According to the Obama administration, the adoption of EHRs could save billions of dollars.
More than $2 trillion was spent on health care in 2008, according to the Kaiser Family Foundation. In 2009, President Obama signed the American Recovery and Reinvestment Act (ARRA) into law. This law contains a number of provisions that are intended to promote health information technology as a way to help decrease the escalating costs of health care.
One of these provisions relates to electronic health records, or EHRs. The Health Information Technology for Economic and Clinical Health (HITECH) Act under ARRA establishes incentives for health care providers who implement and use EHRs according to government standards. In 2014, providers that do not implement EHRs in line with these standards will face reduced reimbursements from Medicare and Medicaid.
Oversight
The federal program to encourage EHR adoption is administered by the Centers for Medicare and Medicaid Services (CMS) and the Office of the National Coordinator for Health Information Technology (ONC). The ONC developed the standards and criteria that eligible providers and hospitals must follow to certify their EHR systems. CMS established the minimum requirements these providers and hospitals must meet to show they are using their their systems in a meaningful way to receive incentive payments.
Certification
EHR systems must be certified to meet federal requirements. The ONC deems certain companies be ONC-Authorized Testing and Certification Bodies (ONC-ATCB). These companies test and review the technical capabilities of EHR systems and determine if they are able to provide the necessary functionality to help providers and hospitals meet the meaningful use guidelines set forth by CMS.
Meaningful Use
In July 2010, CMS released its final rule related to meaningful use. To qualify for incentive payments, providers and hospitals must show that their EHR systems are being used in a meaningful way. This means that these systems are being used to exchange health information in a way that improves health outcomes and that they are being used to report clinical measures.
Meaningful use is encompassed in three stages. Stage 1 runs from 2011 to 2012 and includes specific requirements related to data capture and sharing. In this stage, providers must meet 20 requirements to qualify for incentive payments. Of the 20 requirements, 15 are core requirements and must be met, the other five requirements can be chosen by the provider from a list of 10. Hospitals must meet 19 requirements of which 14 are required and the other five can be chosen from a list of 10. Additionally, providers and hospitals must use their EHR systems to report on clinical quality measures. Providers must report on six measures while hospitals must report on 15.
Incentives and Penalties
Providers and hospitals that have certified EHR systems and are found to be using them in a meaningful way are eligible to receive incentive payments from Medicaid and Medicare. Hospitals can receive payments from both organizations while providers have to choose one. Payment amounts are based on when the provider or hospital begins using a certified EHR system. The longer a provider or hospital waits to adopt and certify an EHR system, the less they will be paid. In 2015, providers and hospitals that do not have a certified EHR system will face decreased Medicare reimbursements.
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