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Effect of EMR Stimulus Money Flowing

Posted on May 20, 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.

Yesterday on EMR News, we posted about the first case I’ve seen where someone has collected EHR stimulus money after attesting to meaningful use.

It’s the day many have been waiting for. The first checks arrive for those showing meaningful use of a certified EHR (Medicaid had sent some EHR Stimulus checks previously). Yes, the government really is going to pay out the money. Yes, people really are getting paid. In fact, it seems that they’ve pretty much stuck to their schedule for meaningful use stage 1 and paying out the first EHR stimulus checks. Props to the people at CMS and ONC for being able to stick to that schedule (even if meaningful use stage 2 might be delayed).

I do have to say that an electronic bank transfer isn’t nearly as exciting as a check in the mail. Plus, a picture of someone checking their online banking isn’t as compelling as a picture of someone with a check. So, technology has hurt the visible image that would illustrate this occasion. However, the “shovel ready” ARRA stimulus money has started to flow (sorry I had to point out the irony of “shovel ready” or lack therof).

Since seeing the news, I’ve wondered whether the cash flowing will have the impact on doctors that one would expect. Will doctors start saying, “I want to get my EMR stimulus check!”? Certainly the cash has just started flowing and so we can’t fully assess the impact of these first checks. However, I personally think that the cash flowing will provide little momentum to EHR adoption.

First, from those I interact with, there aren’t that many fence sitters. Most have already decided to do EMR or not to do EMR. The flow of money would be great to get the fence sitters off the fence, but I don’t believe it’s strong enough to get those against EMR to finally go for it.

Second, the lack of certainty around meaningful use stage 2 and 3 is a major concern. Most people aren’t and shouldn’t be concerned with the payments for meaningful use stage 1 (unlike PQRI incentives). Why should they be? After all, it’s a self attestation process for meaningful use stage 1. Check the right check boxes and give them the right numbers and you get paid. However, the same certainty isn’t available around MU stage 2 and 3. We don’t know how it will be measured nor what it will include.

Third, it takes real time for the word of mouth discussions between doctors to disperse in the medical community. Will the message of stimulus money get out quickly enough for it to matter to most doctors who are mostly against an EHR?

It’s great to see the EHR stimulus money flowing. We’re still in a wonderful EHR and healthcare IT bubble that will continue for at least another couple years. However, EHR incentive money flowing isn’t going to contribute much to that bubble.

Meaningful Use Measures: Clinical Quality Measures – Meaningful Use Monday

Posted on April 11, 2011 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.

I am starting the discussion of the individual meaningful use measures with “reporting on clinical quality measures (CQM)” for two reasons: It is one of the three pillars of meaningful use identified in the legislation, and it is a measure that appears to be causing a great deal of confusion.

Just one of the 15 core measures required of meaningful users, it sounds a lot like PQRI (now PQRS); and many of the measures are, in fact, taken from that program. However, unlike PQRS, meaningful use requires reporting only—it does not set required thresholds, at least not in Stage 1—and reporting is not limited to Medicare patients. Interestingly, physicians can earn both PQRS and EHR Incentives in the same reporting period (in contrast to ePrescribing and EHR incentives.)

While EPs cannot exclude this measure, providers can report “0”s (for denominators and numerators) if they cannot find measures that apply to their patient population.

The Final Rule shortened the list of quality measures contained in the Proposed Rule—eliminating the specialty-specific measure sets—and created a list of 44 CQMs from which EPS must choose. Some specialists perceived this change as good news, while others were disappointed.

Reporting Requirements:

Eligible professionals must report on 3 “Core CQMs” and 3 “Additional CQMs” as follows:

  • There are 3 Required Core CQMs” (Hypertension, Smoking Cessation, and Adult Weight Screening) and 3 “Alternate Core CQMs” (Weight Assessment for Children, Flu Vaccinations for Patients over 50, and Childhood Immunizations.) EPs must report on the 3 Required Core CQMs. If a physician reports “0”s for one or more of the 3 Required Core CQMs, he/she must then report on up to 3 Alternate Core CQMs. (Some specialists, therefore, may have to report on as many as 6 core CQMs.)
  • There are 38 Additional CQMs from which physicians must also select 3. Again, there will be some specialists who find few measures, if any, that are relevant to their patient populations. They must still report on 3 of these measures with actual numerators and denominators where possible and “0”s for the others.

You can read more about the quality measures and their specifications in the Final Rule, pages 44398-44408, and on the CMS website.

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.

Meaningful Use Monday: How Will You Actually Get Your Meaningful Use Money?

Posted on March 14, 2011 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.

There is a great deal of skepticism about when EHR incentives will be paid and how providers will actually get their money. This is not surprising, given the negative early experiences with the PQRI program and the fact that ePrescribing providers are having to wait until September or October to receive their bonuses for the prior year for the MIPPA incentive program.

The good news is that CMS is promising to distribute the first EHR incentives in May, following successful attestations of meaningful use for the initial 90-day reporting period.

So how will this happen? A common misconception is that the first year incentives are automatically $18,000. According to the legislation, the incentives are earned at a rate of 75% of Medicare Part B FFS Allowable Charges up to the maximum, (i.e., $18,000 for year 1). What this means is that once a provider successfully attests to meeting meaningful use, CMS will check to see if he/she has generated sufficient Medicare revenue to warrant the $18,000 incentive—i.e., $24,000 in charges. If so, CMS will issue the check. If not, CMS will wait until the provider reaches $24,000 and then release the incentive payment. For the few providers with very small Medicare populations, CMS will wait until February 2012 to receive all of the provider’s claims for 2011, and then send an incentive in the amount of 75% of his/her 2011 Medicare charges.

Lynn Scheps is Vice President, Government Affairs at EMR 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.