With the advent of computer technology and the internet, Electronic Health Records (EHRs) have become an increasingly accepted and convenient way to keep track of important patient information. One of the main advantages of EHRs is their convenience, and major medical service providers have recognized that efficiency can be greatly improved by using EHRs. Medical billing and coding professionals will recognize this first hand, as they compare leafing through paper patient histories, physician notes, and medical charts with electronic files that can be easily accessed and organized on a computer.
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The federal Centers for Medicare and Medicaid Services (CMS), functioning as one of the largest insurance providers in the country, has also recognized that costs can be saved by adopting Electronic Health Records as a standard for operating. To encourage health care providers who work with these federal programs to transition to EHRs, the federal government has taken a carrot-and-stick approach.
In 2009 congress passed the HITECH Act, or Health Information Technology for Economic and Clinical Health Act, as part of an economic stimulus package. A section of this act included legislation that allows for an incentive program to be created that rewards healthcare providers who contract with CMS (ie- accept Medicare and Medicaid patients) if they make meaningful use of EHRs. Currently that incentive program allows for healthcare providers to earn up to $63,750 over a six-year period if using EHRs with Medicaid, and $44,000 over a five-year period for those using EHRs with Medicare.
Besides these incentives, CMS will also penalize qualifying doctors who accept Medicare patients and do not make meaningful use of EHRs by 2015. The penalty starts with a one percent reduction in overall Medicare reimbursement, and grows to a three percent reduction after three years by 2018.
Meaningful Use
The operative phrase in the last two paragraphs is “meaningful use.” To avoid the Medicare penalty or claim incentive payments, healthcare providers need to demonstrate “meaningful use” of Electronic Health Records. Medical and billing and coding professionals should be aware of how to use an EHR and if their employer is going to be penalized, which could mean a drop in revenue.
The first step is to check if a healthcare provider is eligible for incentive pay or penalties. CMS has developed an online assessment tool that does just this. To avoid the one percent penalty, eligible healthcare providers must attest to meaningful use of EHRs by October 1st of 2014. As this date approaches, “meaningful use” is likely to gain increasing media attention.
According to one American Medical Association (AMA) official, so far half of all doctors who accept Medicare patients have not achieved meaningful use of EHRs and therefore face a one percent penalty. Of the eligible healthcare providers who registered for incentive payments because they make meaningful use of EHRs, less than 60 percent have made an official attestation of such.
Providers can claim meaningful use of EHRs via the web with the CMS’s online attestation system. There are two stages of meaningful use, and healthcare providers must fulfill the requirements to claim completion of either according to the CMS’s meaningful use definition.