Meaningful Use Subsidies for Health Care Providers, Impacted Areas

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Meaningful Use Subsidies for Health Care Providers, Impacted Areas

Physicians and hospitals each have a list of objectives to qualify for subsidies. For physicians, the goals include:

  • Incorporate at least 50 percent of all lab tests in the electronic medical record (EM).
  • Use the EMR to send preventive care reminders to at least half of all patients over age 50.
  • Record and chart vital signs for all patients over age 2, including blood pressure and BMI.
  • Maintain a list of medications prescribed to 80 percent of all patients.
  • Generate patient lists by condition, such as hypertension, for quality improvement.
  • Make sure that at least 80 percent of patients can obtain their electronic health records within 48 hours.
  • Check insurance eligibility for at least 80 percent of all patients.
  • Implement five clinical decision-support rules that are a high clinical priority.
  • Submit at least 80 percent of all claims to public and private payers electronically.
  • Provide at least 10 percent of all patients timely access to electronic health records.
  • Provide clinical summaries for at least 80 percent of all patient visits.
  • Use CPOE systems for 80 percent of all prescriptions.

For a full list of goals for physicians and hospitals, go to the www.federalregister.gov web site or use this direct link: http://edocket.access.gpo.gov/2010/E9-31217.htm.

Source: Medicare and Medicaid Programs; Electronic Health Record Incentive Program.

Physicians who demonstrate the required use for 90 days in 2011 can qualify for the first of several promised payments. In subsequent years they must demonstrate meeting the meaningful use rules for all 12 months. The way these payments are arranged, a doctor can actually start in either 2011 or 2012 and under the federal schedule still qualify for the full $44,000 in subsidies available per physician.

Key Impacts on Health Care Providers By Category

While the feral government wants to speed along adoption, providers will be challenged to grapple with some of the issues below:

  • Staff Education & Training
  • BusinessProcess Analysis of Health Plan Contracts
  • Coverage Determinations, & Documentation
  • Changes to Superbills
  • IT System Changes
  • Increased Documentation Costs
  • Cash Flow Disruption
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About the Author:

Michael is Managing Partner & CEO of No World Borders, a leading health care management and IT consulting firm. He leads a team that provides Cybersecurity best practices for healthcare clients, ICD-10 Consulting, Meaningful Use of Electronic Health Records. He advises legal teams as an expert witness in HIPAA Privacy and Security, medical coding and billing and usual and customary cost of care, the Affordable Care Act and benefits enrollment, white collar crime, False Claims Act, Anti-Kickback, Stark Law, Insurance Fraud, payor-provider disputes, and consults to venture capital and private equity firms on mHealth, Cloud Computing in Healthcare, and Software as a Service. He advises self-insured employers on cost of care and regulations. Arrigo was recently retained by the U.S. Department of Justice (DOJ) regarding a significant false claims act investigation. He has provided opinions on over $1 billion in health care claims and due diligence on over $4 billion in healthcare mergers and acquisitions. Education: UC Irvine - Economics and Computer Science, University of Southern California - Business, Stanford Medical School - Biomedical Informatics, Harvard Law School - Bioethics.
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