What is the American Recovery and Reinvestment Act (ARRA) of 2009?

The ARRA is an economic stimulus package in which President Obama has allocated $20 Billion to incentivize hospitals and physicians to adopt IT Healthcare Technology such as Electronic Health Records (EHRs) and E-Prescribing. The government is providing incentives through Medicare and Medicaid reimbursement systems to help physicians and hospitals adopt EHRs in the amount of $17.2 Billion. While the specific rules for administrating this program are still in development, we do know that the program will operate much like the CMS/Medicare incentives now in place for E-Prescribing. Similarly, Physicians must use a "certified" EHR, and will have to show "meaningful use" of that EHR software on an on-going basis through yet-to-be-established reporting procedures. If they meet these requirements, physicians would receive substantial incentive payments through the Medicare and Medicaid reimbursement systems.

How much will physicians get paid?

Physicians and hospitals that participate will receive Medicare and Medicaid reimbursements paid out over the next several years of up to $44,000 (Medicare) and $65,000 (Medicaid). The specifics of the requirements are still being worked out however the basics have been established and can easily be adopted by physician's offices today. Physicians need to use a "certified" EHR in specified ways such as data reporting and exchanging information with other providers. For participating in 2010, physicians that meet these requirements will see a payment of up to $18,000 in 2011 from Medicare and up to $25,000 from Medicaid. -see Table 1 (Medicare) and Table 2 (Medicaid).

Source: American Recovery and Reinvestment Act 2009

Source: American Recovery and Reinvestment Act 2009

When will physicians get paid?

The earliest a physician could receive an incentive payment is in 2011. Follow on payments for participating physicians would then occur on an annual basis in the amounts shown in the tables above.

Why should physicians buy now?

The benefits that physicians can realize in their practice through the use of an EHR including higher reimbursements, better care and efficiency, the ability to see more patients in less time, are well established. For instance, physicians who do not use an EHR make less money each and every year they put off the move to Electronic Health Records. The government incentives shouldn't affect this equation in the short term with the exception that by adopting an EHR now, physicians and their practices can be assured that they will be ready with "meaningful use" of an EHR when 2010 rolls around and the program kicks into gear. Inevitably, those that wait too long will find it more difficult to obtain training and implementation services before the first of the year and may not be ready when the program starts. There are over 200,000 practices in the 1-10 physician range with only 4% using EHRs in a "meaningful way”. If a practice doesn't implement now, they will not be eligible for the first year payments.

What if I don't adopt an EHR by 2015?

Physicians that do not participate will begin to see penalties after a certain amount of time (beginning in 2015). The following table details reductions that physicians will see in their Medicare reimbursements for not adopting an EHR.

Source: American Recovery and Reinvestment Act 2009

Are there any benefits if I already use an approved EHR?

If you are already using an approved EHR than you are eligible to receive benefits starting in 2011. The ARRA does not differentiate between already implemented and yet to be implemented EHR systems. It is advisable to adopt CCHIT (Certification Commission on Health Information Technology).

What are some important points to consider when choosing an EHR?

Get up to date information on the Stimulus Package EHR requirements.
Identity the benefits of adopting an EHR for your practice.
Assess your current office needs and make a list of your practices requirements.
Prepare and implement a plan to transition to a certified EHR system.

Can you go over some of EHR criteria for ARRA:

First make sure you are implementing an ARRA "certified" EHR that has been approved by CCHIT. Physicians can start earning incentives in 2011 by demonstrating "meaningful use" of an EHR. "Meaningful use" has been defined as follows: eligible providers will be treated as a meaningful user of EHR technology if they meet the following three criteria:

• Uses a certified EHR in a meaningful manner, which includes the use of Electronic prescribing (e-prescribing)
• Uses a certified EHR that can accommodate the electronic exchange of Health information to improve quality of health care
• Submits information on clinical quality measures, as chosen by the Health and Human Services (HHS) Secretary, for the reporting period

In order to receive incentives from Medicaid, providers must meet the following eligibility requirements:

• Physicians, nurses and midwife nurses who are not hospital based and whose patient volume is at least 30% attributable to Medicaid, are eligible for up to maximum 85% of their net allowable technology costs, which is subject to specific annual limits.
• Medicaid incentives will be available only to non-hospital based clinicians, encompassing dentists, certified nurse midwives, and physician assistants practicing in rural health clinics.
• Medicaid incentives range up to $63K over a five-year period.
• Acute care hospitals with Medicaid patient volume of 10 percent or more and children's hospitals with any Medicaid volumes are also eligible.
• Medicaid has not mentioned any penalties for lack of adoption of EHR.
• After obtaining startup funds, providers who will prove "meaningful use" can be eligible to receive up to $10 K annually in reimbursement payments for an additional four years.

What Products Are (Or Will Be) Certified?

ARRA does not specify what certification criteria will be used, nor does it specify the organization that will set the criteria and test EHR vendors for compliance. It does specify that the criteria must be announced no later than December 31, 2009. According to analysis from HIMSS (Healthcare Information Management Systems Society) and other experts, the criteria will be announced much earlier than that and the responsible certification entity will most likely be the CCHIT (Certification Commission for Health Information Technology). This organization is already under contract to the Department of Health and Human Services and has a track record of establishing criteria for EHR standards, and certifying products under those standards.

Will MedicSupplier Be Certified?

Yes. MedicSupplier is very involved in the EHRA (Electronic Health Records Association) and other industry organizations that will be the first to know the specific certification requirements and rules when they are available. And our highest development priority is to ensure that our EHR options are fully compliant when the incentives program is implemented.