Economic Stimulus Plan:

The Revolution in Healthcare

On February 17, 2009 President Barack Obama signed the American Recovery and Reinvestment Act (ARRA). ARRA is intended to achieve widespread adoption of Electronic Medical Record systems (EMR systems) and enable exchange of electronic patient medical records and other health information. It offers incentives through Medicare and Medicaid to reward providers for demonstrating the “meaningful use” of certified EMR systems.

The Facts

Starting in 2011, meaningful EMR system users can earn $44,000 under the Medicare plan and $64,000 under the Medicaid plan over 5 years.
Early adopters benefit most, as about 70% of the payments come in the first two years.
Those engaged in the Physician Quality Reporting Initiative (PQRI) and electronic prescribing can earn an additional $6,000 - $8,000 per year beginning immediately.
Physicians that do not adopt an EMR system by 2015 will be penalized through percent decreases in Medicare reimbursement rates.

What is Meaningful Use?

It is not enough to just purchase and implement an electronic patient medical records system. “Meaningful use” is defined in the legislation as:

Using a certified EMR system that includes electronic prescribing
Using EMR system technology that allows electronic exchanged of health information
Eligible professionals must submit information for the period on the clinical quality measures and other measures selected by the Secretary of the Department of Health and Human Services (HHS).

It is anticipated that HHS will provide specifics and clarity about what providers will need to do to demonstrate meaningful use. This means that most providers will have one year – 2010 – to finish EMR system implementation and put the infrastructure, applications and training in place to be eligible to receive as much of the incentive money as possible.

Privacy

In addition to these regulations, Congress passed a number of privacy protections (i.e., the Health Insurance Portability and Accountability Act, HIPAA). designed to safeguard the rights of patients to keep health records private whether or not an EMR system, or personal health record software (PHR), is used. The Bill:

Prohibits the sale of medical records without consent. (There are exceptions for research, public health and treatment.)
Limits marketing
Requires any entity using an EMR system or PHR to keep an audit trail of all people and organizations with whom they share your information.
Mandates policies setting standards for technology systems to segment sensitive information.
Mandates policies setting standards for encryption of data
Increases monetary penalties for violations

The Internet Opportunity

The Internet presents special opportunities for the new ARRA and security provisions. The Internet’s wide access at extremely low cost is driving medical providers to seek end-to-end web solutions, including web based EMR and web based medical billing software over conventional server based solutions. Why? The answer is simple: a web based EMR can be adopted for less cost than the ARRA payout to yield a net profit. Server based solutions cost more than the ARRA incentives to yield a net loss. But to succeed, web based solutions will have to be built from the ground up to meet the ARRA and security requirements.

The Solution

Providers can now choose from dozens of technology companies and evaluate which will allow them to seamlessly upgrade to a paperless practice and become a part of the healthcare revolution. There is only one choice that will give physicians the ability to:

Document their patient encounters through use of multiple input methods in less time than it takes today.
Access medical records anywhere, at any time, through a secure Internet connection so all of their patient’s doctors can access the record in an emergency in a HIPAA-compliant manner.
Upgrade to a paperless practice with a minimal investment and meet new government guidelines for electronic patient medical records.
Use a revolutionary web based medical billing software that allows them to create claims from voice-driven hybrid digital medical records and prepare and submit claims to insurance providers in less than 30 minutes.
Order labs, send prescription requests and earn the full Medicare E-Prescribing bonus payments and provide educational material to patients through a friendly PHR.
Participate in a virtual community of colleagues and find the right answers faster.
Take advantage of the growing abundance of web services, including personal health record software, designed to improve their patient care and practice effectiveness.
Be a part of the Internet healthcare revolution.

Doctations Doctations is the world’s first web-native EMR system. It is a web Based EMR Software as a Service for doctors, patients and billing staff to enhance healthcare delivery. This innovative technology helps doctors rapidly and sensibly author high quality Internet-enabled electronic patient medical records (which we call iDMRs). This revolutionary technology was integrated with an intelligent front desk management system and a state-of-the-art, automated web based medical billing software to help physicians achieve practice efficiencies not previously possible.

Doctations leverages the Internet to share workload, conserve physician time, increase practice profitability and improve patient care. All while moving physicians and their patients towards Internet healthcare and onto a shared network called the DocPatientNetwork.

By utilizing subscription pricing instead of a substantial upfront investment, Doctations provides physicians with an affordable option that is completely customizable to suit any medical practice and enables the practice to benefit from ARRA incentives.

Through efficient patient interactions, interoffice communications and by leveraging the Internet, Doctations enables doctors to collaborate on shaping solutions to the national healthcare crisis. The future of healthcare is on the web. By leveraging the Internet, Doctations improves doctors’ quality of life and empowers a grassroots movement to improve healthcare for all of us.

ARRA Bonus Tables

Over $29 billion has been dedicated to healthcare information technology in the Health Information Technology for Economic and Clinical Health Act, part of the 2009 American Recovery and Reinvestment Act (ARRA) that Congress has passed.

$29 Billion Stimulus Breakdown:

$2B for Health Information Technology (HIT) infrastructure, especially Health Information Exchanges (HIE)
$17.2B Medicare/Medicaid incentives to doctors and hospitals for “meaningful” use of certified EMR Systems, PHR and other HIT capabilities (net after government projected savings)
$4.7B for the National Telecommunications and Information Administration´s Broadband Technology Opportunities Program
$2.5B for the U.S. Department of Agriculture´s Distance Learning, Telemedicine, and Broadband Program
$1.1B for comparative effectiveness grants from Agency for Healthcare Research and Quality (AHRQ), National Institutes of Health (NIH), and HHS to answer the question, “Does automation improve care?”
$1.5B for the community health centers through the Health Resources and Services Administration;
$500M for the Social Security Administration;
$85M for the Indian Health Service;
$50M for the Veterans Benefits Administration; and
Assorted “pockets” of HIT funding in state and community funding allotments.

$29.6B IN TOTAL (not counting local funding)

Note: There is actually another $20B for Medicare Incentives before government calculations for savings. The real total for Health IT is about $50 B.

Meaningful Use of EHR technology:

For physicians to take advantage of incentives, they must be able to demonstrate “meaningful use” of an EMR System:

The EMR System is being used to e-prescribe
The EMR System is connected to provide electronic exchange of health information to improve quality and promote care coordination
The EMR System is able to report on clinical quality measures as specified by the Secretary

Medicare Incentives:

Incentives will start in 2011
Available to all non-hospital physicians who see Medicare patients
Eligible physicians can receive up to $44K over a five-year period
Minimum for Medicare participation: Providers must bill 125% of the total incentive received over the five-year period of incentive distribution
Must prove "meaningful use" of an EMR System
Physicians who have not adopted an EMR System by January 1, 2015 will be penalized by reduced Medicare payments

Medicare Incentives Schedule
*Year*	*2011*	*2012*	*2013*	*2014*	*2015*	*2016*	*Total*
1-4	$18K	$12K	$8K	$4K	$2K		$44K
1-4		$18K	$12K	$8K	$4K	$2K	$44K
1-4			$15K	$12K	$8K	$4K	$39K
2-4				$12K	$8K	$4K	$24K
No Pay							$0

Medicaid Incentives:

Available only to non-hospital based clinicians, including dentists, certified nurse midwives, and physician assistants practicing in rural health clinics, Federally Qualified Health Centers, or FQHCs
Medicaid incentives range up to $65K over a five-year period.
Minimum for Medicaid participation: 30% of a clinician´s patients must use Medicaid, with the exception of pediatricians, who only need to have 20% of their patients using Medicaid
Startup incentive up to $25,000 in state loan funds will be available in year one toward the purchase a certified EMR System
After receiving startup funds, providers who can prove "meaningful use" can receive up to $10,000 annually for an additional four years
No penalities have been defined by Medicaid for lack of adoption

Medicaid Incentives Schedule
*2011*	*2012*	*2013*	*2014*	*2015*	*2016*	*2017*	*2018*	*Total*
$25K	$10K	$10K	$10K	$10K				$65K
	$25K	$10K	$10K	$10K	$10K			$65K
		$25K	$10K	$10K	$10K	$10K		$65K
			$25K	$10K	$10K	$10K	$10K	$65K
				$25K	$10K	$10K	$10K	$55K
					$25K	$10K	$10K	$45K

Notice:

This is provided to you for informational purposes only. Nothing on these pages is or should be used as a substitute for professional advice of any kind. You should seek such advice solely from attorneys, accountants, compliance or other professionals you retain to advise you.