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Stimulus Overview: The What, the Why and the HowLeigh Burchell,
Director of Government Relations, Allscripts
Dr. Gary S. Schenk, Sr., Gaston Family Care
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This will cut waste, eliminate red tape, and reduce the need to repeat
expensive medical tests.
It just won't save billions of dollars and thousands of jobs -- it will save lives by
reducing the deadly but preventable medical errors that pervade
our health care system.
- President Obama
“
”
Eventful Times
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Today’s Agenda
›
Breaking down the Stimulus Bill
›
What Incentives Are Available for You?
›
Real Utilization from a Real EHR Client
›
Q & A
›
The American Recovery and Reinvestment Bill signed−
$790 billion
−
Billions within the Bill is allocated towards the improvement of healthcare in some form
›
The Health Information Technology for Economic and Clinical Health Act (“HITECH”) includes a net appropriation of $19 billion for health information technology
Breaking it down…
What is in the $19 Billion?!
$46 billion
+ $2 billion
-
$28.5 billion
= $19.5 billion
Physician IncentivesIncentive Bonuses from Medicare/Medicaid
HHS Discretionary Funds(For Use By National Coordinator of Health IT)Standards Development, Grants (AHRQ, HRSA, CMS), HIE Infrastructure, Loans to the States for EHR, Regional HIT Resource Centers, Telemedicine, Efficacy Studies
Savings Through Improved Efficiencies, Tax Revenues, Penalties
HRSA = Health Resources and Services Administration
AHRQ = Agency for Healthcare Research and Quality
Well, it isn’t really $19 billion…
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HITECH Act: Overview›
The Bill Aims to Accomplish Four Major Goals:−
Health information technology infrastructure for interoperability in place −
Standards expanded by 2010−
Saving the government $18 billion−
Strengthening Federal privacy and security law through standards
maturation
›
How?−
Incentives, jump start $$, other funds for Comparative Effectiveness, FQHCs
›
The Result?−
The Congressional Budget Office estimates that 90% of doctors and 70% of hospitals will be using comprehensive EHR by 2020
HITECH Act: Physician Incentives
›
First Adopters Will Benefit The Most (Sliding Incentives)−
Physicians can earn between $44,000 to $64,000 over five years from Medicare / Medicaid if they are utilizing an EHR in 2011
−
Providers may receive incentives under only one of the programs
›
Hospitals can earn up to $2,000,000 plus discharge bonuses (total payout to them could be $10 million +)
›
BUT…"Meaningful Use”−
The EHR must be a certified product
and include ePrescribing−
The EHR must be connected−
The provider must comply with submission of reports on clinical quality measures
HITECH Act: Physician Incentives, Cont.
›
In Medicare, Funding is Front Loaded−
$30,000 (close to 70% of the funding) comes in the first two years−
10% bonus in a health provider shortage area (HPSA)−
Incentives start in 2011, decrease over time and go away after 2016
−
Penalties begin in 2015 if no meaningful use in 2014−
Calculated by multiplying 75% by the physician’s Medicare allowables
up to the cap for the year
HITECH Act: Physician Incentives, Cont.
›
In Medicaid, Front Loaded but Different−
Big payment the first year for purchase or upgrade, then payments for maintenance−
Receiving external funding for EHR purchase can decrease incentive payments
−
Must meet minimum threshold of Medical patients, but no calculation based on charge submission
−
Mid-level qualification−
No penalties under Medicaid to date –
likely will come from the states
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How To Be Meaningful›
What does “Meaningful Use”
really look like?
−
What type of product should qualify for certification?
−
What does “connected”
mean?
−
How should reporting be completed?
−
What quality measures should be tracked?
−
How do we write rules that challenge the industry but don’t leave out the little guys?
›
Allscripts: White House meetings, testimony, meetings with HHS / ONC, meetings on the Hill
June 16th – Draft Due!!
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HITECH Act: HHS Discretionary Funds
›
Secretary Sebelius
owns developing the plan to allocate the $2 billion−
CMS writes the rules, but ONC will weigh in heavily
›
Core areas of focus:−
HIE Infrastructure, National Health Information Network (NHIN)−
Federal grants through AHRQ, HRSA, CMS; State Grants in 2010−
Promote advanced EHR –
disease mgmt., quality care measures
›
Regional Health IT Resource Centers−
“Meaningful Use”
support, workflow reengineering, implementation
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HITECH Act: Privacy & Security
›
Federal privacy and security laws (HIPAA) were expanded to protect patient health information, including:−
Defining which actions constitute a breach (including some inadvertent disclosures)
−
Imposing restrictions on certain disclosures, sales, and marketing of protected health information
−
Requiring an accounting of disclosures to a patient upon request−
Authorizing increased civil monetary penalties for HIPAA violations−
Granting authority to state attorneys general to enforce HIPAA
Next Up from Congress›
Health Reform−
Payment Structure
−
Delivery Mechanisms›
May include revisions to HITECH−
Possible: addition of some mid-levels to Medicare incentive programs
Friend or Foe?Doctors and Technology
Stacks and Stacks of
•Chasing information•Inefficient records systems•Errors in medication and documentation•Management of messages/labs/tests•Staff requirements
Remember systems have EHR & PM!EHR Side
Charting
Messaging
Coding
PM Side
Scheduling
Billing
Insurance – filing and verifications
System Needs
•Hardware requirements•Scanning old and new materials•Faxing•Practice Specificity•“Paper”
Flow
•EHR company needs to be able to implement your system•Flexibility
Implementation
“Buy-in”
Key personnel
Rally the troops
Scheduling during “Go Live”
Master Lists
Templates
Procedure notes
How to chart
Scanning options
Above ALL…..
GarbageOUT
Keys to Implementation
•Training•Training
•Training
The only thing to fear…..Change
Cost
Equipment failure
Technical Support
The Money
Slide
Transcription
Staffing
Improved coding
Multiple locations
Provider’s time
Office space
Paper and supplies
The “green” office
8 years later
“Metal and electricity”
Patient perspective
Patient education
Office flow
Flexibility of the software
Staff - satisfaction/ champions
training
“clicks”
Tweaking
Allscripts
Journey
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Questions?
What Should You Do?For more education, a demonstration or a FREE Stimulus assessment for your organization:
And don’t forget to join us June 18th
and June 25th
for the remaining webcasts in the EHR Stimulus series!
Call or Email to receive a customized ROI Calculation or to schedule a product demonstration.
Check out the site to find new resources and to learn when the tour is coming to a city near you!
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