Frequently Asked Questions About the Stimulus Package
What healthcare IT incentives are available for the Stimulus Plan?
The government is investing 19 billion dollars into healthcare – for physicians and hospitals. The bulk of this investment is going to modernizing healthcare technology – particularly by use of electronic health records (EHR).
What is the difference between Electronic Medical Records (EMR) and Electronic Health Records (EHR)?
Electronic Health Records and Electronic Medical Records are terms that Microwize, and many others in the healthcare technology industry use interchangeably. EMR/EHRs are electronic versions of patient records. In the past, Electronic Health Records were distinguished as including the ability for reporting. However, with full suites of medical software that include Practice Management (PM) along with EMR, electronic medical records are capable of clinical reporting as well. Therefore, in terms of the stimulus package, they are essentially the same.
Who can qualify for the Stimulus Package?
Qualified medical professionals for the Medicare HIT incentive include doctors of medicine, osteopathy, surgery, dental medicine, podiatric medicine, optometry and chiropractors. You must also not be hospital based, demonstrate meaningful use of a certified EHR and Submit Medicare Part B Claims.
The Medicaid incentive is extended to include certified nurse mid-wives, nurse practitioners and physicians assistants (under certain circumstances). You must also not be hospital based, demonstrate meaningful use of a certified EHR and at least 30% of your patients must receive Medicaid assistance (this is lowered to 20% for pediatricians).
What is “Meaningful Use of a Certified EMR?”
Can I still qualify if I already had an EMR before the stimulus was passed?
Yes, absolutely. You may also qualify for the early adopter incentive. Anyone who qualifies before 2011 is eligible for the early adopter incentive of another $3,000 for the first year.
What’s the maximum amount I can receive and when will I receive it?
Funds for physicians will become available on January 1, 2011. The maximum amount if you qualify under Medicare is $44,000 over 5 years. This includes the early adopter incentive. In order to qualify for the early adopter bonus, you should start implementing and training now if you have not already. The payments are front loaded, with the bulk of the payments coming in the first 2 years. For Medicaid, the maximum amount is $64,000 over 6 years.
What happens if I don’t use an EMR?
If you do not demonstrate meaningful use of electronic medical records, by 2015, you will see a reduction in your Medicare payments. For 2015, you could lose 1% of your Medicare payments. This percentage will increase by 1% until 2017, at which point the secretary may increase the reduction up to 5%.
What do I have to do to qualify for the maximum payment?
In order to qualify to receive the stimulus incentive under the Medicare portion, you must be a qualified professional who demonstrates meaningful use of an EMR and submit Medicare Part B claims. The EMR stimulus pays you the amount of 75% of your Medicare Part B claims, up to the maximum of $44,000 over 5 years, with the bulk of the payments in the first two years. In order to receive the maximum payment, you bill the following amounts in Medicare Part B claims:
- $24k for the first year
- $16k for the second year
- $10.7k for the third year
- $5.3k for the fourth year
- $2.7k for the fifth year
You must also qualify for the early adopter bonus of $3,000. In order to get the early adopter bonus, you must have an EMR implemented, be properly trained and use the EMR at point of care, which means you need to get started now in order to qualify. Microwize can help you every step of the way.
The Medicaid Provision pays you 85% of the net allowable costs for your EMR. This includes implementation, training, maintenance, etc. Therefore, the maximum really depends on the cost of your system. In order to receive a payment, you must first implement an EMR (which will qualify you for your “year 1″ payment. By year 2, you must demonstrate “meaningful use.” Again, the payments are front-loaded, and it is to your benefit to qualify sooner rather than later.
What products have the latest CCHIT Certification?
Because meaningful use has not yet been defined in its entirety, choosing an EMR that will qualify for the stimulus can be nerve-wracking. A good rule of thumb to go by is whether or not a product meets latest CCHIT Certification guidelines. Meaningful use criteria is expected to be based off of these guidelines. Microwize offers four products that meet the latest CCHIT guidelines.
How do I choose the right EMR?
What is EMR?
According to the Medical Records Institute, five levels of an Electronic HealthCare Record (EHCR) can be distinguished:
- The Automated Medical Record is a paper-based record with some computer-generated documents.
- The Computerized Medical Record (CMR) makes the documents of level 1 electronically available.
- The Electronic Medical Record (EMR) restructures and optimizes the documents of the previous levels ensuring inter-operability of all documentation systems.
- The Electronic Patient Record (EPR) is a patient-centered record with information from multiple institutions.
- The Electronic Health Record (EHR) adds general health-related information to the EPR that is not necessarily related to a disease.
- Immediate access to patient records at any given location
- Secure storage of referrals, messages, and clinical data
- Accurate and complete claims processing by insurance companies
- Clinical decision support tools at the point of care
- Complete flexibility and customization to support diverse practices and workflows
- Paperless charts
- Integration with all major information systems
- Patient population management
- Facilitation of HIPAA compliance
- Unparalleled implementation experience and user community
- Electronic Prescriptions
- Built in automated checks for drug and allergy interactions
- Sending and viewing lab information
Prime Suite by Greenway:
Prime Suite is an effective, and affordable charting solution for many medical specialties. Designed with the user in mind, it relies heavily on a user-friendly interface with powerful and dynamic features.
Easy to buy, Easy to use. One of the most popular EMR software packages with complete integration to the most popular practice management systems.
Medical Billing and EMR Software Full Suites!
Our integrated EMR and Practice Management solutions offer the best value for your medical practice. All of our software suites come with full practice management systems including patient accounting and billing, accounts receivable, appointment scheduling, reporting, electronic claims and ERA, eligibility verification and more. Plus, with your newly streamlined practice, you get EMR software, which helps make healthcare safer and improves quality of care. All of our solutions are CCHIT certified for 2008. EMR software can qualify you for the EMR Stimulus Plan.
When will payments be made?
Payments start for physicians on January 1st, 2011 and penalties start for lack of EMR adoption in 2015.
What benefits are there for early adopters?
Early adopters qualify for a $3,000 bonus applied to the first year of payments. Therefore, early adopters increase their maximum payment for the first year from $15,000 to $18,000, and their overall payments from $41,000 to $44,000.
Do hospital based physicians qualify?
No, the stimulus bill specifically states that hospital-based physicians are not eligible.
Who qualifies for the additional 10% rural health incentive for office-based physicians?
An “eligible professional” who predominantly furnishes services in a geographic area that is designated by the HHS Secretary as a health professional shortage area may receive a 10% increase in their annual payment.
How will Payments be made?
Payments have been proposed to be made in a single, consolidated annual payment. Annual Payments are proposed to be equal to 75% of the total Medicare allowed charges for covered services during that year. The Medicare allowed charge is the lesser amount of the actual charge or the Medicare physician fee schedule amount. Please note that these are the proposed methods of payment. The final rule on this is expected spring or early Summer 2010.
Is MIPS worth it?
With the negative payment adjustment being 9% in 2022, the minimum that CMS will take away for not reporting is $8,100 for eligible providers. Cost and time to report is less than half of what CMS will adjust from your base Medicare payments. So, yes, it is worth reporting for the Merit-based Incentive Payment System. The reporting measures are also intended to improve your quality of care, so you will have healthier, happier patients.