there will be a broader array of measures from which to choose. One option under consideration would consolidate reporting for meaningful use and PQRS.
  • 2015 penalties can be avoided by demonstrating meaningful use in 2013, or for those who enter the program in 2014, by successfully attesting no later than October 3, 2014.

For more information, see the CMS Stage 2 Meaningful Use Fact Sheet.

February 27, 2012 I Written By

Lynn Scheps is Vice President, Government Affairs at EHR vendor SRSsoft. In this role, Lynn has been a Voice of Physicians and SRSsoft users in Washington during the formulation of the meaningful use criteria. Lynn is currently working to assist SRSsoft users interested in showing meaningful use and receiving the EHR incentive money.

Are Retiring Physicians Eligible for Incentives? – Meaningful Use Monday

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Lynn Scheps is Vice President, Government Affairs at EHR vendor SRSsoft. In this role, Lynn has been a Voice of Physicians and SRSsoft users in Washington during the formulation of the meaningful use criteria. Lynn is currently working to assist SRSsoft users interested in showing meaningful use and receiving the EHR incentive money. Check out Lynn’s previous Meaningful Use Monday posts.

As the industry anxiously anticipates the Proposed Rule for Stage 2 meaningful use—likely expected during HIMSS this week—many providers are still struggling to understand meaningful use Stage 1. So while we wait for the impending news story to break, let me address another question that was recently posed by a reader. 

Q: Can a physician attest and earn a Medicare EHR incentive for his second reporting year if he will be retiring in the middle of the year? 

A: To my surprise, this situation is not explicitly addressed in the regulations. One would think that a physician who works full time for part of the year would be just as eligible as one who works part time for the full year. The retiring physician, however, faces two obstacles: 1) The regulations require that an EP report for an entire calendar year after receiving a first meaningful use payment. 2) The EP must have an active enrollment record in PECOS (Medicare) to be eligible to attest—if he retires and withdraws from Medicare, he would no longer have active status. These factors suggest that a retiring physician is not eligible for an incentive (unless, of course, he times his retirement for the end of the year!)

In lieu of a definitive answer to the question, however, I offer the following food for thought: 1) Couldn’t the retiring physician simply wait until December 31 to attest and then report on the full calendar year? 2) What if he simply postpones surrendering his PECOS enrollment until the end of the year? (According to a local Medicare contractor, nothing prohibits him from doing that even though he would no longer be submitting claims.) If there are countervailing reasons not to do this that readers are aware of—and there may well be—please share your insights by commenting below. 

(Note: This is not an issue for retiring physicians in their first incentive year since they attest immediately upon the conclusion of their 90-day reporting period.)

February 20, 2012 I Written By

Lynn Scheps is Vice President, Government Affairs at EHR vendor SRSsoft. In this role, Lynn has been a Voice of Physicians and SRSsoft users in Washington during the formulation of the meaningful use criteria. Lynn is currently working to assist SRSsoft users interested in showing meaningful use and receiving the EHR incentive money.

Big Health IT News Flowing – ICD-10 Delayed, Meaningful Use Stage 2 Imminent, and More

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If you live and love the EMR, EHR and Healthcare IT world like I do, then you’re enjoying all the big news that’s coming out right now. A part of me thinks that the big news is coming out because HIMSS is so close, but some of the news seems like it might not necessarily be timed directly to HIMSS. (To see company news coming out at HIMSS, check out our EMR, EHR and Healthcare IT News site.)

For those not keeping track, here’s a quick run down of some of the major news pieces I’ve seen that really point to larger trends in healthcare IT:

Meaningful Use Stage 2
We know that meaningful use stage 2 is imminent. It’s just a question of when we’re going to hear it. In fact, it might be announced as I’m writing this post. Neil Versel first queued us into the Meaningful Use Stage 2 Announcement prior to HIMSS, but the Twittersphere is also full of rumors about the announcement. Brian Ahier commented on my Facebook message about it:

Nothing is official until it’s released, but since Monday is a holiday it is very unlikely they will wait until next week. My understanding is that the review at the OMB is complete and the proposed rule is ready to be published…

For those who want a sneak preview on what to expect in meaningful use stage 2, check out Jennifer Dennard’s meaningful use stage 2 post.

ICD-10 Delayed
Many have wondered if ICD-10 would be delayed with most arguing that 5010, meaningful use and ICD-10 was a lot to change all at once. Two days ago I got an email from someone saying they thought ICD-10 wouldn’t be delayed. I replied that I wasn’t sure either way, but it seemed like there was movement that could make a delay quite possible. Although, I must admit that I didn’t even think the ICD-10 delay announcement would happen so quickly.

Regardless of prognostication, ICD-10 is going to be delayed. You can read my thoughts on the ICD-10 Delay on EMR Thoughts.

HIMSS Acquires mHealth Summit
Maybe this feels like bigger news since it’s so close to HIMSS and I can see how powerful this conference has become. You can read the press release on the acquisition here. This isn’t that surprising since HIMSS had partnered with the mHealth Summit last year. I think this spells really good things for the growth of the mHealth Summit. I’m not sure I’d want to be another mHealth conference, but there’s a niche for the right event.

I still have a hard time distinguishing mHealth from healthcare IT in general. There could be some differentiation, but I still believe that over time the dividing line between the two is going to be hard to see. Richard Scarfo, HIMSS’ vice president of vendor events (previously mHealth Summit director) is right to be concerned that it will be HIMSS 2.0.

Navinet Acquired by Blues Plans and Lumeris
Read more about the acquisition here. I must admit that I’m still trying to process exactly what this means. Although, one thing I’m sure it means we’re moving the tectonic ACO plates that will be necessary to change how we pay for healthcare.

Vince Kuraitis and Leonard Kish provide some interesting insight in this Google+ thread asking whether this is a shift from institution (enterprise) centered IT to patient centric IT or if it’s becoming payer centric IT. They also mention United’s restructuring of payments and Aetna’s acquisition spree as indicators of the shifting plates of healthcare reimbursement.

Aneesh Chopra as Senior Advisor to the Advisory Board Company
This isn’t as big of news, but it just came out so I thought I’d throw it in. For those that don’t know Aneesh Chopra is now former CTO of the US. Everyone just wondered what he’d do next. Brian Ahier posted that Aneesh Chopra landed at The Advisory Board Company where he worked previously for about 10 years. Looks like Aneesh and his energy and enthusiasm will still be around healthcare. I think that’s a very good thing.

February 17, 2012 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 5000 articles with John having written over 2000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 9.3 million times. John also recently launched two new companies: InfluentialNetworks.com and Physia.com, and is an advisor to docBeat. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and Google Plus. Healthcare Scene can be found on Google+ as well.

The Financial Implications of Skipping Years and Switching Incentive Programs – Meaningful Use Monday

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Lynn Scheps is Vice President, Government Affairs at EHR vendor SRSsoft. In this role, Lynn has been a Voice of Physicians and SRSsoft users in Washington during the formulation of the meaningful use criteria. Lynn is currently working to assist SRSsoft users interested in showing meaningful use and receiving the EHR incentive money. Check out Lynn’s previous Meaningful Use Monday posts.

A reader posed the following question: What happens if a physician receives a Medicaid EHR incentive in 2011, no longer meets the 30% eligibility threshold for Medicaid in 2012 and therefore elects not to apply for any incentive that year, and then has to switch to the Medicare program in 2013 because his Medicaid volume is still too low to qualify under Medicaid? Below is a follow-up to a prior post, (“Switching Between Medicare and Medicaid Incentive Programs”), that provides the additional information needed to not only answer this particular question, but also to evaluate the financial impact of other scenarios in which a provider might skip years and/or switch between programs. 

Here are the rules regarding switching programs and skipping years:

  • An EP can switch between programs only once after receiving his first incentive payment, and the switch must occur in 2014 or earlier.
  • When an EP switches programs, he is “placed in the payment year he would have been in had he begun in—and remained in—the program to which he has switched.”
  • Medicare and Medicaid treat skipping years differently. Medicare incentives require that payment years be consecutive—so while an EP can skip a year, if he does, he forfeits that year’s incentive permanently. Medicaid incentive payments, on the other hand, can be non-consecutive with no adverse impact on total available revenue.
  • The last year that payments will be available also differs between the two programs. Under Medicare, no payments will be made after 2016, whereas EPs have until 2021 to earn incentives under Medicaid.
  • Although an EP who switches to or from the Medicare program could—under certain circumstances—earn more than the total Medicare incentives ($44,000), in no cases would any EP be paid more than the maximum available under Medicaid ($63,750). 

To get back to the physician in the reader’s question, when he switches to the Medicare program after skipping 2012, 2013 would be considered (and paid as) his third payment year. 

Confused? To analyze the financial implications of switching programs and/or skipping a year under scenarios that might apply to your practice, make a chart and do the math—taking into account the above rules and the schedules of annual incentives.

February 6, 2012 I Written By

Lynn Scheps is Vice President, Government Affairs at EHR vendor SRSsoft. In this role, Lynn has been a Voice of Physicians and SRSsoft users in Washington during the formulation of the meaningful use criteria. Lynn is currently working to assist SRSsoft users interested in showing meaningful use and receiving the EHR incentive money.