The strong momentum for physician adoption of EHRs achieved in 2011 seems to have hit a speed bump. The Center for Medicare and Medicaid Services (CMS) reported recently that the rate of registrations by physicians for the Medicare and Medicaid meaningful use programs declined in both March and April.
Combined registrations by eligible professionals (physicians) for the Medicare and Medicaid EHR incentive programs dropped in April to 12,228, down 12 percent compared with March numbers. Through May some 155,000 physicians had registered for the Medicare program and 56,214 had qualified. Those qualifying earned $953 million in incentive payments.
Why the slowdown in registrations after a fast start in 2011?
First, many physicians and hospitals that attested in the first 12 months of the program were early adopters of EHR systems. They were well along the path of purchasing and fully implementing an EHR.
Second, many physicians are growing concerned about the future of healthcare reform overall and the Medicare payment system in particular. The fact is the EHR meaningful use program is supported by both parties and will continue in stages through 2015.
Any practice leader who is still "standing on the sidelines" waiting to make a decision about adopting an EHR does not fully understand what is at stake. Here are five reasons to adopt an EHR system and register for the meaningful use program.
1. Stages 2 and 3 of the Meaningful Use program are definitely coming.
The recent controversy about the complex set of requirements for Stage 2 of the meaningful use program has created confusion about whether it might be scrapped. Here are the facts:
The comment period on the proposed Stage 2 rules is now closed and the CMS is expected to incorporate the comments and issue final rules by early August. The Stage 2 program is currently scheduled to take effect for eligible providers on Jan. 1, 2014; however, there is a good chance this date will be pushed back. While it may be delayed, it will definitely be implemented.
Another factor causing concern is the U.S. Supreme Court's scheduled ruling on the Patient Protection and Affordable Care Act (PPACA) during the last week in June. Even if the Court were to strike down significant portions of the law, it will not have a major impact on the EHR meaningful use program. In particular, the incentives and penalties will remain in place. The meaningful use program is part of the HITECH Act, passed in 2008, which has not had a major court challenge and which both political parties support.
2. If you don't register and attest soon, you are leaving cash on the table.
The key fact is physicians must complete the attestation process by Dec. 31, 2012, to earn the full $44,000 in incentive payments. If EPs wait until 2013 to begin the attestation process, they can earn only $39,000.Those who wait until 2014 to qualify will only be eligible for $24,000 in payments.
Technically, EPs only have to submit 90 days of clinical data obtained through their certified EHR to qualify for Stage 1 payments. Therefore, EPs could begin the Stage 1 reporting period as late as Oct. 3, 2012, and still be eligible to receive the maximum incentive payment. In practical terms, however, it takes most practices two to three months to install the EHR, adjust workflow, and "get up to speed" in collecting the needed clinical information for successful attestation.
Note also that the carrots will eventually turn into sticks. Physicians who do not meet meaningful use standards by October 2014 will face Medicare payment cuts of 1 percent in 2015 and 2 percent in 2016.
3. Many practices who fully implement an EHR experience improvements in reimbursements and office productivity.
Many physicians have expressed concern that EHR adoption will slow their workflow, force them to see fewer patients and reduce reimbursements. In fact, several surveys have found that by fully adopting an advanced, fully-certified EHR, many practices experience productivity increases. Many EHRs incorporate voice recognition and custom templates enabling accurate summaries to be created in seconds with only a few clicks of a mouse.
For example, in 2011 the Medical Group Management Association (MGMA) surveyed some 5,000 medical practices. They found that 61 percent of respondents who reported full adoption of an advanced EHR said the system had increased provider productivity and boosted practice revenue. Practices also find that an EHR reduces staff time in retrieving and storing medical records. Many EHRs also include dictation systems that can increase profits by eliminating transcription costs.
4. An effective EHR improves the overall value of your practice.
Today physicians practice in a highly connected world. More and more of the medical groups and hospitals they work with are moving to EHRs. Hospitals, in addition to being eligible for the meaningful use incentives, are also subject to a series of penalties based on patient readmissions and medical errors. Hospital executives are looking at many new clinical data metrics, most of which require EHRs.
Practices that refuse to adopt EHRs will soon become isolated islands of paper charts, unable to communicate with the larger interconnected world of digital data.
In addition to maintaining current practice patient flow, practice executives need to be concerned about attracting and retaining new physicians to their medical group. Virtually all new medical school graduates are highly computer savvy. These young physicians will be seeking to practice in an environment that supports the latest technology.
5. An advanced EHR system can reduce medical errors and improve patient care.
An article in the March 2010 edition of the New England Journal of Medicine reported that advanced EHRs can help physicians make improved diagnoses in a number of ways including:
• organizing and filtering patients' medical history and test results;
• facilitating collaboration between clinicians and patients;
• allowing for constant refinement and updating of patient data;
• improving follow-up and patient education.
In addition to improving individual patient care, EHRs will improve overall patient health. The widespread availability of patient data will transform our often reactive disease-management system to an efficient, proactive health system focused on patient health and well-being, including early detection and even prevention of diseases.
Zubin Emsley is chief executive officer of ChartLogic Inc. For more information, see www.ChartLogic.com.
5 Reasons to Register for the Meaningful Use Program FeaturedWritten by Zubin Emsley, CEO of ChartLogic Inc. | June 21, 2012
This article is written by Zubin Emsley, CEO of ChartLogic Inc.
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