Jul

22

Meaningful Use Myths

It is important to note that adopting an EHR that meets the meaningful use standard is not a mandate providers are required to adhere to. It is a mandate if qualified health care professionals who accept Medicare Part B or Medicare Advantage or qualify for the Medicaid incentives are interested in tapping into the EHR incentive dollars outlined in the American Recovery and Reinvestment Act (ARRA), Division B, Title IV.

While the incentive section of ARRA includes additional dollars for qualified health care professionals working in underserved areas, small and rural providers are still at a disadvantage. To take advantage of the incentive dollars, the provider is required to implement an EHR that meets the meaningful use requirements before they can take advantage of the incentive dollars. That means the small practice needs to pay for the application, pay for staff training, pay for data conversion (often from paper), etc. before any dollars are received as part of this federal stimulus program. This has been identified by small and rural providers as a significant barrier to moving to an EHR that can demonstrate meaningful use.

It is important to note that this is somewhat of a domino process - now that the rules are out there, vendors need to reprogram or upgrade EHRs and EMRs, those applications need to be certified by the federal government (and the CCHIT certification many already have does not count) and then providers can implement or upgrade to an EHR or EMR where the provider can demonstrate meaningful use. It is not necessarily likely that hospitals can take advantage of the incentives by October 1, 2010 and other qualified health care professionals by January 1, 2011. Implementation or an upgrade is usually not a quick and simple process.

Another barrier that is not necessarily being fully considered is all covered entity health care providers need to move to the ICD 10 diagnostic code set by 2013. A number of provider organizations will be balancing implementation and upgrade of EHRs now to an application that does not accommodate ICD 10 (that’s not a vendor requirement now) to take advantage of the incentives and upgrading again in 2012 to meet the ICD 10 conversion federal rule requirements.

Large providers will likely take advantage now by upgrading EHRs but small to medium sized providers may wait until 2013 to avoid the cost of a second upgrade, more training, data conversion, etc. The conversion to ICD 10 is significant and will be very costly to the healthcare industry.

Another barrier to moving to “meaningful use” sooner rather than later is the low Medicare reimbursement in Oregon. As one Eugene specialist told me, he does not take Medicare patients so the “stick” built into the incentive language (a reduction of Medicare reimbursement 1% per year) has not impact. As he said, “A reduction of 1% of zero is still zero. Why should I spend the money?”