EMR Funding for Small Practices

The federal government wants the healthcare industry to move towards digital information like many other industries have done. In 2009, the American Recovery and Reinvestment Act (ARRA) and the Health Information Technology for Economic and Clinical Health (HITECH) Act was created to fund and support a paperless national health information network through the adoption of electronic health records (EHR). The stimulus is based either on Medicare OR Medicaid but not both. The incentive per practice provider began in 2011 and reduces payments through 2016. After this date a penalty of 2% less reimbursement from CMS occurs for physicians not using EMR’s.

According to the Centers for Medicare & Medicaid Services, the average cost to adopt, implement, and/or upgrade HIT is $54,000 per full-time equivalent (FTE) physician, while annual maintenance costs average $10,000 per physician FTE.

Medicaid has a payout of $17.7 billion where eligible professionals can receive up to $44,000 over five years. This amount works out to be about $ 500 per month for the EMR system plus a couple of hundred for various services like prescriptions and eligibility checking. Many of the cloud based EMR systems are charging nearly the same amount for their services as the physicians will be reimbursed for the implementation of the EMR system.

Medicaid has incentives of $12.4 billion where eligible professionals can receive up to $63,750 over the six years. The cloud based systems are the most affordable and depend on the internet to connect to their facilities which house the provider data. At any time the provider can import this data into their own systems if they wish to maintain the control in their facilities but this requires servers and additional IT support which comes at a higher upfront cost.

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Eligible professionals are that which have a minimum 30% patient volume or a minimum 20% Medicaid patient volume, and is a pediatrician. Providers which are covered in this payment include

A physician assistant, nurse practitioner, or clinical nurse specialist

A certified registered nurse anesthetist

A certified nurse-midwife

A clinical social worker

A clinical psychologist

A registered dietitian or nutrition professional

More details are available at  

Hundreds of EMR vendors exist with verification from following certification bodies that the EMR systems meet the needs as outlined by the Office of National Coordinator of the Health Information Technology.

Surescripts LLC – Arlington, VA

Date of authorization: December 23, 2010.

Scope of authorization: EHR Modules: E-Prescribing, Privacy and Security.

ICSA Labs – Mechanicsburg, PA

Date of authorization: December 10, 2010.

Scope of authorization: Complete EHR and EHR Modules.

SLI Global Solutions – Denver, CO

Date of authorization: December 10, 2010.

Scope of authorization: Complete EHR and EHR Modules.

InfoGard Laboratories, Inc. How Much Of A Vitamin Supplement Is Absorbed – San Luis Obispo, CA

Date of authorization: September 24, 2010.

Scope of authorization: Complete EHR and EHR Modules.

Certification Commission for Health Information Current Health Policy Issues In The News Technology (CCHIT) – Chicago, IL

Date of authorization: September 3, 2010.

Scope of authorization: Complete EHR and EHR Modules.

Drummond Group, Inc. (DGI) – Austin, TX

Date of authorization: September 3, 2010.

Scope of authorization: Complete EHR and EHR Modules.

Typical success in installing these EMR system require the practice and their vendor address the following.

Have a project manager who heavily involves providers in the process

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Modify workflow…. Carefully

Implement in stages with big wins first like e-prescribing

Adapt to changes before moving forward into next stage

The Office of National Coordinator (ONC) has three stages for EMR implementation and meaningful use.

Stage 1 (which began in 2011 and remains the starting point for all providers): “meaningful use” consists of transferring data to EHRs and being able to share information, including electronic copies and visit summaries for patients.

Stage 2 (to be implemented in 2014 under the proposed rule): “meaningful use” includes standards such as online access for patients to their health information and electronic health information exchange between providers.

Stage 3 (expected to be implemented in 2016): “meaningful use” includes demonstrating that the quality of health care has been improved.

by Mike McElroy, MHA, PMP

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