Presentation on theme: "Electronic Medical Records (EMRs) & The Stimulus Plan"— Presentation transcript:
1 Electronic Medical Records (EMRs) & The Stimulus Plan
2 Topics:I. Government Stimulus Act for Electronic Medical Records (EMRs)Medicare IncentivesMedicaid (Medical) IncentivesII. How to Qualify for Government Incentive Payments?What You Need to Participate in an EHR ProgramSpecifics of Stage 1 Meaningful UseBeyond Stage 1 Meaningful UseIII. Why SuiteMed IMS?CertificationIMS Meaningful Use Dashboard
3 I. American Recovery and Reinvestment Act Health Information Technology for Economic & Clinical Health (HITECH) Act
4 Stimulus ActIn February 2009, President Obama signed into law the American Recovery & Reinvestment Act, authorizing $27 billion to:Transform the healthcare system and improve thequalitysafety andefficiency of careConfidential information provided by AC Group, Inc.4
5 What Does This Mean to You as a Provider? Eligible Providers (EP) to receive from $44,000 to $63,750 in incentives from Medicare, or Medicaid over the next 5 years:As they adopt, implement & demonstrate meaningful use of certified EHR technologyIncentives available under only one of the programs for office-based providers
6 Medicare/ Medicaid Summary Table * Physicians (defined in Section1861 Social Security Act) include: doctors of medicine, osteopathy, dental surgery, dental medicine, podiatry, and optometry
8 I.A. Medicare IncentiveEligible professionals (EP) who are meaningful EHR users can receive up to $44,000 over 5 yearsThe incentive payment is equal to 75% of Medicare allowable charges for covered services furnished by the physician in a year, subject to a maximum payment (not to exceed this table).A hospital-based EP who furnishes 90% or more of their services in the hospital setting is not qualified as an EP to receive meaningful use incentives.Physicians operating in a "provider shortage area" will be eligible for an incremental increase of 10%.For the 1st year for which an EP applies for and receives an incentive payment (2011), the EHR Reporting Period is 90 days. After 2011, the EHR reporting period is the entire year.Physicians who do not adopt and use an EHR by 2015 will be penalized by reduced Medicare payments (to a potential maximum of 5%):
9 I.B. Medicaid Incentives Start20112012201320142015201620172018Total21,2508,500$63,750$55,250$46,750$38,250The Medicaid incentive payment program will begin January 1, 2011 for eligible professionals. An eligible professional can receive Medicaid incentive payments over a 6-year period with a first-year payment of up to $21,250 and five subsequent annual payments of up to $8,500. The eligible professional must demonstrate meaningful use of a certified EHR by the second payment year.9
10 I.B. Medicaid (Medical) Incentives Available to non-hospital based physicians, dentists, certified nurse midwives, and physician assistants – only if they lead providers in rural health clinics or FQHCsIncentive payments will go to Eligible Providers (EPs) as they adopt, implement, upgrade, or demonstrate meaningful use of certified EHR technology in their 1st year and for up to 5 remaining participation years.Upfront Funding: Start up incentives up to $21,250 for the purchase, implementation and upgrade of a certified EHR technology.After receiving start up funds, EPs who can prove “Meaningful Use” can receive up to $8,500 incentive payments for the next 5 years.To be eligible, more than 30% of patient volume must be attributable to Medicaid and/or Badger Care Plus (20% attributable to pediatrics).No penalties for lack of adoption (yet).Confidential information provided by AC Group, Inc.10
12 What You Need to Participate in an EHR Program: 1. Certified EHR Technology: All eligible professionals (EP) need to have certified EHR technology.Standards are now available in government sites, which establishes the required capabilities of that technology to support the achievement of meaningful use.2. NPI, NPPES Use Account and PECOS Enrollment: All Medicare eligible professionals must have a National Provider Identifier (NPI) & be enrolled in the CMS Provider Enrollment, Chain and Ownership System (PECOS) to participate in the EHR incentive program.Most will also need an active user account in the National Plan and Provider Enumeration System (NPPES).CMS will use these systems' records to register for the program and verify Medicare enrollment prior to making Medicare EHR incentive program payments.If you are a Medicare EP that does not have an NPI and/or an NPPES web user account., use the following website to apply for an NPI and/or create a NPPES user account:https://nppes.cms.hhs.gov/NPPES/welcome.do
13 How to Qualify for EHR Incentives? To qualify for incentive payments in 2011 and 2012, EP must achieve:Specifics of Stage 1 meaningful use and clinical quality measure (CQM) reportingThe Recovery Act specifies 3 main components of Meaningful Use. The use of a certified EHR:In a meaningful manner (e.g., e-Prescribing);For electronic exchange of health information to improve quality of health care;To submit clinical quality and other measures.
14 Specifics of Stage 1 Meaningful Use (2011 & 2012) For Stage 1, which begins in 2011, the criteria for meaningful use is based on a series of specific objectives that allows EPs to demonstrate meaningful users of certified EHR technology.For EPs, there are total of 25 meaningful use (MU) objectives:15 Core Set Objectives (mandatory),5 Menu Set Objectives (optional, out of 10)For details see:In 2011, EPs seeking to demonstrate Meaningful Use are required to submit aggregate clinical quality measures (CQM) and MU numerator, denominator, and exclusion data to CMS (or the States) by attestation.In 2012, seeking to demonstrate meaningful use must electronically submit clinical quality measures selected by CMS directly to CMS (or the States) through certified EHR technology.By using certified EHR technology to report information on clinical quality measures electronically to a health information network, a State, CMS, or a registry, the burden on providers that are gathering the data and transmitting them will be greatly reduced.
15 Beyond the Stage 1 Criteria for Meaningful Use CMS intends to propose through future rulemaking two additional stages of the criteria for meaningful use.Stage 2 would expand upon the Stage 1 criteria in the areas of disease management, clinical decision support, medication management support for patient access to their health information, transitions in care, quality measurement and research, and bi-directional communication with public health agencies. These changes will be reflected by a larger number of core objective requirements for Stage 2.Stage 3 would focus on achieving improvements in quality, safety and efficiency, focusing on decision support for national high priority conditions, patient access to self management tools, access to comprehensive patient data, and improving population health outcomes.
16 III. Why SuiteMed Intelligent Medical Software (IMS)?
17 III.2. Meaningful Use Made Easy with SuiteMed IMS Meaningful Dashboard You can gather real-time indications of your current Meaningful Use levels.Monitoring of countless CMS-required data elements.Quick exporting of the data for delivery to Regional Health Information Exchanges
18 Guide to Meaningful Use: Core Set (Mandatory) Objectives
19 Guide to Meaningful Use: Menu Set (Optional) Objectives
21 III. Why SuiteMed IMS?III.3. EMR Systems, Authorized Partner of SuiteMed IMSYou Will Experience Peace of MindExceptional long-term support (customized CPSP forms)Local experts, sales and supportMaximize the effectiveness to youSeamless implementationHands-on consultative approach to trainingSaas & Client-Server ModelsIII.4. Proven Positive Return on Investment (ROI)*Cost savingsRevenue enhancementsData accuracy, patient security and safety* ROI – for details, see Appendix (1)21
22 Appendix (1): Proven Return on Investment Data Accuracy & Patient SafetyReduced risk of transcription errorsReduced risk of missing critical informationRegulatory compliance & reduced professional liability rateCost SavingsEliminates soaring dictation & transcription costsMinimizes paper costs (storage rooms, copying, printing, staff time)Eliminates out sourcing billing costsSubstantial cost savings through qualifying for the Gov’t Financial StimulusRevenue EnhancementsAccuracy of codingBuilt-in protocols & reminders including health maintenanceImproved quality of charting & documentationEase of integration with specialists, labs, pharmacies, insurance companies, etc.Increasing number of patient visits per day
23 Appendix (2): About SuiteMed LLC Financially secure companyFounded 1998 – privately held and self fundedHeadquartered in Oakland, CA with offices nationwideIntegrated PM / EMR/ Patient Portal & moreOver 26 different medical specialtiesLocal technology experts, sales, service & supportMultiple sister companies, community health, plastic surgery, pharmacy automation, allergy, pain management and moreOver 3000 physician users nationwide
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