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In a perfect world, healthcare providers would reach to the bookshelf and pull out a copy of “Attestation Made Easy”. It would guide providers through the ins and outs of attesting to Meaningful Use (MU) of Electronic Health Record (EHR) systems, and would return to practicing medicine.
Unfortunately there is no such book. But attestation can be made easy by understanding the fundamentals of EHR and seeking the appropriate providers to implement it.
In 2009, congress passed the Health Information Technology Economic and Community Health (HITECH) Act, establishing guidelines for medical practices and hospitals for adopting and utilizing electronic health records by the end of 2015. To ensure that providers and hospitals weren’t just installing EHRs but using them in a way that actually improved patient outcomes, HITECH established the criteria for Meaningful Use (MU) and the Centers for Medicare and Medicaid Services (CMS) was tasked with validating MU.
Attestation is simply verifying to the CMS that MU has been met. However, proving MU can be difficult. Medicare providers must meet 15 core objects and five additional objectives and need to do so for 90-continuous days. The 15 core objectives include items like e-prescribing, medical history, drug allergies and other identifiable markers. Providers must also prove achievement of five of ten “menu” objectives.
After the necessary criteria are met, the provider can attest to MU by registering with CMS and providing the necessary data. By attesting in 2011, physicians began to see payout from the MU incentive programs. In fact providers are eligible for up to $18,000 if attesting in either 2011 or 2012. According to reports, providers received their payments within just 45 days.
Three months of monitoring EHR use can be difficult. This is why DrFirst has developed AttestEasyTM, a premium service as a companion to its Rcopia-MU TM stand-alone certified EHR module.
AttestEasy TM will assist users completing the CMS registration and providing timely monitoring and guidance of the practices usage, flagging potential errors and measuring MU. In addition the service provides usage analysis, which assists in the attestation process.
With help from companies like DrFirst, the task of attestation does not have to be a headache, however the clock is ticking. In order to receive maximum incentives, providers need to begin the process of proving MU so attestation by the 2012 deadline is a reality.
It’s a fact that e-prescribing can save a practice valuable time. And time is money. But does your practice realize just how much money in e-prescribing incentives is available? Are you aware of how much a financial penalty your practice might suffer if it does not switch to e-prescribing?
In 2008, the Medicare Improvements for Patients and Providers Act, better known as MIPPA, established a series of incentives and penalties designed to encourage medical practitioners to switch from prescribing medications with pen and paper to filing prescriptions electronically. The theory behind MIPPA is simple: medical facilities will operate more efficiently and waste less money when switching to e-prescribing. At the same time, e-prescribing can help doctors avoid errors such as prescribing the wrong dosage with the result of improved patient outcomes.
The good news is that a growing number of providers have gotten the message that e-prescribing is the way of the future. Whether it’s a desire for MIPPA’s financial incentives or an equally strong desire to avoid penalties, according to Surescripts, in November 2011,52% of office-based physicians reported they were e-prescribing. In September 2010, only 32% of office-based physicians reported e-prescribing.
If your practice does not fall in the group of e-prescribers, you are missing out on simple and easy to obtain federal incentives designed to increase adoption. The incentives are decreasing over the next two years:
- In 2011, physicians using e-prescribing software began receiving a 1% Medicare bonus; the bonus remains at the same in 2012.
- In 2013, the e-prescribing Medicare bonus will fall to 0.5 %.
- In 2014, the bonus disappears entirely.
Beginning in 2012, MIPPA will impose penalties for those physicians still relying on pen and paper to send prescriptions to pharmacies.
- In 2012, non-complying physicians will experience a 1% reduction in Medicare reimbursements.
- A 1.5% reduction in 2013.
- A 2% reduction in 2014.
The message is clear. Those physicians who do not e-prescribe will not only miss out on lucrative financial incentives, but will experience financial penalties. Do not make the mistake of waiting too long; explore the benefits of e-prescribing today.
Meaningful Use is one of the most talked about components of the Health Information Technology Economic and Clinical Health (HITECH) Act. Unfortunately it’s also one riddled with myths, rumors and misunderstandings.
Essentially, Meaningful Use (MU) is an incentive program established by HITECH and the American Reinvestment and Recovery Act (ARRA). MU provides financial incentives to Medicare and Medicaid providers who have implemented an Electronic Health Records (EHR) system and demonstrated its use in a meaningful way to improve patient outcomes.
It is a complicated program of which the final implementation is being sorted out by the U.S. Department of Health and Human Services and Centers for Medicare and Medicaid Services (CMS).
Here are some of the most common myths:
1. I still have plenty of time.
Although the deadline for participating providers and hospitals to demonstrate meaningful use isn’t until Dec. 31, 2015, adoption of an EHR system is a lengthy process. The set up alone includes system training and practice integration. Depending upon the practice staff’s level of comfort with new technology, the learning curve can be long.
If the practice intends to take advantage of the incentive programs, time is running out. Medicare eligible providers have until Dec. 31, 2012 to attest to MU in order to be eligible for the maximum incentive payouts. Each year thereafter, the bonus amount decreases. If a provider does not attest by the end of 2015, penalties will be levied on Medicare and Medicaid payments..
2. Once EHR is set up, MU will be established.
Meaningful Use is not always instantly achieved upon implementation of an EHR system. In fact, it can take months to receive MU designation. Because MU criteria requires quantity and quality metrics, several patient visits need to be included in attestation documents. In addition the EHR must be in use for 90-continuous days in order to qualify for CMS incentives.
3. Your EHR vendor will provide your MU certification
The vendor’s main responsibility is providing the technologies making it possible to achieve MU. Some companies will make attestation easier through a variety of support programs, like DrFirst’s AttestEasy. Ultimately the burden of proving MU falls on the healthcare provider.
4. Meaningful Use is a project for your IT provider.
Although the initial set up and networking project will most likely fall with a computer expert, proving MU is the responsibility of the clinical and administrative team within the practice or hospital. Training may be offered by the IT provider, but after the initial set up phase, the IT provider role is complete, except for troubleshooting technical issues. Some offices may appoint an IT project manager to spearhead the program..
5. Meaningful Use only involves Medicare/Medicaid patients.
Although CMS offers the incentive program, EHR and attesting to MU in the practice covers all patient outcomes regardless of payer. When proving MU, data for every patient encounter entered into the EHR is taken into account for attestation.
6. We only need to prove five of the 25 set objectives in order to attest to MU.
That is partially true. All eligible providers must meet 15 core requirements of MU established to help realize the clinical and financial returns, including improved care coordination, e-prescribing and patient engagement. Providers then must choose at least five of ten additional measures which to attest.
There are instances where the criteria will not meet the practice’s workflow. If a particular objective is not relevant to the practice, the provider can attest to that and will not be required to meet the objective.
The Attestation process may seem daunting, but with time and experience, EHR and MU will make healthcare more efficient for both the provider and the patient.
What rumors have you heard? Are there any that are preventing you from implementing your EHR?
It is an inevitability that many attempting to delay. Electronic health records (EHR) are not going away. The deadline to take full advantage of the financial incentives available from the Centers for Medicare and Medicaid Services (CMS) for incorporation and proving Meaningful Use (MU) is approaching.
It’s not too late to identify the right system for your practice. It’s important to note, however, that you must prove MU in 2011 or 2012 in order to receive the maximum payout of up to $44,000. Those providers practicing in under-served or rural areas are eligible for up to $48,400 in Medicare reimbursements.
The following table shows the reduction in Medicare reimbursements by delaying adoption of EHR and proof of meaningful use.
Some providers may find it more beneficial to take advantage of the Medicaid bonus program based upon payer mix. Although participants have until 2016 to prove Meaningful Use and can receive up to $63,750 in incentives, the process is more complex. In order to participate in this program, a provider must prove that at least 30 percent of the practice’s patients receive Medicaid benefits. There are several calculators available to help providers choose the program best suited to the practice.
The following table shows the maximum disbursement schedule for providers choosing the Medicaid Meaningful Use Program.
It’s not too late to start working toward attestation in 2012. But, if you have yet to begin researching EHR systems, the time is now. It’s not a decision to be taken lightly, as the initial investment and time commitment can be substantial. It’s important to note that incentive payments are available not just when the program is incorporated, but when Meaningful Use is proven. That means systems will need to be implemented and staff trained in the new technology before Meaningful Use will ever be established.
In 2011, CMS established three phases of MU. By 2015 Medicare eligible professionals and hospitals will be required to meet MU or may be subjected to financial penalties. Financial penalties may include a reimbursement reduction of one percent the first year and up to three percent by 2017.
With uncertainty surrounding the criteria for Stage 2, CMS has recently extended Stage 1 until 2014, giving an additional year to those who have not already attested. The requirements for Stage 2 and Stage 3 have not yet been clearly defined by CMS.
Here are some key dates:
February 29, 2012: Last day to attest to Stage 1 in order to receive payment for usage in 2011.
Sometime in 2014: Medicare eligible participants must meet Stage 2 of Meaningful Use.
December 31, 2014: Last day to qualify for any type of Medicare incentives.
January 1, 2015: First day Medicare penalties may be implemented.
December 31, 2016: Last day to qualify for any type of Medicaid incentives.
Don’t get left out of receiving the thousands of dollars to help offset the cost of EHR implementation. Start the process today.
Running a prison is not inexpensive. A 2011 Financial Times article reported that states spend $50 billion a year on correctional facilities—the second largest expense the second-largest expense, right behind Medicaid. In that article, findings revealed it costs more than $44,000 per year to incarcerate a person in California—equal to spending a year, including room and board, at Harvard.
It’s important for prison officials to do everything possible to save money. One approach is to implement electronic health records and do away with the old-fashioned pen-and-paper system. Electronic health records save states money and assists in enabling better care for inmates.
First, consider the cost savings. According to a report by CIO|Insight magazine, a study of 14 medical practices found it took an average of two-and-a-half years to recoup the costs of transitioning patient health records from a paper-based to an electronic system. Once the pay-back period ended, the practices enjoyed $23,000 in annual savings, mostly from increased efficiency and reduced staff hours.
In a 2010 report, the Rhode Island Department of Corrections noted a significant savings of both time and money from its adoption of electronic health records.
For instance, when patients were transferred from one detention facility to another, at the same time someone had to physically transfer the health records. Today, prison officials log onto their computers to access a patient’s medical history, including prescribed medications, treatments and allergies or illness. In the past, medical personnel would attach sticky notes to a paper file, inevitably misread or lost in the chain of hands. Today, medical personnel simply update the patient information in the prison computer system.
Rhode Island’s experience proves that switching to electronic health records can save prisons not only significant money annually, but also improve the medical care provided to inmates.
In a recent story, the website Corrections.com, praised the Obama administration’s decision to invest $10 billion over a five-year period — ending in 2013 – to move U.S. healthcare to an electronic-based system, citing the positive impact electronic systems could have on U.S. prisons.
The story pointed to a study published in 2005 by the RAND Health Corporation.. The study found that electronic health records could result in savings by reducing redundant health care, making patient treatment more efficient, boosting patient safety and keeping patients healthier longer.
Consider how this would work in a prison system. With electronic health records, prison physicians would reduce the potential of prescribing errors and would make it more difficult for patients to abuse addictive drugs. By improving inmate care, physicians could generate significant annual treatment cost savings.
