CMS Clarifies Hospital Patient Requirements Under Meaningful Use

Last week, CMS revised an online frequently asked questions site regarding provisions in the meaningful use ehr program that affect patient-reporting requirements for hospitals, AHA News reports.

Under the 2009 economic stimulus package, health care providers who demonstrate meaningful use of certified electronic health records can qualify for Medicaid and Medicare incentive payments.

According to the revised FAQ site, eligible hospitals and critical access hospitals have two choices concerning the type of patients to consider for Stage 1 rules of meaningful use ehr:

• The “Observation Services method” includes patients who are admitted directly to an inpatient setting, patients who arrive in an emergency department and then are taken to an inpatient department, and patients who receive treatment in an ED and are given observation care.
• The “All ED Visits method” includes patients who receive care in and are discharged from an ED.
  

The FAQ section was revised based on feedback from hospitals that earlier guidance was not clear about which observation services can be counted.

The revision recognizes that some hospitals are prioritizing EHR adoption in their EDs, while others are concentrating on deployments in inpatient departments, according to AHA News (AHA News, 12/2).

Source : http://www.myemrstimulus.com/cms-clarifies-hospital-patient-requirements-under-meaningful-use/

EMR Spending Expected to Double in 4 years

Government incentives for using electronic medical records will result in spending on systems doubling by 2015, according to a report by IDC Health Insights. However, the study notes that much of that growth will come closer to end of that projected period, because vendors are having trouble keeping up with the orders.

Total EMR spending, which is expected to grow from $1.9 billion in 2009 to $3.8 billion by 2015, is about twice the growth rate analysts are seeing over the health information technology market and the general IT market, said Judy Hanover, research director of provider IT strategies for the Framingham, Mass.-based market research company and co-author of the report.

The report notes that a separate IDC survey in August 2010 found that 44% of health care organizations plan to accelerate or aggressively accelerate their plans to deploy EMRs because of financial incentives in the 2009 economic stimulus package. The stimulus provided incentives of up to $44,000 under Medicare and nearly $64,000 under Medicaid for meaningful use of an EMR.

But this rapid deployment is causing a vendor backlog that has resulted in unanticipated delays of up to six months for some practices and hospitals. Hanover said this has been a bigger issue for inpatient system deployments, but analysts are starting to see it on the ambulatory side as well.

The authors of the report predicted that the largest chunk of EMR investments will come in 2015. Not only is the backlog expected to cause delays, but some physicians will put off purchasing until it gets closer to 2015, when incentives turn to penalties.

The forecast shows clinics and physician practices will spend $335 million on EMRs in 2011 and $490 million in 2015. Ambulatory EMR spending overall was $633 million in 2009 and is expected to reach $1.4 billion in 2015.

Making an early decision on an EMR will help ensure that staff members are available for its installation, Hanover said. Practices might want to consider looking at third-party vendors if their primary vendors are experiencing a backlog, she said. Many third parties can provide installation and training services with the help of the vendor, she said.

After 2015, vendors are expected to enter a “maintenance cycle” in which revenue will come mostly from replacement systems or upgrades. Not only could the government require EMRs to perform more functions than they do today to qualify for incentives, health system reform may have an impact.

“We do expect to see, as health care reform goes into effect, a massive consolidation in the provider community in terms of acquisitions and reductions in the total number of providers,” Hanover said. “And that will drive some replacements and upgrading and reinvestment in EMRs.”

Source : http://www.emrspecialists.com/2011/02/emr-spending-expected-to-double-in-4-years/

Medicare EMR Incentive Program Begins Registration

Washington — Starting Jan. 3, eligible physicians and hospitals will be able to register for the Medicare electronic medical record incentive program, a prerequisite for obtaining billions in available federal bonuses, the Centers for Medicare & Medicaid Services announced Dec. 22, 2010.

Also starting Jan. 3, registration for the Medicaid EMR incentive program will launch for Alaska, Iowa, Kentucky, Louisiana, Oklahoma, Michigan, Mississippi, North Carolina, South Carolina, Tennessee and Texas. In February, registration will open in California, Missouri and North Dakota. The remaining states probably will launch their Medicaid EMR incentive program sign-ups in the spring and summer, CMS said.

Officials with CMS and the National Coordinator for Health Information Technology said they hope for broad registration by doctors and hospitals. To prepare for the process, health professionals are encouraged to visit the CMS website (www.cms.gov/ehrincentiveprograms/).

“With the start of registration, these landmark programs get under way, and patients, providers and the nation can begin to enjoy the benefits of widespread adoption of electronic health records,” said CMS Administrator Donald M. Berwick, MD.

David Blumenthal, MD, the national health IT coordinator, said, “It’s time to get connected.”

He added that his office and CMS have numerous resources to help physicians and hospitals enroll in the program. They include a website that lists more than 130 certified EMR systems (onc-chpl.force.com/ehrcert/).

Another site lists the 62 regional extension centers that can assist physicians in obtaining the bonuses (healthit.hhs.gov/portal/server.pt/community/healthit_hhs_gov__rec_program/1495/).

Physicians who want to participate must register in either the Medicare or Medicaid EMR incentive programs. Participants must choose only one program — they cannot receive payments from both. However, after receiving a bonus for a given year, they may change their program selection once before 2015.

In 2010, CMS finalized standards that doctors and hospitals must meet to demonstrate meaningful use of their EMR systems. Physicians can receive as much as $44,000 over a five-year period through Medicare, and up to $63,750 over six years through Medicaid.

CMS on Dec. 22, 2010, announced several additional key 2011 dates for the EMR physician incentive program:

• January — Some state agencies begin issuing Medicaid EMR incentive payments.
• April — Participants begin to attest eligibility for Medicare bonuses.
• May — CMS begins issuing Medicare bonuses.
• Oct. 3 — Physicians have a final chance to begin their 90-day reporting period to demonstrate meaningful use in 2011.
• Dec. 31 — 2011 bonus payment year ends for eligible professionals.
  

Source : http://www.emrspecialists.com/2011/01/medicare-emr-incentive-program-begins-registration/

AMA Meeting: Physician Input Welcomed On Meaningful Use, CMS Official Says

San Diego — With stage 1 regulations for meaningful use released and discussion begun on stage 2, a federal official speaking at the AMA Interim Meeting called for more feedback to ensure these regulations will be workable for physicians.

“We need to work together and make sure that meaningful use ehr is defined and carried out appropriately,” said Betsy L. Thompson, MD, DrPh, chief medical officer for the Centers for Medicare & Medicaid Services’ Region IX office in San Francisco. She spoke during an educational session at the meeting. Based on a show of hands when she asked the crowd about EMR use, about half of the participants had an EMR in their offices, and the remainder were considering getting one.

Stage 1 rules are intended to increase adoption of health information technology, stage 2 rules are meant to change the process of care, and stage 3 rules are for improving outcomes. “Right now our emphasis is for practices to adopt and start to use these systems,” Dr. Thompson said. “At stage 2, we expect processes of care to change so that we can truly improve outcomes and population health by stage 3.”

Achieving meaningful use at the three stages qualifies physicians for financial incentives for using electronic medical records. They were part of the 2009 economic stimulus package. While finalizing meaningful use standards for stage 1, CMS received more than 2,000 comments, including those from the AMA and other medical associations.

“We had to read and respond to each, and the comments improved the rule substantially,” Dr. Thompson said.

This led to stage 1 rules being issued with more flexibility for physicians and deferral of some early requirements, but the AMA continues to request improvements.

“These are challenging times. … It is worth the effort to be able to collect data and collaborate with each other for the betterment of the patient, but we have reasons to be concerned and worried about what the future holds,” said AMA Trustee Steven J. Stack, MD.

Stage 2 of meaningful use is scheduled to begin in 2012.

Source : http://www.myemrstimulus.com/ama-meeting-physician-input-welcomed-on-meaningful-use-cms-official-says/