| Maximizing
Stimulus Incentives for your Organization
On February 17th, President Obama signed the
2009 American Recovery and Reinvestment Act, allocating
$19.2 billion for health information technology.
The provision of the legislation known as the
HITECH Act will be distributed as follows
- $17.2
billion incentive payments for EHR use.
- $2 billion is available for grants and loans for
health information technology advancement.
When coupled with existing measures, these funds
represent significant income opportunities for
existing EHR users and to assist new users with
adoption related costs.
The maximum potential incentives available are
as follows:
| |
Private Practice |
Non-FQHC Safety Net |
FQHC |
| Medicare HITECH Incentive |
$48,400 per provider |
$48,400 per provider |
$48,400 per provider |
| Medicaid HITECH Incentive |
- |
$65,000 per provider |
$65,000 per provider |
| e-prescribing bonus |
2% bonus |
2% bonus |
2% bonus |
| Medicare PQRI |
2% bonus |
2% bonus |
- |
| Medicare MCMP |
$12,500 per provider |
$12,500 per provider |
- |
Providers not currently on an EHR who wish to
take greatest advantage of the incentives should
begin the selection process now in order to be
implemented by 2011. Existing EHR users should
ensure that they meet requirements for each incentive
program and bring on board any other providers
in their organization still reluctant to make
the change.
Summaries of each opportunity, adoption requirements
and details about how N2 Technologies can partner
with you to maximize your bonuses are provided
below. Some initiatives are still in defining
stages; please use our website (http://www.n2networks.net/news.html)
for updates as new information becomes available.
HITECH Act
The HITECH Act was created to encourage EHR adoption
and stimulate the economy by providing direct
bonuses to providers. Both new and existing EHR
users qualify for the incentives.
Many of the detailed requirements of the HITECH
Act are awaiting the new Health and Human Services
Secretary for final definition. What is known
so far is:
Qualifying EHRs must meet certification standards
defined by the HHS secretary. This is expected
to be the existing CCHIT certification, which
already includes products provided by N2 Technologies
(SuiteMed or Lytec MD http://www.n2networks.net/Medical.html
) at a minimum, certified EHRs will need to be
capable of:
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- Providing clinical decision support
|
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- Supporting physician order entry
|
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- Capturing and querying information relevant
to health care quality
|
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- Exchanging electronic health information
from other sources
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The provider must be able to demonstrate “meaningful
use” which includes
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- Electronic exchange of information to
improve quality and care coordination,
including e-prescribing
|
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- Reporting on quality measures
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Medicare Incentive
Medicare will provide up to $44,000 per provider,
broken down in yearly payments as shown below.
After 2012 the incentives decrease, becoming zero
in 2015. An additional 10% is provided for physicians
operating in a designated Health Professional
Shortage Area (HPSA) (go to http://hpsafind.hrsa.gov/HPSASearch.aspx
to determine if you are located in an HPSA).
| |
Current User |
Adopt in 2011 |
Adopt in 2012 |
Adopt in 2013 |
Adopt in 2014 |
| 2011 |
$18,000 |
$18,000 |
- |
- |
- |
| 2012 |
$12,000 |
$12,000 |
$18,000 |
- |
- |
| 2013 |
$8,000 |
$8,000 |
$12,000 |
$15,000 |
- |
| 2014 |
$4,000 |
$4,000 |
$8,000 |
$12,000 |
$15,000 |
| 2015 |
$2,000 |
$2,000 |
$4,000 |
$8,000 |
$12,000 |
| 2016 |
- |
- |
$2,000 |
$4,000 |
$8,000 |
| Total |
$44,000 |
$44,000 |
$44,000 |
$39,000 |
$35,000 |
| HPSA |
$48,400 |
$48,400 |
$48,400 |
$42,900 |
$38,500 |
After 2015, CMS will begin introducing penalties
against providers not utilizing an EHR by decreasing
reimbursement.
The method for reporting to Medicare is awaiting
the new HHS Secretary’s definition.
Medicaid
Incentive
Medicaid may provide up to $65,000 per provider,
also broken down in yearly payments as shown below.
To receive funding, providers must qualify by
2016.
Unlike the Medicare plan, the exact payments
for the Medicaid plan are not fully determined.
The HHS Secretary will gather data to determine
the average costs associated with the installation,
adoption, maintenance, and support of certified
EHRs. The Medicaid incentive will be no more than
85% of these average costs. If the Secretary determines
the average cost per provider over five years
to be less than $76,500, the Medicaid payments
could be reduced.
This money is available either separately or
in conjunction with the Medicare incentive, although
the Medicare payment will be credited towards
the Medicaid payments if both are utilized. While
the Medicaid payments allow for greater potential
income and a longer adoption window than the Medicare
program, the requirements are much more complicated
and less defined.
Under the Medicaid plan, qualifying providers
must have a patient population comprised of at
least 30% needy patients. Pediatrics with a 20%
needy population qualify for 2/3 payment, while
those with 30% qualify for the full amount. The
legislation defines a needy patient as covered
by Medicaid, receiving services under Title XXI,
unable to pay, or receiving services on a sliding
scale due to inability to pay.
|
Current User |
Adopt in 2011 |
Adopt in 2012 |
Adopt in 2013 |
Adopt in 2014 |
Adopt in 2015 |
Adopt in 2016 |
|
$25,000 |
$25,000 |
- |
- |
- |
- |
- |
2012 |
$10,000 |
$10,000 |
$25,000 |
- |
- |
- |
- |
2013 |
$10,000 |
$10,000 |
$10,000 |
$25,000 |
- |
- |
- |
2014 |
$10,000 |
$10,000 |
$10,000 |
$10,000 |
$25,000 |
- |
- |
2015 |
$10,000 |
$10,000 |
$10,000 |
$10,000 |
$10,000 |
$25,000 |
- |
2016 |
- |
- |
$10,000 |
$10,000 |
$10,000 |
$10,000 |
$25,000 |
2017 |
- |
- |
- |
$10,000 |
$10,000 |
$10,000 |
$10,000 |
2018 |
- |
- |
- |
- |
$10,000 |
$10,000 |
$10,000 |
2019 |
- |
- |
- |
- |
- |
$10,000 |
$10,000 |
2020 |
- |
- |
- |
- |
- |
- |
$10,000 |
Total |
$65,000 |
$65,000 |
$65,000 |
$65,000 |
$65,000 |
$65,000 |
$65,000 |
Our website will be updated as details, including
the actual incentive amount chosen by the Secretary,
are determined. Contact us at 602-357-3450, sales@n2networks.net,
or http://www.n2networks.net/contact.html
and give us your email address to receive an update
as soon as this information becomes available.
Grants
The stimulus act also providers grant monies
aimed at Community Health Centers, Rural Health
Centers, and Indian Health Centers. Some of this
money will come from HITECH while others will
come from other provisions elsewhere in the stimulus:
- $4.7 billion for the National Telecommunications
and Information Administration's Broadband
Technology Opportunities Program.
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- $2.5 billion for the U.S. Department
of Agriculture's Distance Learning, Telemedicine,
and Broadband Program.
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- $1.5 billion for the community health
centers through the Health Resources and
Services Administration.
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- $500 million for the Social Security
Administration.
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- $85 million for the Indian Health Service.
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- $50 million for the Veterans Benefits
Administration.
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E-Prescribing
Bonus
Beginning January 1, 2009, Medicare began offering
a bonus to providers utilizing a qualifying e-prescribing
system. The bonus is based on a percentage of
the Medicare allowable fee schedule and runs through
2014. Providers not utilizing a qualifying e-prescribing
system by 2012 will see a reduction in their Medicare
fee schedule.
Year |
Bonus |
Penalty |
2009 |
2.0% |
- |
2010 |
2.0% |
- |
2011 |
1.0% |
- |
2012 |
1.0% |
-.05% |
2013 |
0.5% |
-1% |
2014 |
- |
-2% |
A qualifying e-prescribing system must incorporate
the following functionality:
- Select medications, transmit prescriptions
electronically, and warn the prescriber
of possible undesirable or unsafe situations.
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- Generate an active medication list incorporating
electronic data received from applicable
pharmacies and benefit managers.
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- Provide information on lower-cost, therapeutically-appropriate
alternatives
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- Provide information on formulary or
tiered formulary medications, patient
eligibility, and authorization requirements
transmitted electronically from the patient’s
drug plan.
|
N2 Technologies EMR systems comply with the requirements.
Providers must report one of three HCPCS codes
on at least 50% of their Medicare claims. Incentive
payments for each year will be made by the middle
of the following year.
PQRI
The Physician Quality Reporting Initiative (PQRI)
provides up to 2% additional reimbursement based
on providers’ Medicare allowable fee schedule.
For 2009, the reporting program is based on 153
quality measures gathered by your EHR and submitted
on Medicare claims using special HCPCS codes developed
specifically for reporting. To qualify, providers
select at least three quality measures which must
be reported on at least 80% of Medicare claims.
MCMP
The Medicare Care Management Performance (MCMP)
program provides a one-time incentive for reporting
quality measures and then additional yearly incentives
for performance against those quality measures.
MCMP utilizes an electronic database called MCMP-PAT
through which providers enter the quality measures
for a pre-defined patient population.
| |
|
2007 |
2008-2010 |
| Pay for Reporting |
Max per Physician |
up to $1000 |
|
Max per Location |
up to $5000 |
up to $10,000 |
| Pay for Performance |
Max per Physician |
|
up to $10,000 |
Max per Location |
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up to $25,000 |
| EHR Bonus |
|
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- Additional 25% |
MCMP-PAT users can either manually enter the
data or can use a flat file feed from their EHR's
database into the tool. Providers using a CCHIT
certified EHR are entitled to an additional 25%
on top of their bonus. Providers will be able
automatically send the data to MCMP-PAT.
Additional Incentives
Many additional private and public financial
incentives are available, including:
- Payer incentives – Payers are offering
significant incentives for EHR use. Ask
your payer representatives to find out
what is available.
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- Hospitals – Through the Stark Law exceptions,
hospitals can provide EHR subsidies to
providers. This money is sometimes funneled
through local medical groups (eg IPAs,
MSOs). Check with your hospitals and medical
groups to determine what’s available in
your area.
|
- Local governments – Most state and local
governments are offering additional programs.
A helpful search tool, located at http://ehrdecisions.com/incentive-programs,
can provide information on programs applicable
to you.
|
- Pharmaceutical Companies and Research
– Pharmaceutical companies and research
groups, including universities, will sometimes
provide payment for de-identified patient
health information.
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Partnering with N2 Technologies
to Maximize Incentives
N2 Technologies and SuiteMed has become a forefront
leader in maximizing incentives for the EHR community
and we would like to partner with you to ensure
you’re optimally positioned to take full advantage
of this unique opportunity. N2 Technologies offers
a variety of services to assist you in meeting
the requirements for the incentive programs:
- SuiteMed EMO – Your complete Electronic
Medical Office. Scheduling, Billing and
EMR. Lab connects, electronic prescribing,
electronic claims, Automated Fax Server
integrated into the system, Vitals interface,
EKG interface, convert data from ANY other
system. CCHIT CERTIFIED
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- Specialties – We work with just about
any specialty with Program custom designed
and content specific to the way you practice.
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- Hardware/Networking – We are a full
IT company that can provide Computers,
Servers, support, maintenance at top quality
for the lowest price.
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Please contact us to discuss your organization’s
potential for maximizing these incentives.
N2 Technologies
http://www.n2networks.net/contact.html
Sales@n2networks.net
602-357-3450
Disclaimer: The information provided in this
white paper is not intended to constitute legal
or financial advice. N2 Technologies encourages
you to consult your attorney and financial advisor
prior to making any legal and/or financial decisions.
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