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Getting Clear on EHR Incentives and Value

84074530By Mark Wallin

For many years we have been hearing an increasing amount of information regarding Electronic Health Records (EHR) and related technologies with acronyms such as EMR, PHR, HIE to name a few. More recently, we have been hearing an emphasis on incentives and programs that may be available to physicians that adopt or utilize technology and provide quality reporting, including the federally funded Electronic Prescribing (eRx) Incentive Program, PQRI (Physicians Quality Reporting Initiative) as well as some privately funded programs from some health plans. Today, there is significant attention on what is commonly referred to as “meaningful use.”

The September 29 program at the Philadelphia County Medical Society will provide information on the “final rules” that were announced last month by the Centers for Medicare and Medicaid Services (CMS) and the Office of the National Coordinator for Health Information Technology (ONC), which will guide desired EHR use for the next few years, including “meaningful use” requirements, and identify how medical professionals must use EHRs to improve care, in order to be eligible for financial incentives for Medicare (up to $44,000 over five years) and Medicaid (up to $63,750 over six years) under the Health Information Technology for Economic and Clinical Health (HITECH) Act, which was part of The American Recovery and Reinvestment Act of 2009 (ARRA), also known as the Stimulus Bill passed in February 2009.

The program will also address elements of the HITECH Act which authorizes a Health Information Technology Extension Program, including the creation of Regional Extension Centers (RECs). ONC awarded two RECs in Pennsylvania, both won by Quality Insights of Pennsylvania (QIP) and its sub-contractors. The RECs in PA, named PA REACH, (“East” and “West”) specifically target primary care providers for support in achieving meaningful use of EHRs. Meaningful use incentives are available to a wide selection of specialties; however, PA REACH will provide services to eligible primary care physician practices, subsidized by the ONC grant.  The grant subsidies will mean very low fees from PA REACH for consultations regarding technology needs assessment and acquisition, and implementation support for technology adoption in order to help participating physician practices achieve “meaningful use.”

In addition, and just as important, it is critical for all practitioners to understand and take advantage of the value of technology beyond the incentives of the next few years. The long-term purpose of technology must enhance and improve care and safety for patients; improve efficiencies and access to clinical data for physician practices, while supporting workflows and driving cost savings.

Technology should be viewed as a tool (or tools) by which the best individual patient care can be delivered based on the most robust information made available at the point of care, and to be able to measure and evaluate populations of care within the practice. This is a critical perspective to maintain while considering technology adoption or enhancements. Technology must be adaptable enough to support the service-based claims reimbursement processes used today as well as the outcomes-based or value-based claims reimbursement processes that are likely to become the norm in the years ahead.

Mark Wallin is President of eHealth Consultants, LLC.

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