What is the HITECH Act?

On February 17, 2009, President Obama signed into law a $789 billion stimulus package known as the American Recovery and Reinvestment Act (ARRA).  Included in this law is the Health Information Technology for Economic and Clinical Health (HITECH) Act which distributes $19 billion to physicians and hospitals who demonstrate “meaningful use” of Electronic Health Records (EHR) by 2015.

The focus of this act is to increase the adoption of EHR by physicians and hospitals to facilitate information exchange between healthcare organizations.  Research has shown when EHR’s are utilized both patient care and satisfaction increases, errors are minimized and costs are reduced over the long term.

What does this mean to me and what is “meaningful use?”

Under HITECH, physicians can qualify for up to $44,000 in Medicare or $64,000 in Medicaid incentives if they demonstrate “meaningful use” of a certified Electronic Health Record.  Starting in 2015 physicians who do not use an EHR will be penalized with a 1% Medicaid fee reduction and a penalty increase to 3% if an EHR is not implemented by 2017. The requirement for “meaningful use” is still being worked on by the Office of the National Coordinator for Health Information Technology (ONCHIT), but is to be implemented three stages carried out until 2015.

Stage 1: Stage 1 begins in 2011 and focuses on electronically entering health information in a coded format; using that information to track key clinical conditions and communicating that information for care coordination purposes, implementing clinical decision support tools to facilitate disease and medication management and reporting clinical quality measures and public health information.  A list of more detailed criteria for Stage 1 can be found here. (Stage 1 Meaningful Use Criteria List).

Stage 2: Stage 2 begins in 2013 and is expected to encourage the use of health related information technology for continuous quality improvement and the exchange of information in the most structured format possible.  This criterion is expected to be published by the end of 2011.

Stage 3: Stage 3 begins in 2015 and is expected to focus on advanced decision support and improving population health. Guidelines are scheduled to be published by the end of 2013.

Medicare HITECH incentive timeline

Medicaid HITECH incentive timeline

In order to qualify for Medicaid incentives at least 30% of patient cases must be attributable to Medicaid.  For pediatricians, the minimum percentage of Medicaid patients is 20%.  Office-based pediatricians are only eligible to receive two thirds of the maximum payment.

E-prescribing Bonus Incentive Timeline

The e-prescribing incentive program provides payment to eligible professionals who successfully e-prescribe medications in 2009 equal to 2 percent of their total Medicare payments for the year. The incentive amount is shown below.  For details on the specifications that will be used to determine if physicians are successfully electronically prescribing visit https://www.cms.gov/ERxIncentive/06_E-Prescribing_Measure.asp.

Learn more about  HITECH government stimulus act by visiting: http://healthit.hhs.gov/portal/server.pt?open=512&objID=1325&parentname=CommunityPage&parentid=1&mode=2.

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HITECH Stimulus Package Frequently Asked Questions

The HITECH Act specifies that physicians can qualify for $44,000 or more in economic stimulus incentives for adopting an EHR.  Below are the answers to a few frequently asked questions:

Are HITECH incentives per physician or per office?

HITECH incentives are paid on a per provider basis. One physician alone could earn $44,000 or more in HITECH incentives.

What types of physicians and practitioners qualify for HITECH incentives?

The following types of physicians and practitioners can all qualify for $44,000 or more in HITECH stimulus incentives according to Social Security Act, section 1861(r):

Doctor of Medicine or Osteopathy- M.D. or D.O                     Physician Assistant

Doctor of Dental Surgery or Medicine – D.D.S or D.D.M         Nurse Practitioner

Doctor of Podiatric Medicine- D.P.M                                       Clinical Nurse Specialist

Doctor of Optometry- O.D.                                                      Certified Nurse-Midwife

Chiropractor- D.C.                                                                   Clinical Social Worker

Certified Registered Nurse Anesthetist                                      Clinical Psychologist

Registered Dietitian                                                                   Nutrition Professional

Which geographic locations qualify for HITECH incentives?

All 50 U.S. States                                                                     Puerto Rico

District of Columbia                                                                  Virgin Islands

Guam                                                                                       American Samoa

Northern Mariana Islands

Will your medical partner’s EHR be certified to qualify for HITECH incentives?

Our medical partner guarantees that their EHR will be certified and available to all physicians who want to qualify for 2011 HITECH payments. 

When should I switch to EHR?

Some practices may be taking the wait-and-see approach because they are unsure of which EHR to select or they want to wait until the “meaningful use” requirements have been established.  However, the time to act is now. Since our medical partner guarantees that their EHR solution is designed to meet the criteria for “meaningful use,” by acting now, practices will earn the most stimulus money and start maximizing office efficiency immediately.  Furthermore, we offer a free solution for transcription clients, allowing your practice the chance to qualify for incentives without the financial risk of other companies.  Even if you do not qualify for government incentives, you will increase office productivity, cut costs without spending thousands of dollars on an EHR system. 

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Stage 1: 25 Requirements for Meaningful Use

Stage 1 of the meaningful use criteria beginning in 2011 includes 25 objectives/measures for physicians and 23 objectives/measures for eligible hospitals. To be considered a meaningful EHR user, you must meet all of the criteria listed below:

• Use Computerized Physician Order Entry (CPOE)

            Prerequisite: For 80% or more of all orders.

• Implement drug-drug, drug-allergy, drug-formulary checks
• Maintain an up to-date problem list of current and active diagnoses based on ICD-9-CM or SNOMED CT®

                  Prerequisite: For 80% or more of all patients.

• Generate and transmit permissible prescriptions electronically (eRx)

            Prerequisite: For 75% or more of all permissible prescriptions.

• Maintain an active medication list.

                  Prerequisite: For 80% or more of all patients.

• Maintain active medication allergy list.

                  Prerequisite: For 80% or more of all patients.

• Record demographics including: preferred language, insurance type, gender, race and ethnicity, and date of birth.

                  Prerequisite:  For 80% or more of all patients.

• Record and chart changes in the following vital signs: height, weight, and blood pressure and calculate and display body mass index (BMI) for ages 2 and over; plot and display growth charts for children 2-20 years, including BMI.

                  Prerequisite: For 80% or more of all patients.

• Record smoking status for patients 13 years old or older.

Prerequisite: For 80% or more of all unique patients 13 years old or older seen by the EP “smoking status” recorded.

• Incorporate lab-test results into EHR as structured data.

                  Prerequisite: For 50% or more of all clinical lab tests.

• Generate lists of patients by specific conditions to use for quality improvement, reduction of disparities, research and outreach.

                  Prerequisite: One or more reports.

• Report ambulatory quality measures to CMS
• Send reminders to patients per patient preference for preventive/follow-up care.

                  Prerequisite: For 50% or more of all patients who are 50 and over.

• Implement five clinical decision support rules relevant to specialty or high clinical priority including: diagnostic test ordering, along with the ability to track compliance with those rules.
• Check insurance eligibility from public and private payers.

                  Prerequisite: For 80% or more of all patients.

• Submit claims electronically to public and private payers.

                  Prerequisite: For 80% or more of all claims.

• Provide patients with an electronic copy of their health information (including problem lists and medication lists) upon requests.

                  Prerequisite: For 80% of all patients who ask for a copy within 48 hours.

• Provide patients with timely access to their health information (including lab results, problem list, education lists, allergies) within 96 hours of the information being available to EP.

                  Prerequisite: For 10% or more of all patients.

·        Provide clinical summaries for patients for each office visit.

            Prerequisite: For 80% or more of all office visits.

• Capability to exchange key clinical information (e.g., problem list, medication list, allergies, test results) among providers of care and patient authorized entities electronically

            Prerequisite: One test or more.

• Perform medication reconciliation at relevant encounters and each transition of care

Prerequisite: For 80% or more of all relevant encounters and transitions of care.

• Provide summary care record for each transition of care or referral.

            Prerequisite:  For 80% or more of all patients.

• Capability to submit electronic data to immunization registries and action submission where required and accepted

            Prerequisite: One test or more.

• Capability to provide electronic syndrome surveillance data to public health agencies and actual transmission according to applicable law and practice.

                  Prerequisite: One test or more. (Not required if the public health agencies can’t receive the information electronically.)

• Protect electronic health information created or maintained by the certified EHR using implementation of appropriate technical capabilities.

                  http://healthit.hhs.gov/portal/server.pt?open=512&objID=1325&parentname=CommunityPage&parentid=1&mode=2