carepaths^TM

CarePaths is currently working to meet the anticipated standards for EMR certification. The standards will address interoperability of EMRs so that information can be passed back and forth between different systems. In behavioral health it is anticipated that a Continuity of Care document will be used. This document will pull essential information from the behavioral health chart (e.g. medications, diagnosis, etc) and allow for uploads and downloads to EMRs of other providers. Currently, CarePaths is working on the technical infrastructure for EMR interoperability.

What follows is a recap of the HITECH act. This act states that “eligible professionals” who demonstrate “meaningful use” of a “certified EHR” will qualify for stimulus funding and incentives.

Definitions:

Eligible professional are office-based physician.

Meaningful use includes use of ePrescribing and quality measures reporting as designated by the Health and Human Services Secretary.

Certified EHR HIT Standards have yet to be finalized nor have the organizations been selected who will conduct the certification.

Providers may receive reimbursement incentives from either Medicare or Medicaid but not both.

MEDICARE INCENTIVE

Providers may receive up to $44,000 over five years for proving meaningful use of a certified EHR.

First payment year: $18,000 if first payment year is 2011 or 2012
$15,000 if first payment year is 2013
$12,000 if first payment year is 2014

Second payment year: $12,000
Third payment year: $8,000
Fourth payment year: $4,000
Fifth payment year: $2,000

Eligible professionals working in health professional shortage areas (HPSAs) will receive a 10% increase in incentive payment amounts.

MEDICARE PENALTY

Providers who have not begun to demonstrate meaningful use of an EHR by 2015 will experience a reduction in Medicare fee schedules as follows:

2015: 99%
2016: 98%
2017 and on: 97%

MEDICAID INCENTIVE

In order to qualify for the Medicaid incentive, providers must rely on Medicaid assistance for at least 30% of their patient volume. For eligible Medicaid providers, the State is authorized to provide reimbursement for 85% of net average allowable costs of EHR adoption and startup – up to $63,750 over 6 years. Medicaid incentives for EHR adoption will begin in 2011. There are no set Medicaid penalties for lack of EHR adoption.