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Where are the Incentives for Adopting EHR Technology...and Should I Wait to Decide?
By Nancy Stafford
We continuously read about the big bailouts and huge corporate bonuses attached to the American Recovery and Reinvestment Act (ARRA). For the rest of the country the mantra is “Show me the money!”
It is finally your turn to see the incentives.
The key, at this point, hinges on your government patient load. The first round of incentives are tied to Medicare and Medicaid claims. Beginning in 2011, the stimulus money will be available for practices that use electronic health records (EHR) in a meaningful way. Those that sign up early will have a huge monetary advantage over those that wait. The bulk of the money will be distributed in the first two years. Those who wait too long, past 2015, will be penalized by decreases in Medicare and Medicaid reimbursement rates.
We are not talking small potato incentives. An individual practitioner could qualify for up to $64,000. That is enough to pay for an EHR system, depending on the size of the scale. So now is the time to get to the EHR planning stage for your practice.
What's the hurry? Let's think about that. Now in August, we are in the bottom half of this year. That leaves about 16 months to have your system in place to beat the last minute rush in December 2010. Since an estimated 30 percent of practices currently have EHR systems, 70 percent will be in line to get them before the deadline. That could be a long line. No big deal – right? – you will just call a vendor and they will come the next day to install your EHR system. Wrong. Right now practices are waiting up to six months for an install.
So let's see. Let’s go backwards with the timeline:
· Install, let's say, October 2010. Remember that you have to demonstrate meaningful use before you can apply for the incentive money.
· Call vendor to get on their list, no later than May 1, 2010
(Oh wait, since other practices are trying to beat the 2011 deadline, the wait is now eight months)
· Hire and call the vendor to get on the install list, no later than March 1, 2010 (much safer)
· Discuss vendors' answers/proposals/deliverables to find your best match, end of February
· Receive vendors proposals, February 15, 2010
· Distribute requests for proposals (RFP), February 1, 2010
· Discuss all possible uses for EHR in your practice, February 1, 2010
· List all possible uses for EHR, January 1, 2010
· Delegate to team members areas to explore, November 20, 2009
· Gather your team to begin thinking about your EHR system, November 20, 2009
This is August. You still have your patients to see and your practice to run. Time flies. Consider also that some incentive money is available right now. Can you find any good reason to wait? If you can, then here is one more reason to start your EHR plan: There are currently incentives of up to $8,000 for effective EHR use.
Where is this money?
Now that is an adventure. Type into your search engine “Electronic Health Record Incentives” and – whoosh – in seconds, there is a list of nearly 230,000 matches. Just some gentle reading for your leisure time.
Begin with the U.S. Health and Human Services Web site to see what the incentives are all about. You will find the actual ARRA bill and some of it re-written in plain English. On the Web site they explain that many essential parts of the EHR incentive plan is still in the planning stage. For instance, they mention having a “certified EHR system,” but there is not yet a definition of certified. Nor, are the “certified” guidelines listed anywhere, because committees are trying to decide what will be required for a “certified” system. The good news is that most reputable EHR software and system designers are probably going to be “certified.”
You have also heard that your EHR system has to support meaningful use and outcomes. As of yet, there is not any definition of what is “meaningful.” So not much help here in helping you decide which system would be best for your practice.
So now let's find some grants that will fit your practice's goals. The Health and Human Services Web Site is a good place to start. Go to the “Grant Information for Current and Prospective Grantees.” Find the “Find a Grant.” You would think that is where you would find EHR stimulus money. Don't bother to look just yet, as the only one listed is one for state primary care offices. There is up to $2,000,000 available. Hurry, though, if you think you might qualify. It was posted July 30, but has a submission deadline of August 15. Here is the direct Web address for the application: Https://grants.hrsa.gov/webexternal/FundingOppDetails.asp?FundingCycleId=22939CF0-7952-40FD-AFC3-DBF352507A69&ViewMode=EU&GoBack=&PrintMode=&True&pageNumber=1
Centers for Medicaid and Medicare Services actually have control of the incentive money. Their plan is to coordinate and develop the selection of grantees in FY 2009. But, beginning in FY 2010, they will start funding the grants. You know the federal government fiscal year begins October 1. Get ready to find the grant applications that will lead you to the ARRA money. When you do find a grant that your practice is eligible for, begin by reading the entire grant first.
Make sure your practice fits into the eligibility guidelines. If it does not, look for another grant opportunity. If it does, press on. Answer each question honestly and thoroughly. Remember that you will be required to quantify your successes in the end, so only promise what you will be able to count. If this seems a bit daunting, you might consider a professional grant writer. You will need to be involved, but a professional can make sure your ideas are presented in the best light. Your specialty is helping patients, a grant writer's specialty is writing grants. They are well worth the money and time they can save you.
However, there are other methods to lead you through the grant packages. For instance, one Health Resources and Services Web site offers information to practices on how to evaluate the vendor selection.
Soon, your practice will be a recipient of the ARRA stimulus money. Be ready. Begin now to plan your approach to adopting electronic health record technology and you will be ready to see the money.
What can I do?