ARRA Stimulus Funds
The American Recovery and Reinvestment Act of 2009, also known as the stimulus law, provides –through legislation – that providers that achieve meaningful use will qualify for over 17 Billion Dollars in federal payments. These payments will be made over a five year period to each eligible professional that qualifies. In order to qualify, a physician must select a certified electronic medical record program and then not only achieve but also demonstrate Meaningful Use. Physicians must further qualify through a volume of Medicare or Medicaid revenue coming into their practice.
ELIGIBLE PROFESSIONAL includes doctors of medicine (MDs), doctors of osteopathy (DOs), doctors of dental surgery (DDS), doctors of Dental Medicine (DDMs), doctors of podiatric medicine (DPMs), doctors of optometry (ODs) and chiropractors. Hospital based professionals such as pathologists, emergency room physicians, and anesthesiologists are excluded.
CERTIFIED EMR is a qualified EMR that is certified by an authorized authority as meeting standards applicable to the type of record involved.
QUALIFIED EMR is an electronic health record that:
- Includes patient demographic and clinical health information
- Has the ability to provide clinical decision support
- Support Physician Order Entry
- Has the ability to capture query information related to healthcare quality
- Has the ability to exchange health information electronically and integrate health information from other sources.
MEANINGFUL USER has several requirements:
- You must send prescriptions to pharmacies electronically
- Your EMR must connect electronically to other EMRs, such as hospitals, other practices and labs
- You must submit statistical information on quality of care to the government
- Other requirements not yet determined. The Meaningful Use Self-Assessment provides the best known information today on what we can expect for meaningful use requirements over the next several years.
If you meet the requirements, you will receive incentive payments according to the following schedule. The greatest benefits are available to eligible providers who meet the requirements by the end of 2012:
MEDICARE INCENTIVES
| Year |
2011 |
2012 |
2013 |
2014 |
2015 |
2016 |
2017 |
Total |
2011 |
18,000 |
12,000 |
8,000 |
4,000 |
2,000 |
0 |
0 |
44,000 |
2012 |
|
18,000 |
12,000 |
8,000 |
4,000 |
2,000 |
0 |
44,000 |
2013 |
|
|
15,000 |
12,000 |
8,000 |
4,000 |
0 |
39,000 |
2014 |
|
|
|
12,000 |
8,000 |
4,000 |
0 |
24,000 |
2015 |
|
|
|
|
-1% |
|
|
-1% MFS |
2016 |
|
|
|
|
-1% |
-2% |
|
-3%MFS |
2017 |
|
|
|
|
-1% |
-2% |
-3% |
-6% MFS |
Medicaid Incentives
Medicaid incentives are different but provide for more incentive money:
ELIGIBLE PROFESSIONAL is a physician, dentist, certified nurse midwife, or physician assistant (PA) practicing in a federally qualified health center led by a PA. In addition, Medicaid services must comprise a certain volume of your practice: 30% for non-hospital based professionals (20% for non-hospital based pediatricians); 30% for professionals who practice predominately in federally qualified health centers or rural health clinics; and 10% for children’s hospitals and acute care hospitals.
MEANINGFUL USERS in the Medicaid program must meet the same federal requirements for Medicare, but must also meet requirements that will be created by each state and approved by the Department of Health and Human Services at a later date.
CERTIFIED EMR requirements are the same for the Federal program.
By meeting these requirements, an eligible provider will receive up to 85% of the “net allowable cost”. It is widely believed that the maximum total payment over five years could be $ 65,000 based on the schedule below:
| Year |
Maximum Incentive |
1 |
$ 25,000 |
2 |
$ 10,000 |
3 |
$ 10,000 |
4 |
$ 10,000 |
5 |
$ 10,000 |
The final Meaningful Use rules for Stage 1 have been released as of July
2010. Physicians are required to meet 15 Core criteria and they must select 5 of
ten Menu criteria.
CLICK HERE TO PERFORM A MEANINGFUL USE SELF ASSESSMENT.
| Physician objectives |
Physician measures |
| Use computerized physician order entry for
medication orders |
CPOE is used for at least 30% of
patients with at least one medication in their medication list have a least one
medication ordered through CPOE. |
| Maintain diagnosis list (ICD-9 or SNOMED) |
At least 80% of patients have at least one entry or an indication of "none" |
| Maintain active medication list |
At least 80% of patients have at least one entry or an indication of "none" |
| Incorporate clinical lab results |
At least 40% of all ordered tests are incorporated as structured EMR data |
| Send reminders to patients for preventive/follow-up care |
At least 20% of patients age 65 or older
or 5 years of age or younger receive reminders through the EMR |
| Provide patients an electronic copy of health information |
At least 50% patients who request a copy receive it within
3 business days |
| Provide clinical summaries for patients |
At least 50% of all office visits result in a summary
within 3 business days |
| Check capability to provide electronic surveillance data to public health agencies |
At least one test of the EMR is performed
with follow-up submission |
Source: Centers for Medicare & Medicaid Services