Take Advantage of the Economic Stimulus Incentive Payments

The current buzz on the nightly news is the Government’s Economic Stimulus package called the American Recovery and Reinvestment Act (ARRA) of 2009 that was recently announced. While most of you dictate and there are some of you that are even still using paper charting, the stimulus package is intended to move you into an electronic medical record system (EMR) by 2011. As matter of fact, The ARRA put aside over $20 billion dollars specifically for improving Health Care and Health Information Technology. Modernizing our Health Care System is central to this landmark legislation. This should not be news to you. As I have stated in previous articles, with Executive Order 1335 signed by President Bush in 2004, a process was started to get all of health care computerized by 2014. The current economic crisis, along with ARRA, has made computerizing healthcare a priority. So, now is the time you really need to get serious about making such changes in your practice. If you have not seen any reimbursement repercussions yet, you will soon if you don’t make the change to electronic records.

For doctors that have been paying attention to the news, going to conferences, speaking to consultants, etc. must be thoroughly confused about the current stimulus package and what it means to them. I have talked with many doctors recently that understand they need to move towards an EMR, however, some think they are going to receive a lump sum payment from the government this year. Don’t hold your breath! Because, while there are incentives in place, you will have to make the investment in order to qualify for the incentive payments. The government is not going to send you a check and “hope” that you will spend the money on an EMR and then correctly use it. In order to qualify for incentives payments, you will have to demonstrate to Medicare your ‘meaningful use’ of EMR technology. There will be specific requirements that define what ‘meaningful use’ means and you can bet that dictating and/or using paper files will not be meet these requirements.

Recovery and Reinvestment Act (ARRA) of 2009
Qualify for Over $44,000 of EMR Incentives

Starting in 2011, you will be able to qualify for incentive payments through Medicare with a possible $18,000 available to you for that year. Your first reaction is, “Well, I can wait until 2011.” The answer is a resounding “No!” You have to ask yourself how long will it take for you and your clinic to fully implement an EMR in order to demonstrate ‘meaningful use.’ The government expects you to make the investment before you can qualify for the money. Again, I want to stress, the government is not going to send you a check and then hope you decide to spend it on an EMR and then utilize it. You will need to make the commitment first. A flowchart of how the EMR incentive will be disbursed to physicians is illustrated in Figure 1.

Figure 1. Incentive disbursements to physicians who demonstrate implementation and meaningful use of EMR system.

The following is a phased approach in order for you to qualify for the incentives to come:

• Get organized in your EMR evaluation by designating a person to be the point person to help you with your evaluation. Planning/setting goals will take approximately one month.
• EMR evaluations should take about three to six months.
• Inventory and possibly update your current computer system. This can happen concurrently with the above but plan for it to take one to two months.
• Picking a finalist EMR company, checking out references, finalizing on agreements and payment should be planned to take at least one month.
• Does the system interface with current billing systems? Depending on your current system, writing, interfacing, testing, and then properly linking could take one to two months. If you decide to change your billing/practice management system tack on another six to twelve months for evaluation and implementation.
• Set up a liaison person that will help you with your implementation. That person will be crucial to your success. However, it is key is that you, the doctor, be closely involved for a successful implementation!
• Start your training and implementation process.
• Typical start-to-finish implementation could take between two to four months. You can expect a much longer time frame for larger facilities that have a lot of paper.
• Plan to re-evaluate and continue training towards the end of the implementation in order to make sure the system is properly used from then on.
• Don’t forget. You will be expected to start electronically communicating with Regional Health IT Centers in the near future and should to be ready to do so.

During this transition, there may be disruption to your practice and you may lose personnel resulting in a stressful situation. However, if you make the right decision on an EMR company and make the commitment to training and implementation, then you will find this to be a very rewarding decision and lucrative over time.

To be able to demonstrate ‘meaningful use’ will take at least two years for most clinics. Think about it, you will need to start with system evaluation and that, in itself, is a time-consuming process. You do not want to make a mistake at this stage and it is crucial that you purchase an EMR system specific to pain management. You can bet that there will be delays—many on your part—because this is something you will need to do while keeping your practice moving forward.

Governmental Disincentives

Starting in 2015, if you have not met the standard of ‘meaningful use of an EMR’ you will start to receive lower Medicare reimbursements. From 2015 until 2017, there will be 1% per year reduction (total of 3%) in Medicare reimbursements for doctors who have not fully adopted an EMR. The reductions in reimbursements could cost most clinics in excess of $20,000 over the three-year period.