Tri-State REC: An Overview of the Costs and Benefits of Adopting Health IT

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Tri-State REC An Overview of the Costs and
Benefits of Adopting Health IT

• Keith Hepp
• Chief Financial Officer
• HealthBridge

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Definition

• Meaningful use is defined as
• Use of a certified EHR in a meaningful manner
  (ex e-prescribing)
• Use of certified EHR technology for electronic
  exchange of health information
• Reporting on clinical quality and other measures.

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Meaningful use ? an EHR.

• To receive incentives, for example, practices
  have to use technology for a variety of uses
• Medication and allergy lists
• E-Prescribing
• Access to lab results
• Electronic orders
• Submitting claims
• Checking insurance eligibility
• Clinical summary to other providers and patients
• Clinical decision support
• Health information exchange
• Quality reporting to the federal government
• Among others

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Hard Costs

• Hardware computers, handheld devices, printers,
  etc.
• Software - EHR software, other software,
  customization
• Network and internet connectivity
• Staff Time Planning, project mgmt, vendor
  selection, purchasing, contracting, etc.
• Legal costs - contracts
• Facilities costs changes to site, furniture
• Staff User Training
• Customization configuration by vendor
• Data collection and conversion of older data
• One-time and ongoing Interface costs
• with external data sources

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Harder to quantify

• Transition costs - Reduction in productivity for
  3-6 months as staff learns new system
• Morale - Workplace satisfaction may drop with
  such a huge change
• Ongoing training and support needed

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Potential Benefits

• Revenue Increases
• Increased reimbursement
• Higher patient volume
• Faster revenue cycle, fewer errors in claims
• Productivity improvements process automation,
  fewer phone calls
• Overhead cost reduction
• E.g., Lower lease due to less record storage
• Higher quality care and greater customer
  satisfaction

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Medicare Incentive Funding
MEDICARE EP Incentive Payment - Based on First Calendar Year EP receives MEDICARE EP Incentive Payment - Based on First Calendar Year EP receives MEDICARE EP Incentive Payment - Based on First Calendar Year EP receives MEDICARE EP Incentive Payment - Based on First Calendar Year EP receives MEDICARE EP Incentive Payment - Based on First Calendar Year EP receives MEDICARE EP Incentive Payment - Based on First Calendar Year EP receives
Calendar Year CY 2011 CY 2012 CY 2013 CY 2014 CY 2015 and later
2011 18,000
2012 12,000 18,000
2013 8,000 12,000 15,000
2014 4,000 8,000 12,000 12,000
2015 2,000 4,000 8,000 8,000 0
2016 2,000 4,000 4,000 0
TOTAL 44,000 44,000 39,000 24,000 0
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Medicaid funding higher
MEDICAID EP Incentive Payment - Based on First Calendar Year EP receives MEDICAID EP Incentive Payment - Based on First Calendar Year EP receives MEDICAID EP Incentive Payment - Based on First Calendar Year EP receives MEDICAID EP Incentive Payment - Based on First Calendar Year EP receives MEDICAID EP Incentive Payment - Based on First Calendar Year EP receives MEDICAID EP Incentive Payment - Based on First Calendar Year EP receives MEDICAID EP Incentive Payment - Based on First Calendar Year EP receives
Calendar Year CY 2011 CY 2012 CY 2013 CY 2014 CY 2015 CY2016
2011 21,250
2012 8,500 21,250
2013 8,500 8,500 21,250
2014 8,500 8,500 8,500 21,250
2015 8,500 8,500 8,500 8,500 21,250
2016 8,500 8,500 8,500 8,500 8,500 21,250
2017 8,500 8,500 8,500 8,500 8,500
2018 8,500 8,500 8,500 8,500
2019 8,500 8,500 8,500
2020 8,500 8,500
2021 8,500
TOTAL 63,750 63,750 63,750 63,750 63,750 63,750
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Medicaid Patient Thresholds
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Other Incentives
Other Medicare Incentive Program Interaction with ARRA/HITECH MU Incentives
Medicare Physician Quality Reporting Initiative (PQRI) Yes, if the PQRI incentive is extended in its current format beyond 2010, EPs can participate in both if they are eligible
Medicare Electronic Health Records Demonstration(EHR Demo) Yes, if the EP is eligible
Medicare Care Management Performance Demonstration (MCMP) Yes, if the practice is eligible. The MCMP demo will end before EHR incentive payments are available
Electronic Prescribing Incentive Program (eRx) If the EP chooses to participate in the Medicare EHR Incentive Program, they cannot participate in the Medicare eRx Incentive Program simultaneously. If the EP chooses to participate in the Medicaid EHR Incentive Program, they can participate in the Medicare eRx Incentive Program simultaneously

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Practical Guidance

• Need to capture all the hard and soft costs of
  EHR adoption
• Capture all of the revenue factors
• Consider mix of patients Medicaid funding
  higher but have to meet thresholds
• Biggest incentives come in first few years but
  your practice may not be ready for such a large
  leap
• Consider if you can double dip with other
  incentive programs

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Questions?

• The Tri-State REC can help!
• www.healthbridge.org
• rec_at_healthbridge.org
• 513-469-7222