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Tue, Dec 08 2009 7:21 PM EST
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Health care providers need to take some giant IT steps—quickly—if they want to cash in on $46 billion in Medicare and Medicaid incentive payments intended to promote electronic health records. Hospitals will likely be required to use CPOE for 10 percent of all patient care orders in 2011 and for all orders by 2013, David Classen, M.D., said at a session titled “Clinical Decision Support: Implications for Meaningful Use and the American Recovery Reinvestment Act.” In 2015, the “carrots” of incentives will be replaced by “sticks” in the form of payment penalties. Classen is associate professor of medicine, senior partner and CMO, Computer Sciences Corp.
Providers expecting the government to relax its requirements are likely to be disappointed. The timelines are very explicit, Classen said, and the whole initiative is law-based, not rule-based, so loosening criteria would be very difficult. “What they are saying is ‘You will do this and we’re not going to change anything,’ ” he said. “They are deadly serious about implementing EHRs to achieve savings in health care.”
Hospitals will probably be paid the Medicare incentive money per patient, Classen said; to qualify, they’ll need to include extra coding in their Medicare reimbursement forms showing the patient was treated with an EHR according to the meaningful use criteria. After paying the bonus, CMS will likely come back to audit the hospital to verify it did what it said it did. If the audit goes against the hospital, the money will have to be returned.
Classen drew a loud groan from the audience when he shared the rumor that CMS will carry out those reviews by using the same firms it now uses for RAC audits. Most audience members nodded agreement when one person said, “In my opinion, those companies are nothing more than bounty hunters.”
Bill Santamour, managing editor of H&HN, is blogging from the IHI conference.
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