There is some good news for physicians within the American Recovery and Reinvestment Act (ARRA) to assist providers in making the transition to EHR systems. The government is providing an incentive up to$44,000 over the next five years for providers who make the transition to an EHR system. This incentive is for EACH INDIVIDUAL PROVIDER. In a multi-doctor clinic, each provider may be eligible for the incentive payments, based on certain eligibility requirements.

In order to be eligible for the incentive payments each provider must:

Utilize a certified EHR system
Use the certified EHR system in a meaningful way as will be defined by the National Coordinator for Health Information Technologies, and the CMS.
Be a Medicare provider (Incentives are based on Medicare eligible charges (75%) billed in a calendar year, but with maximum limits.
As the law currently stands, these incentives will begin in 2011 for providers who meet the eligibility requirements. Incentives will be paid on a sliding scale over the next five years, with the payments the highest in 2011 and 2012, and decreasing until they are phased out in 2016.

While a $44,000 incentive program sounds very good, and the future of medical note taking and billing record keeping is with EHR systems, and from an efficiency standpoint you should convert to an EHR system anyway, I have my doubts about this program. Being the skeptic (mostly the cynic) that I am, I see some serious problems with the program immediately:

At the time of writing this article, there is no certifying agency in place to ‘certify’ an approved EHR system.

No certifying entity means no certified EHR systems.

In order to receive the incentive payment you must demonstrate that you use the ‘certified’ EHR system in a ‘meaningful’ way. To whom do you demonstrate it and what exactly is ‘meaningful’? To be fair there is a detailed application you must fill out and file (hopefully electronically) that demonstrates ‘meaningful’ use, but this may change by the time it is required.

If the government will reimburse each provider up to $44,000 for implementing an EHR system into their practice, how much do you think it will cost a provider to buy an EHR system? (I’m thinking $44,000, and it may be too late to invest in a company who sells the software by the time you read this)

In talking to several sources, there are a couple of items which you need to be aware of before you buy an EHR system:

Since there is currently no certifying entity, and therefore no certified EHR system presently available, make sure that your vendor will guarantee that their system will meet all certification criteria when the criteria are established.
Make sure that whichever EHR system you buy integrates the medical record keeping and not taking functions with a billing or claim generating function. Some programs on the market only offer Electronic Medical Records (EMR) or Electronic Clinical Records (ECR) with no billing programs. Since the main focus of an audit is the correlation between your notes and billing codes, these two components need to be integrated to save billing time and to provide audit protection.
Electronic Heath Records should be more efficient for the doctor, provide safety for the patient, and ensure accuracy for the payer (insurance company or Government). You might as well take advantage of the incentive program being offered to make the transition to an EHR system in your office. But, as I stated earlier, I am skeptical of a large government handout to encourage people into behavior that they should do anyway. What’s the catch?

Note: I will try to keep my eyes open for any information that becomes available for certification of EHR systems. In the meantime you can read this document concerning this topic. It can be found in the ARRA’s HITECH Act. Frequently asked questions and answers can be found here.

Submitted by Dr. DG Comfort, CO

 
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1 Comment
#1 by Chris Carraway, DC on November 24th, 2010

Quote

Dr Comfort writes: “I am skeptical of a large government handout to encourage people into behavior that they should do anyway. What’s the catch?”

I am too doc. I can tell you what the catch is. The catch is opening your record keeping to the government so they have full access to have a nurse, (nothing against nurses) look at your records or worse yet a damned computet examine them to check for a endless stream of mindless details….to make sure you are in “compliance”. Insurance companies are all for this as they will able to look at claims and records and make determinations from miles away how they should down code or discount your fees or put caps on your services as in numbers of visits or types of treatments. Even how you wish to treat a particular condition.

This already being done in other countries. Take a look at the way a damaged car is treated in the body shop. The insurance claims agent will tell the shop. You asscess the damage. We will tell you that it should take 3.6 hours to repair that damage and we are only going to pay for aftermarket parts, not OEM. Oh and use the cheapest paint made to paint the car.

I have three managed care groups that rate me as a Tier 1 provider. The best rating they have. Yet, CMS tells me that my visits per condition was way off the mark and I am over treating patients. Who is right?

I use EHR and plan to go for the 44K. I do not expect to get a dime of it. Every time I look, the government had added new requirement and hoops to jump through to comply. The finish line keeps moving. No matter how fast I run or the software developers write….the finish line moves away faster.

I also know that if you are not compliant and used EHR when this is all over. They are going to fine you by reducing your fees and increasing percentage each year….until you break or quit.

I vote to repeal this damned Health Care Bill.