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
Year of adoption:
|
HITECH incentive payout over
time
|
|
|
|
2011
|
$18,000
|
|
|
|
2012
|
$12,000
|
$18,000
|
|
|
2013
|
$8,000
|
$12,000
|
$15,000
|
|
2014
|
$4,000
|
$8,000
|
$12,000
|
$15,000
|
2015
|
$2,000
|
$4,000
|
$8,000
|
$8,000
|
2016
|
|
$2,000
|
$4,000
|
$8,000
|
TOTAL
|
$44,000
|
$44,000
|
$39,000
|
$31,000
|
Medicaid
HITECH incentive timeline
Year of adoption:
|
|
|
|
|
|
|
No adoption
|
2011
|
$25,000
|
|
|
|
|
|
|
2012
|
$10,000
|
$25,000
|
|
|
|
|
|
2013
|
$10,000
|
$10,000
|
$25,000
|
|
|
|
|
2014
|
$10,000
|
$10,000
|
$10,000
|
$25,000
|
|
|
|
2015
|
$10,000
|
$10,000
|
$10,000
|
$10,000
|
$25,000
|
|
1% penalty
|
2016
|
|
$10,000
|
$10,000
|
$10,000
|
$10,000
|
$25,000
|
2% penalty
|
2017
|
|
|
$10,000
|
$10,000
|
$10,000
|
$10,000
|
3% penalty
|
2018
|
|
|
|
$10,000
|
$10,000
|
$10,000
|
|
2019
|
|
|
|
|
$10,000
|
$10,000
|
|
2020
|
|
|
|
|
|
$10,000
|
|
TOTAL
|
$65,000
|
$65,000
|
$65,000
|
$65,000
|
$65,000
|
$65,000
|
|
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.
Year of adoption
|
Bonus
|
Penalty
|
2009
|
2.00%
|
|
2010
|
2.00%
|
|
2011
|
1.00%
|
-0.05%
|
2012
|
0.50%
|
-1.00%
|
2013
|
|
-2.00%
|
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.
_______________________________________________________________________________________
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.
_______________________________________________________________________________________
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
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