HITECH Overview and the Requirement of Doctors to use Electronic Medical Records

The American Recovery and Reinvestment Act of 2009 has been passed. Physicians are required to move from paper based medical charts to computerization. Sorry, docs.

The cost of incentives is estimated to be $19 billion in increased Medicare and Medicaid payments. Probably a moving target.

The Act includes a portion known as HITECH (Healthcare Information Technology for Economic and Clinical Health to encourage electronic medical records (EMR). The incentive portion starts in 2011: a physician who is a "meaningful user" of EMR is eligible to receive additional payments under the Medicare program that can extend over five years. The penalty portion starts in 2015, when physicians who are not meaningful EHR users will begin to see declines in their Medicare payments. The incentive payment schedule is as follows for encouraging EMR adoption:

2011 $18,000
2012 $12,000
2013 $ 8,000
2014 $ 4,000
2015 $ 2,000

The loger you wait, the more you lose out. Thinking of retiring or selling your practice, missing out on the whole need to participate in the HITECH program and the change to EMR? Consider this: buy a EMR in 2011 and have a fully implemented EMR in place, adding 20% to your sell price!

Under the penalty provisions, physicians who are not meaningful EHR users in 2015 will see a 1% reduction in their fee schedule amount. The reduction increases to 2% in 2016, and 3% in 2017 and each subsequent year.

As for “meaningful use”, this simply means that the EMR system must be certified by the CCHIT organization or a qualified private validation firm. The EMR must pass inspection, like your care to be recognized. EMR vendors have been paying about $30,000 for the stamp of approval. That’s an expensive stamp.

There are HUNDREDS of EMR systems and resellers to chose from. Expect phone calls.

If HHS finds that by 2017, the proportion of physicians who are meaningful EHR users is less than 75%, HHS may continue to scale back payments by 1% a year (but may not reduce payments below 95%). There will be some exceptions based on socioeconomic and geographical considerations.

To be a "meaningful EHR user", the physician must satisfy three criteria: e-Prescribing, exchanging information and sending measured/requested data to HHS.

HHS will designate the way in which a physician is recognized as a meaningful user (through attestation, submission of claims with codes indicating that a patient encounter was documented using certified EHR technology, survey responses, submission of quality reports, or other means).

The Act also authorizes state Medicaid programs to provide additional payments to physicians, at least 30% of whose patient volume is services to Medicaid beneficiaries.

In addition to HITECH, $2 billion is available as to ONCHIT Coordinator, Dr. David Blumenthal for implementation of the programs, including grants to states to establish loan programs for physicians seeking to acquire certified EHR systems., Health Information Exchanges (HIEs) and Regional Extension Centers (RECs).

Keep checking back with the gang at MyEMRchoice. The HITECH Act has all the markings of a policy that can change quicker than the weather in Texas.