Thursday

EHR Meaningful Use Final Rules - What's The Verdict?

So, doctors and hospitals will be rewarded for the "meaningful use" of electronic medical records. The final rules (all 864 pages), issued last Tuesday lighten up on the proposed requirements that the healthcare industry deemed unrealistic. A brief overview in the July 14th edition of the New York Times indicated the industry could receive as much as $27 billion over the next 10 years to buy equipment to computerize patients’ medical records. A doctor can receive up to $44,000 under Medicare and $63,750 under Medicaid, while a hospital can receive millions of dollars, depending on its size.


I don't think there's any argument EMR meaningful use will lead to “better, smoother care, more reliable care”, as Don Berwick, the new administrator of the Centers for Medicare and Medicaid Services, has stated. The question is, will doctors and hospitals be able to achieve meaningful use in the time frame required by CMS. The clock for progressive attainment of meaningful use runs from 2011 through 2016. There won't be any incentive payments after that, and if a provider doesn't achieve the measure of progress in a given year the incentive payment for that year cannot be recovered. Meanwhile, at this point only 20 percent of doctors and 10 percent of hospitals use even basic electronic health records, according to Kathleen Sebelius, secretary of Health and Human Services.
 

Under  the incentive program, eligible providers must utilize “certified EHR technology” if they are to be considered eligible for the incentive payments. Whether "meaningful use" can be achieved in the time frame allotted remains to be seen, but this is only one of a number of issues raised. For example, as reported in Crain's Health Pulse, several of New York's hospitals are protesting a CMS decision to award the promised $27 billion in funding based on Medicare provider identification numbers. In New York's hospital systems, many smaller hospitals use their flagship hospital's Medicare I.D. number. One major tertiary system, which has 1,500 beds on three campuses, will be treated like it has only 500 beds,” says it's Chief Executive Officer. In his system's case, that means a loss of $25 million in potential government funding.

At the Greater New York Hospital Association, a spokesman says so many of the region's hospitals are in the same situation that the association's lobbyists are pressuring Congress to change the eligibility rules. “We're deeply disappointed,” he says of CMS' decisions, noting the restriction will prevent scores of hospitals from getting the federal money. “We do not believe this was Congress' intent.”

As always, the devil is in the details. It remains to be seen how this will all shake out. I sincerely hope truly meaningful use of EMRs will be a reality in the not-too-distant future, but it can't happen without the realization of the significant dollars associated with the Medicare and Medicaid Programs Electronic Health Record Incentive Program.

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