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How will the ARRA affect health care providers?
Can physicians receive both Medicare and Medicaid incentive
payments?
How do health care providers qualify for the EHR incentive
payments?
Will the EHR meaningful use requirements remain the same
throughout the funding period?
What is a certified EHR technology and is there a listing of
qualified EHRs?
Is there any financial assistance available for providers to
purchase and implement EHRs?
Answers
How will the ARRA affect health care providers?
The ARRA provision that will have the greatest affect on health care providers
will be incentive payments for health care providers (i.e., hospitals and
physicians/eligible professionals) for the meaningful use of certified
electronic health records (EHR). The Medicare and Medicaid programs will make
these payments directly to providers. Providers must establish meaningful EHR
use before they can receive any Medicare incentive payments. Recipients of
Medicaid incentives will have 1 year to achieve meaningful use after receiving
the first incentive payment. By 2015, Medicare providers that are not meaningful
EHR users will have their Medicare reimbursement rate decreased by 1% per year
up to a potential maximum penalty of 5%.
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Can health care providers receive both Medicare and Medicaid
incentive payments?
Eligible hospitals can receive both Medicare and Medicaid incentive payments.
However, individual eligible professionals cannot receive incentive payments
from both Medicare and Medicaid. They must choose whether to receive incentive
payments from Medicare or Medicaid, and this choice will most likely depend on
their Medicare and Medicid patient volume.
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How do health care providers qualify for the EHR incentive
payments?
A health care provider (eligible professional or hospital) must be a meaningful
user of an EHR to qualify for the incentive payments.
"Meaningful use" is generally defined in the legislation. Health care
providers must:
- Use a certified EHR technology in a meaningful manner which includes the
use of electronic prescribing;
- Demonstrate the EHR technology is connected in a manner that provides
for the electronic exchange of health information to improve quality of
care, such as promoting care coordination. This electronic exchange must be
in accordance with the aw and standards applicable to the exchange of health
information; and
- Use the EHR technology to submit clinical quality measures and other
such measures to Centers for Medicare and Medicaid Services (CMS) in a
manner and form specified by the HHS Secretary.
The HHS Secretary, through the Office of the National Coordinator (ONC) for
Health IT, will determine the exact criteria for meaningful use and this process
is currently underway and the certification criteria and standards are expected
to be communicated by December 31, 2009.
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Will the EHR meaningful use requirements remain the same
throughout the funding period?
This is yet to be determined. Indications are that the meaningful use
requirements will become more stringent near the mid-point of the funding
period. The specifics will be determined during the regulatory process currently
underway.
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What is a certified EHR technology and is there a listing of
qualified EHRs?
A certified EHR technology is one that meet standards pursuant to the ARRA and
includes patient demographic and clinical health information, such as medical
history and problem lists; and has the capacity to provide clinical decision
support to support physician order entry, to capture and query information
relevant to health care quality, and to exchange electronic health information
with, and integrate such information from, other sources. There is not a list of
qualified EHRs at this time. The Certification Commission for Health Information
Technology (CCHIT) is currently the only recognized certifying body but it is
not named or designated in the legislation. A listing of current CCHIT certified
products can be found at http://www.cchit.org/choose/index.asp
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Is there any financial assistance available for providers to
purchase and implement EHRs?
There is a provision in the ARRA for state loan programs to provide funding to
providers to adopt and implement EHRs in advance of the incentive payments. The
loans could be made to health care providers to facilitate the purchase of
certified EHR technology, to upgrade existing EHR technology, to train personnel
in the use of such technology, and/or to improve the secure electronic exchange
of health information. At this time, we do not know if or when this funding
would be available from the federal government.
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Last Revised: July 12, 2010 | 
