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EMR Educate - ARRA Incentives

Benefits to Healthcare Providers

As part of the Obama administration's plan to reduce medical costs and improve the quality of healthcare, the federal government is encuraging adoption and meaningful use of Electronic Medical Records (EMRs) and other health information technology. Under the American Recovery and Re-Investment Act of 2009 (ARRA), about $20 billion has been appropriated for EMR "incentives" payable to healthcare providers over a 5-year period.

Choice of Two EMR Incentive Programs

Incentive funds are available through two programs, Medicare and Medicaid, and each program has its own set of eligibility criteria, requirements, and incentive payouts. Eligible professionals must choose to accept payments under one or the other program and cannot receive incentive payments under both programs.

The Medicare EMR Incentive Program

Under the Medicare EMR Incentive Program, eligible physicians in ambulatory practices that use a qualified electronic health records are eligible for up to $44K or more per physician over a five-year period as follows:

The Medicaid EMR Incentive Program

Under the Medicaid EMR Incentive Program, eligible physicians can receive up to $63,750 to purchase and use a qualified EMR system. For practices that have not deployed an EMR syste, the Medicaid program offers up to $21,250 per physician to help purchase and implement a system (the physician must purchase before 2016 to be eligible). Thereafter, the Medicaid incentives offer up to $8,500 per physician for "meaningful use" of the EHR. The "meaningful use" payments will be available for up to 5 years (with no payments being made after 2021). Medicaid-eligible professionals must pay at least 15% of the cost to purchase and maintain their EHR technology. The anticipated start date for this program is October 1, 2010.

An "eligible physician" under the Medicaid Incentive Program meets one or more of the following criteria: (1) a non-hospital based physician who has at least 30% Medicaid-insured patient volume; (2) a non-hospital based pediatrician who has at least 20% Medicaid-insured patient volume; OR (3) a physician who practices primarily in a "Federally Qualified Health Center" (FQHC) with at least 30% patient volume identified as "needy individuals".

"Certification" and "Meaningful Use"

In order to qualify for the EMR incentives, physicians must engage in "meaninful use" of a "certified" EMR system.

The definition of "meaningful use" will evolove over time, but it presently includes "computerized physician order entry" (CPOE), such as e-Prescribing, and the ability to electronically submit information on healthcare quality measures (similar to current PQRI and "Medical Home" requirements).

"Certification" means an EMR system has been certified by CCHIT or one of the newly authorized certification bodies. Certification of EMR systems will be easier and less expensive in the future, with the goal of creating more competition within the EMR system market segment.