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February 2011
Clinical Practice Management
Electronic Health Records and “Meaningful Use” Incentives
IDSA resources can help physicians select an EHR system and meet requirements

During the next five years, eligible physicians can receive as much as $44,000 under Medicare or $63,750 under Medicaid for adopting certified electronic health record (EHR) technology and using it to achieve specified goals, known as “meaningful use.” Information to help ID physicians and their practices select an EHR system and qualify for these new incentives is available on IDSA’s website. (You must be logged in to access this page.)

The resources include a free online tool for physicians to evaluate and compare different applications based on criteria specific to the ID specialty, as well as links to additional resources from the American College of Physicians to help practices select health information technology tools.

Selecting an EHR system is a complex process, said Wanda Torres, director of physician billing with ID Care, a private ID practice with 29 physicians and several offices in New Jersey. The practice implemented an EHR system in 2007 after an extensive review process, including viewing demonstrations from several software vendors, visits to other practices using similar systems, and evaluating the functionality and customization options available. With an EHR system in place, the practice is now taking steps to participate in the “meaningful use” incentive program offered by the Centers for Medicare and Medicaid Services (CMS).

To qualify for the incentive payments, eligible physicians must report on six total quality measures and 20 meaningful use objectives. The quality measures include three core measures (hypertension, tobacco screening and cessation, and adult weight screening—alternates can be substituted if these don’t apply) and three additional quality measures. The meaningful use objectives include 15 core objectives (such as implementing drug-drug and drug-allergy checks or maintaining an up-to-date list of diagnoses) and five additional objectives (such as implementing drug-formulary checks or incorporating clinical lab-test results into the EHR).

Registration for the program began in January through the CMS website.  Physicians who provide less than 90 percent of their services in an inpatient hospital setting or emergency room are eligible for the incentive program, a requirement that is verified during the online registration process.

To get the maximum EHR incentive payment of $44,000, Medicare eligible professionals must begin participation by 2012—providers will only have to demonstrate “meaningful use” for 90 continuous days during the first payment year while subsequent payment years will be for the entire calendar year. Payment penalties of 1-2 percent will be levied against eligible professionals who do not become “meaningful users” by 2015.

Of note, a separate CMS incentive program for electronic prescribing (eRx) also has implications for practices using an EHR system. To avoid a payment penalty in 2012, physicians must still report at least 10 electronic prescriptions on their claims during the first six months of 2011 even if they are using an EHR system with eRx functionality.  IDSA has developed a schedule of incentive payments and penalties to help you better understand and compare Medicare’s various incentive payment programs.

For additional information, including a general guide from CMS, a schedule of EHR payment incentives and penalties, and a chart to assist providers in determining their eligibility, see IDSA’s website. For help with registration, an EHR Information Center Help Desk is available for questions at (888) 734-6433 from 8:30 a.m. to 4:30 p.m. on weekdays in all time zones. In addition, a free online video tutorial from CMS provides a step-by-step guide to the registration and attestation process. CMS also recently launched a listserv about the EHR incentive program to provide updates on registration, attestation, and the payment process. Click here to join the listserve.

IDSA’s practice management listserve is another resource for Society members to discuss clinical practice-related issues, including incentive programs. To subscribe, visit IDSA’s website.
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