Getting the most from the HITECH Act, EHR Solutions and Health Information Technology
PSS makes it easy to get the information you need, and capture the reimbursement you deserve.
Meaningful Use. HITECH Act. EHR solutions. EHR incentives. As deadlines loom and physician practices incorporate Health Information Technology into their daily routines, terms like these are becoming part of the industry's everyday vocabulary. As part of our commitment to strengthening the clinical and business outcomes of physicians and health care providers, PSS is here to help you sort through the details - and to find the best EHR and H.I.T. solutions for your practice. Health Information Technology offers multiple benefits for physician practices that utilize it correctly. More and more, H.I.T. is viewed as a valuable tool for improving the quality, safety and efficiency of the health care delivery system.
Specifically, Health Information Technology can help:
• Prevent medical errors
• Increase backoffice efficiencies
• Cut down on paperwork
• Reduce health care costs
• Give more patients access to affordable care
How the HITECH Act can help you integrate H.I.T. and EHR solutions:
HITECH, part of the American Recovery and Reinvestment Act signed into law in February 2009, provides up to $44,000 in Medicare EHR incentives for eligible providers who demonstrate Meaningful Use of certified EHR technology. Incentives begin in 2011, and reduce each year through 2015. Eligible providers who do not adopt certified EHR technology will be penalized via a 1% reduction in Medicare fees. After 2017, that penalty rises to 3%. Click here for the Medicare and Medicaid EHR incentive payouts under HITECH. An eligible provider who can demonstrate Meaningful Use of certified EHR technology in 2011 would be eligible to receive $18,000 from Medicare for the first year and $44,000 in total through 2015. Incentives for adoption are reduced after 2012.
Eligible providers who treat a high volume of Medicaid patients can qualify for up to $63,750 in incentives through the Medicaid program.
For both the Medicare and Medicaid EHR incentive programs, any first year of "Meaningful Use" requires only a consecutive 90 day period, not the full year. A full year requirement would occur in the second year of participation for the Medicaid program participants, as the Medicaid EHR incentive program pays for acquisition and implementation of EHR technology the first year, without being required to achieve "Meaningful Use" criteria that first year. Also, the Medicare penalties start in 2016 only for those who are not in the process of becoming "Meaningful Users" by 2016.
The Medicare program extends to 2016 for those who start any year after 2011. In other words, the last payment is in 2015 only for those who begin in 2011. For a start year of 2012 or later, the payments conclude in calendar year 2016.
The Medicare program application date is January 1, 2011 and the earliest attestation date is May, 2011.
Eligible Providers (EPs) Eligible for Both Programs
If you are an EP that is eligible for both the Medicare and the Medicaid incentive programs, you can only participate in one program, not both. You will need to select which program you want to participate when you register. Here are the general differences:
NOTE: Before 2015, an eligible professional may switch between the programs one time after the first incentive pay ment is initiated. Click here for a flow chart to determine your eligibility.
For more detailed information regarding eligible providers, click here.
Electronic Health Records Meaningful Use objectives consists of 20 objectives:
15 core objectives and five additional objectives must be met to qualify for stimulus payments during the first phase of the EHR incentive program. Of the 5 additional measures, either submission of electronic immunization data to local immunization registries, or , submission of syndromic surveillance data to public health agencies is required. So, participants get to pick one of those, and then four from the other menu objectives and measures.
Eligible Professional Core Measures
- Use computerized provider order entry (CPOE) for medication orders directly entered by any licensed healthcare professional who can enter orders into the medical record per state, local and professional guidelines.
- Implement drug-drug and drug-allergy interaction checks.
- Maintain an up-to-date problem list of current and active diagnoses.
- Generate and transmit permissible prescriptions electronically (eRx).
- Maintain active medication list.
- Maintain active medication allergy list.
- Record all of the following demographics:
- Preferred language
- Gender
- Race
- Ethnicity
- Date of birth
- Record and chart changes in the following vital signs:
- Height
- Weight
- Blood pressure
- Calculate and display body mass index (BMI)
- Plot and display growth charts for children 2–20 years, including BMI.
- Record smoking status for patients 13 years old or older.
- Report ambulatory clinical quality measures to CMS or, in the case of Medicaid EPs, the States.
- Implement one clinical decision support rule relevant to specialty or high clinical priority along with the ability to track compliance with that rule.
- Provide patients with an electronic copy of their health information (including diagnostics test results, problem list, medication lists, medication allergies) upon request.
- Provide clinical summaries for patients for each office visit.
- Capability to exchange key clinical information (for example, problem list, medication list, allergies, and diagnostic test results), among providers of care and patient authorized entities electronically.
- Protect electronic health information created or maintained by the certified EHR technology through the implementation of appropriate technical capabilities.
- Implement drug formulary checks.
- Incorporate clinical lab-test results into EHR as structured data.
- Generate patient lists by specific conditions to use for quality improvement, reduction of disparities, research, or outreach.
- Send patient reminders per patient preference for preventive/follow-up care.
- Provide patients with timely electronic access to their health information (including lab results, problem list, medication lists, and allergies) within 4 business days of the information being available to the EP.
- Use certified EHR technology to identify patient-specific education resources and provide those resources to the patient if appropriate.
- The EP who receives a patient from another setting of care or provider of care or believes an encounter is relevant should perform medication reconciliation.
- The EP who transitions their patient to another setting of care or provider of care or refers their patient to another provider of care should provide summary care record for each transition of care or referral.
- Capability to submit electronic data to immunization registries or immunization information systems and actual submission according to applicable law and practice.
- Capability to submit electronic syndromic surveillance data to public health agencies and actual submission according to applicable law and practice.
View or Download ALL eHR Meaningful Use Core and Menu Set Measures
A detailed list of care goals, objectives, and measures can be found here.
The HITECH Act also provides guidance and funding for establishing at least 62 regional extension centers (RECs) to help promote EHR adoption. Regional centers will offer "technical assistance, guidance, and information on best practices to support and accelerate health care providers' efforts to become Meaningful Users of Electronic Health Records." Regional extension centers are tasked to: "Specifically focus on helping providers select the highest-value option, defined as that which offers the greatest opportunity to achieve and maintain Meaningful Use of EHRs and improved quality of care at the most favorable cost of ownership and operation, including both the initial acquisition of the technology, cost of implementation, and ongoing maintenance and predictable needed upgrades over time." Learn more about the Regional Centers here.
Medicare Advantage Organization Eligible Professionals: The Medicare Advantage EHR incentive program is structured differently than the Medicare EHR incentive program for Medicare Fee-for-Service providers.
