Maryland Docs can get up to $90K for EHR adoption from Insurance Payors

Are you receiving all the money available to you? With this state program, you may be entitled to even more, regardless of whether you plan to participate in the federal government’s ARRA stimulus program. Read on for details from our friends at MedChi Network Services, a division of the Marland State Medical Society.

State-Regulated Payor EHR Adoption Incentive Program

Maryland requires state-regulated payors to provide cash incentives to primary care practices for adopting electronic health records (EHRs). Aetna, CareFirst, Cigna, Coventry, Kaiser Permanente, and United Healthcare must provide a one-time payment to family practitioners, general practitioners, internists, pediatricians, geriatricians, and gynecologists. The total incentive will consist of two separate payment categories: Base Incentives and Additional Incentives. The maximum incentive is $15,000 per practice per payor.

Base Incentives

The base incentive derives from the payor’s share of members treated by the practice. It is calculated at $8 per member up to $7,500 and is limited to Maryland residents. Practices calculate the number of members by either counting the total number of members on the practice panel when the payor assigns a primary care provider, or by determining the total number of members treated by the practice in the past 24 months.

Member eligibility is based on enrollment with the payor at the time a practice makes an incentive request. Payors may exclude members from the incentive calculation if that member was previously included in a different practice’s incentive calculation.

Additional Incentives

The additional incentives are awarded to practices that achieve one of three supplementary goals associated with EHR adoption or use within the immediate 90 days prior to requesting an incentive. The amount will equal $7,500. Practices will receive additional incentives for meeting one of the following:

• Contracts with a state-designated Management Services Organization (MSO) or MSO in Candidacy Status for EHR adoption or implementation services
• Demonstrate advanced use of an EHR
• Participate in quality improvement initiatives and achieve established goals

EXAMPLE

Reimbursements for a practice who sees patients from all 6 payors.

Payer     #Patients      $/Patient              Base         Add’l          Total
Cigna               500         x  $8 =          $4,000    + $7,500 =   $11,500
Coventry         100         x  $8 =              $800    + $7,500 =    $8,300
Kaiser                  2         x  $8 =                  $16    + $7,500 =     $7,516
United             937         x  $8 =           $7,500    + $7,500 =   $15,000
CareFirst         100         x  $8 =              $800   + $7,500 =     $8,300
Aetna                 65         x  $8 =              $520    + $7,500 =     $8,020
Total subsidy paid to practice:                                                 $58,636

Application Process

Practices must apply to each payor by submitting an Incentive Application and a Payment Request. The incentive application can by submitted any time before December 21, 2014. The payor will then send an acknowledgement letter, and the payment request can be submitted no earlier than six months after the application was submitted. Payors are required to adjudicate claims within 60 days and may pay out the incentives over a period of 12 months.

MedChi Network Services will work closely with practices to review how these incentives apply to their specific situation and to receive full payment as soon as possible. Contact Morgan Opie, MedChi Network Services Coordinator, at 410-878-9688 or at mopie@medchi.org.

Free EMR Software?

Is there really such a  thing as “free EMR”? We thought this article posted at http://www.emrapproved.com/free-emr-software.php was worth reading if you are considering this option.

Free EMR Software vs. Standard License or Subscription License Models

A number of free EMR software systems like Practice Fusion™ exist on the market today. But what exactly does FREE mean?

“FREE” essentially means that this is an advertisement supported EHR solution. Therefore you will see advertisements from vendors interested in selling to the medical community while you work. The ads may be distracting to some users. The savings may be worth that distraction for others.

Remove the ads

“FREE” essentially means that this is an advertisement supported EHR solution. Therefore you will see advertisements from vendors interested in selling to the medical community while you work. The ads may be distracting to some users. The savings may be worth that distraction for others.

If you wish to remove those ads, you will instead pay a per month [fee].

What is “Not at all FREE” in this free EMR?

The free EHR does not include an integrated billing module. You will need to export the billing information on a periodic basis and send it to your billing company or system (and be sure to check out the compatibility of your billing system to receive the billing information from your new free EMR system).

If you use a PM system in-house, you will find that your patient scheduling information is now split between the EMR and PM system with no way to synchronize them. Or in some cases you can pay an additional monthly fee per payer provider to include their billing component.

Is the training and EMR support also FREE?

The training and support “included” with your free subscriptions are often inadequate for most practices. Industry-wide it is understood that most practices moving from paper to electronic will require a bit more hand-holding than the FREE e-mail or online reply to inquiry level of assistance. Additional fee offerings here, may also open doors to more substantive assistance (depending upon the vendor). Those with strong technical capabilities may find the system easy to follow – though practices with low technical competency might struggle.

Is there a catch?

With “free” or “reduced price” alternatives such as this one, the vendor reserves the right to sell the data that is collected in the course of hundreds of physicians charting patient visits. Of course, the data is sanitized so as to remove any and all attributes that help identify a patient. This is a sensitive topic but begins to explain how the whole “free” idea came about. As these companies are not 501c3 organizations, they are in the business of business. And therefore will find a way to profit from your participation. If your tolerance level for shared information and advertising outweighs your financial concerns, you may find these alternatives a good option.

How does this service differ from the paid alternatives?

Many of the features will be similar; however with the more robust standard alternatives – you pay for the benefit of certification, added functionality and privacy. More services are also generally available via these paid software options. Higher level implementation, training and support. A wider selection of connectivity. As well as a host of add-on features which can give your practice a more robust electronic experience.

Can I easily switch from one service to another?

This is not a simple answer. At this time, most migrations from one EMR data source to another can be cumbersome, flawed and expensive. Switching mid-stream involves data conversion which can add significant cost to the process. The time could also set your practice back on the timeline to meaningful use qualification.

Stage 2 meaningful use: New EMR/EHR definitions

From our friends at The Kelzon Group.

Here are a few more observations about the recently released Stage 2 proposed requirements:

Evidently ONC decided there was too much confusion about the definition of an EMR/EHR in Stage 1. So now in Stage 2 they have proposed these definitions:
Base EHR (formerly referred to as a ‘Qualified EHR)
1) includes; patient demographic and clinical health
information, such as medical history and problem lists;
2) has the capacity:
i. to provide clinical decision support;
ii. to support physician order entry;
iii. to capture and query information relevant to healthcare
quality; and,
iv. to exchange electronic health information with, and integrate
such information from other sources.
3) Meets the certification criteria adopted by the Secretary at:
§ 170.314(a)(1) through (8); (b)(1) and (2); (c)(1) and (2);
(d)(1) through (8); and (e)(1).  These cover – care coordination,
clinical quality measures, and privacy and security.

Complete EHR – can be setting-specific and must meet all adopted mandatory certification criteria for a setting.  While a certified Complete EHR (under the proposed revised definition of CEHRT) will likely have more capabilities than are necessary for any single provider to achieve MU, CMS believes the “Complete EHR” designation still has significant market value. They state: “it provides purchasing clarity and assurance to EPs, EHs, and CAHs that the EHR technology they have meet the regulatory definition of CEHRT(Certified EHR Technology); it can support EPs, EHs, and CAHs if they attempt to achieve all MU objectives and measures; and it ensures all the capabilities the Complete EHR includes have been tested and certified to work properly together”. As mentioned repeatedly, CMS is counting on the competitive marketplace to push vendors deeper into certification.

These definitions make little difference to Best of Breed (BoB) vendors who still have to get certified on all parts of your chosen criteria (such as Vitals requiring growth charts), while the health provider in his/her MU attestation can skip these elements if the task is not part of their normal practice or health delivery program.

But CMS also made this important point in the definition of a Complete EHR:
“…that a stand-alone, separate component of a certified Complete EHR
      cannot derive “certified” status based solely on it having been included
      as part of the Complete EHR when the Complete EHR was certified. This
      same principle applies to certified EHR Modules with multiple
      capabilities in that the components of the EHR Modules cannot be
      separately sold or purchased as certified EHR technology unless they
      have been separately certified.”

This means that a full EMR vendor who gets all their modules certified under one certification test, cannot sell a component of that full product as a ‘certified’ product. For example a lab system, that was certified as part of a full EHR, then sell the lab system as a standalone, would not be considered a certified lab system. However, if the provider previously purchased the full EHR, but did not initially install the lab component, but at a latter date latter did install the lab – that would be considered a certified lab system.

Webinar for Emdeon clients: Better claims tracking with Emdeon Vision

Emdeon has just announced a free weekly webinar on Emdeon Vision for Claim Management.

Become an expert of your claim management and join a free informational
webinar with one of our Emdeon Vision product gurus! Whether you’re new
to Emdeon Vision or just want to see what’s new in the product, you’ll learn
some best practices to help you use this reporting tool to the fullest!

Every Monday: 10am Central / 11am Eastern
Web access: http://www.emdeon.com/vision-webinar
Audio access: 877.345.2580
Meeting number: 62791804

Here are some of the topics you can expect to learn about in each webinar:

• Learn what’s new in Emdeon Vision
• Learn about the Emdeon Education Center
• Learn multiple ways to search for claims
• Learn how to print a Timely Filing Letter
• Learn how to print and export search results
• Learn how to identify rejected claims
• Learn how to find payment information
• Learn how to use the Dashboard to reduce claim rejections
• Learn how to use the Claim Quick Search feature to quickly find claims

Read more…

CMS Fact Sheet: Stage 2 Meaningful Use

In a recent publication from CMS.gov, CMS proposed requirements for Stage 2 of the Medicare and Medicaid EHR Incentive program.

Here is the information as posted in this fact sheet. You may find it lacking in detail, such as the 17 new core criteria and 5 new menu criteria (of which 3 are required), but it gives an overview nonetheless. Physicians  will have an additional year – through 2014 – to meet requirements for Stage 2.

CMS PROPOSES DEFINITION OF STAGE 2 MEANINGFUL USE OF CERTIFIED ELECTRONIC HEALTH RECORD (EHR) TECHNOLOGY