by Maghed Mikhail
The confusion and skepticism is understandable. The details that describe how physicians get paid this “Incentive Money”, under what conditions it is paid, and when it is paid were finally published in the Federal Register on July 28th, 2010, and became effective after 30 days on August 28th, 2010. If you want to read all 864 pages of it, you can find the document online at ofr.gov/inspection.aspx. If you want the “cliff’s Notes” version, please read on.
While most physicians dictate and some of you are still using pen and paper for documentation, the stimulus
package has been designed to motivate you to switch to an electronic health record (EHR) as early as 2011, but no later than 2012 if you want to get the maximum allowed incentives. As a matter of fact, the ARRA has set aside
$20 billion dollars specifically for improving Health care by improving Health Information Technology. Improving our Health care System was a central goal of this legislation, but it should come as no surprise, because in 2004, President Bush signed Executive Order 1335, which established a process to “computerize” all U.S. healthcare by 2014. The current economic meltdown created the need for the “Recovery Act”, and the Obama administration simply accelerated by two or three years the plan to get all of American healthcare computerized. So now is the time to get serious about switching to an EHR. If you have not seen any repercussions yet, you will if you don’t make the change soon.
Most of the phlebologists with whom I have discussed the incentive plan have made reasonable attempts to understand what is being offered. They have been paying attention to new reports and articles, going to conferences and speaking to consultants. Yet most phlebologists remain thoroughly confused about the stimulus package and what it means to them. I have talked with many physicians recently that understand they need to be investigating the implementation of an EHR, however, many are under the impression that the incentive money will come in the form of a grant from the government “sometime” in 2010 that will allow them to then purchase an EHR. To those physicians I say: “Don’t hold your breath”. The earliest that incentive payments will be made available is the second quarter of 2011.
However, one thing is crystal clear: the government is not going to send you a check and “hope” that you will
spend the money on an EHR and then correctly use it. In order to qualify for incentive payments, you will have to
demonstrate to Medicare your “meaningful” use of EHR technology first and only after that will they send you a payment. The details of what constitutes meaningful use (MU), how you will have to report it, and what the deadlines are for receiving the maximum incentives have now been defined, and are outlined here
Note that if you were to enter the incentive program at a later date and first qualified during cY 2013, the maximum
amount of Incentive Money you can receive is “only” $39,000 over a four year period of time. In other words, the
difference between demonstrating Meaningful Use (MU) in 2011 and 2013 is only an incentive of $5,000 over five years. Because of this, most experts recommend that you should NOT rush into buying an EHR during 2011.
If you are not 100% certain that you and your practice will be happy with a particular EHR for the next five years or more, then don’t buy it.If you rush to grab the Incentive Money and purchase an EHR that is not a good “fit” for you and your practice, the headaches and heartaches you will experience are simply not worth the additional $5,000 you might possibly receive over the subsequent five years. Furthermore, there is no loss of incentives for buying in 2012; so please don’t choose an EHR that you are unhappy with, because you will throw it on the scrap heap, and then you will purchase another EHR in order to help you qualify for more Incentive Money and try to recoup your losses. Obviously, a situation best avoided in the first place.
Also, note that if you were to enter the incentive program at a date after cY 2013 and first qualified during cY 2014,
then the maximum amount of Incentive Money you can receive is now seriously reduced to $24,000 over a three
year period of time. In other words, the difference between implementing an EHR and demonstrating Meaningful Use (MU) in 2011 and 2014 is a whopping of $20,000. Obviously, the penalties for delays are not linear!
“If you are not 100% certain that you and your practice will be happy with a particular EHR for the next five years or more, then don’t buy it.”
Furthermore, if you first demonstrate MU during cY 2015, then the maximum amount of Incentive Money you
can receive is zERO. You might say – why would anyone implement an EHR if there is no incentive? The answer is simple – if you do not demonstrate MU in cY 2015, you will receive a 1% reduction in all Medicarereimbursements, which will probably amount to approximately $3,000. For 2016 the penalty is 2%, for 2017 it is 3%, and who knows after thatclearly, implementation of an EHR and the demonstration of MU is important to your bottom line, and as long as you can demonstrate at least 90 days of MU in 2012, you can still
qualify for the maximum incentive.
Make sure you do your due diligence and properly evaluate and purchase a phlebology-specific EHR or you will find yourself with a frustrating or non-operable system. Because of the lead time required to evaluate and implement an EHR, you need to move quickly (but not too quickly) in order to take maximum advantage of the incentive plan.
Maged Mikhail is the director of development and implementation for Vein Technology Solutions. With a graduate degree in Computer Science from the University of Mississippi and work experience at Electronic Data Systems, inc., and for large business consulting firms (Accenture), Maged began his own IT consulting business focusing
exclusively on the needs of medical practices. In 2004 he developed and installed the first version of the Phlebology Based EHR, Vein Draw™, which is now in daily use by over 20 physicians nationwide.