Web Based EMR Implementation Incentives
What you Need to Know

What are the incentives for web based EMR implementation, and how do you get them?

Due to the recent worldwide recession, the United States government initiated a stimulus program, the American Recovery and Reinvestment Act of 2009.

Part of this program is the EHR incentive program. This directly gives funds to healthcare providers in return for adopting and using new EHR technology.

This means that an eligible doctor, hospital, or critical access hospital can get money back from the federal government when they buy a new web-based EMR package.

These software systems are very expensive, and so the government incentive program aims to help providers justify the initial cost. Once the practitioner adopts EHR in his or her office, the government will send them stimulus payments each year for up to six years, to help pay for the software.

Although this seems easy enough, it's not as straightforward as it looks. The provider has to meet lots of rules, regulations, and deadlines before they get reimbursed for buying an EHR program.

Certified Electronic Medical Record or Electronic Health Record?

EMR incentives

Electronic Medical Records (EMR) and Electronic Health Record (EHR) are often used interchangeably. They both entail the basic elements of an electronic system.

This system records patient visits and sends claims, as well as provide practice management system for the office.

But for the purposes of the government incentive program, only Certified Electronic Health Records (EHR) are eligible for stimulus payments.

Eligible professionals, hospitals, and critical access hospitals (CAHs) must use a certified EHR program to be reimbursed under the incentive program.

They can't use just any electronic medical records system. A certified system guarantees purchasers and other users that the EHR system offers the necessary technological capacity, functionality, and security to meet the stimulus program's criteria.

In other words, employing a certified EHR system tells the government, as well as patients and insurance companies, that your system has the components needed to meet the meaningful use criteria (see below for more on this).

Certified EHR systems also provide peace of mind. They're secure, can maintain data confidentiality, and can work with other EHR, clearinghouse, and insurance company systems.

Here's a list of Medicaid and Medicare certified EHR programs.

Who's eligible?

Although it may seem like any provider is eligible, this is far from the case.

First of all, the EHR incentive program is only offered to Medicaid and Medicare providers. To be eligible for ANY stimulus your provider must bill either Medicare or Medicaid.

There are further requirements, which will determine whether or not your office is eligible for the stimulus program. They are:

  • You must perform less than 90% of your services in an inpatient hospital or emergency room setting
  • At least 30% of your services have to have been performed on Medicaid patients (20% for pediatricians)
  • You must be a physician, dentist, certified nurse-midwife, nurse practitioner, physician assistant, or chiropractor
  • Your practice has 30% or more of a verified needy individual patient threshold
  • You bill for the Medicare Physician Fee Schedule for patient services
  • You demonstrate Meaningful Use (see below).

These requirements basically assure the stimulus program that you'll be using the stimulus money to provide competent and certified services to all members of the population, including the needy.

What is Meaningful Use?

You have to demonstrate meaningful use to be eligible for the stimulus money

To qualify for the stimulus money, you must demonstrate not only that you meet all the criteria and that you have a certified EHR system... you also have to demonstrate meaningful use.

The American Recovery and Reinvestment Act of 2009 specified three criteria required to meet the definition of meaningful use. They are:

  • The use of EHR in a meaningful manner, such as e-prescribing
  • The use of EHR to help improve the quality of care through electronic exchange
  • The use of EHR to submit measures of clinical quality.

All together, meaningful use means that the provider's office is using the EHR technology in a way that improves the quality of healthcare in ways that can be measured.

How much money do you get?

Once you've met the meaningful use criteria, have secured a certified EHR system, and met all other necessary requirements, you're eligible for the incentive payments.

But how much do you get?

These payments vary greatly, depending on two main factors:

  • What type of provider you are, and
  • When you implement your certified EHR.

If you're a Medicare provider, and meet the very first deadline, your office is eligible to receive up to $44,000 over the course of five years.

If you're a Medicaid provider, and meet the very first deadline, your office is eligible to receive up to $63,750 over the course of six years.

Deadlines for the incentive program are very strict, and the clock has already begun ticking for some providers.

If you're interested in receiving stimulus payment through the EHR incentive program, you need to get the ball rolling as soon as possible!

The longer you wait, the less money you'll receive in the long run.

For more information on the EHR Incentive program, see the CMS website.

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