Maryland law will allow state to put stimulus cash toward electronic health records

Maryland Gov. Martin O’Malley will sign legislation Tuesday that provides incentives for health care organizations to implement electronic health records.

House Bill 706 allows the state to make use of federal stimulus dollars available for electronic health records and coordinate those efforts with the state’s own plan to create a state wide health information exchange.

The federal stimulus money provided $19 billion toward electronic health records. State health officials do not know how much of that money will flow to Maryland.

State and federal health officials are pushing electronic health records because they believe they will reduce medical errors and lower costs by eliminating the need for running multiple tests.

The stimulus package enables physicians to receive incentives between $44,000 and $64,000 over the next five years through Medicare and Medicaid.

It costs, on average, $50,000 for a physician practice to implement electronic health records. The incentive payments begin in 2011, and physicians who do not adopt an electronic health records will be penalized through lower Medicaid and Medicare payments starting in 2015.

In the past, the biggest obstacle in getting physicians to install an electronic health record was cost. The federal stimulus money and the state’s health information exchange overcomes that obstacle by providing incentives to adopt health records.

“It’s trying to create a business model to make [health IT] work,” Department of Health and Mental Hygiene Secretary John Colmers said.

While the federal money provides payments to physician practices, the state is taking its own steps to ensure that hospitals can share electronic information. The legislation requires the Maryland Health Care Commission and the Health Services Cost Review Commission to designate a state health information exchange by Oct. 1. State health insurers will provide incentives to hospitals, which include a lump sum payment or increased reimbursement, to adopt electronic health records.

Erickson Retirement Communities, Johns Hopkins Medicine, University of Maryland Medical System and more than a dozen companies and health care institutions have submitted their own plan to the state’s health care commission to create a health information exchange, known as the Chesapeake Regional Information System for our Patients.

American College of Cardiology Supports E-Prescription Mandate

The American College of Cardiology is separating itself from a number of other physician groups by favoring a mandate for Medicare physicians to adopt electronic prescriptions, Modern Healthcare reports.

ACC said it supports the mandate because it has moved quicker than other physician groups in embracing e-prescribing. Many cardiologists are part of large physician practices that already have adopted the technology, Jack Lewin, CEO of ACC, said.

A Senate Medicare bill likely will include a financial penalty for physicians who do not adopt e-prescribing technology, Modern Healthcare reports.

ACC supports increased reimbursements for e-prescribing rather than cuts. In a recent letter to the Senate Finance Committee, the group urged Congress to set the e-prescribing adherence deadline for Dec. 31, 2011.

“We’ve learned from those early adopters that we’re seeing actual cost savings, in addition to improving patient safety,” Lewin said.

Medical Billing Outsourcing Benefits

Your practice gains substantial benefits when it hires a medical billing outsourcing firm. By hiring a medical billing outsourcing firm, you free your self and your staff from the paperwork headaches of the reimbursement claims process.

By hiring a medical billing outsourcing firm, you are able to expedite income generation. Your reimbursement claims can be paid within 7-14 days. Paper claims are processed electronically to check for errors, and a bigger percentage of claims will be paid.

By hiring a medical billing outsourcing firm, you eliminate non-productive office hours. For the medical billing, outsourcing firm handles the non-core activities like billing and coding functions.

Some basic services a medical billing outsourcing firm does:
A medical billing outsourcing firm helps you integrate patient accounting functions and help with the pay follow up services. They will even facilitate third-party and bad debt follows up services.
A medical billing outsourcing firm helps you maximize your cash revenue by handling the management and liquidation of your accounts receivables.
A medical billing outsourcing firm will take over the responsibility of interacting with your patients.

Healthcare, Online Medical Transcription and Medical Billing: What's Involved?

Anyone who watches the evening news or picks up a national news magazine will recognize one thing to be true: Healthcare has become one of the fastest growing industries in the United States.

With such an explosion of the healthcare industry taking place, more and more people are embarking on careers in the healthcare system in two fields that have logically benefited from this growth: medical transcription and medical billing. These two fields compose vital organs of the medical industry body itself. To participate in such a necessary field will be both challenging and rewarding, as these fields continue to grow and evolve.

What exactly is medical transcription?

Medical transcription, also known as “MT,” is a healthcare profession which involves the converting voice-recorded reports as dictated by doctors and other healthcare professionals into text format. This is most often done on a PC, using a data entry program. Often this type of position can be done from home, widening its appeal to those with both financial needs and a need to remain at home due to family constraints. Likewise, taking the medical transcription courses online is a natural transition to working from home.

And what exactly is “medical billing”?

Medical billing has become one of the most popular careers in the nation. HMOs, PPOs, managed care, and private physicians need employees to process the claims forms and other paperwork associated with insurance plans, strictly adhering to procedural protocol between the insurance companies and the medical provider. As a result, the medical billing specialist must be detail-oriented, have a precise and detailed work style, and understand the complexities of insurance billing.

Stimulus cash gives health care records technology a boost

The $4 billion in federal stimulus health care money headed to the Bay State over the next three years will help provide care for those who can’t afford it and it is hoped help stem hemorrhaging costs by funding new technologies.

The bulk of the health care stimulus funding – some $3.5 billion – will keep mostly safety-net programs afloat with Medicaid/Federal Medical Assistance Percentage funds.

But a portion of federal stimulus money is targeted for cost-saving innovation. Massachusetts is expected to receive $1.3 billion in technology and research funds, with more than $500 million slated for initiatives to help create electronic patient records in the commonwealth.

State officials hope the federal investment will lead to a secure statewide database of patient information.

Nationwide, some $19 billion will go to electronic records programs with a goal of freeing health workers from an paper-based system by 2014. President Barack Obama has touted the potential costs-savings from the program.

Stimulus funds will be used to reward those who have already installed the record system and provide money to hospitals and physicians who implement it. The state would also penalize those who fail to upgrade.

Physicians who meet the state criteria for electronic files could receive reimbursements of up to $44,000 each over four years directly from the federal government. There are about 20,000 physicians in the state, according to Health and Human Services.

Partners Healthcare could be a big winner in the stimulus sweepstakes because it has already implemented an electronic records system. With individual reimbursements for its 3,000 members, including teaching hospitals Brigham and Women’s and Massachusetts General Hospital, the health care consortium could receive $10 million to $50 million.

The state’s Health Care Quality and Cost Council estimates that it takes a small medical practice an average of four months to adopt an electronic system at an up-front cost of up to $40,000 per physician.

Up-front costs have been one of the biggest obstacles in creating an electronic system. But Massachusetts, which has nearly twice the national average of doctors using these systems, could face an easier transition with quicker federal reimbursements.

“The adaptation in Framingham was smoother because there wasn’t an existing paper record, so our advisors picked it up very quickly,” said Paula Kaminow, executive director of the Framingham Community Health Center, which began using electronic records when it opened five years ago.

Community health centers are important sources of medical information, Kaminow said, because they serve a wide population that doesn’t have personal physicians. Installation of electronic records in 12 centers could increase staff productivity, allow for expansion in the number of patients and ensure easier and faster sharing of patient information with hospitals.

“From a risk-management standpoint it’s much easier for providers to find the information they need,” Kaminow said. “The handwriting is clean, you can find different chart notes very quickly, and can integrate information from different sources.”

The electronic system could save the nation $530 billion over 10 years, according to the Health Care Quality and Cost Council, which estimates that the stimulus’ initiative could reduce the nation’s health care spending by up to 30 percent.

Kaminow said the most important characteristic for an electronic record is the ability to interface with other types of records.

“The challenge is to make sure that all the different pieces can speak to each other, such as a management system that can speak to an electronic health record, or a lab report,” she said.

The central project for the state is the Health Information Exchange, which is not funded by federal dollars. The state’s newly-established Health Information Technology Council will provide $15 million in initial funding to help install the exchange by 2014.

The exchange would combine electronic record projects for individual practices, hospitals, and community health centers, sharing patient information in a secure statewide database. Anyone in the system treating a patient could quickly learn about the patient’s allergy data, medication and test results.

The initiative has another reward: Job creation.

Private-sector jobs could grow among vendors installing database systems, with positions ranging from entry-level programmers to high-level project managers.

Massachusetts has a leg up in this respect with an already developed system of software and hardware vendors.

“We’re looking to bring on more staff and extend our hours,” said Kaminow. “After a start-up period, our costs are covered through billing, so in that way we’d be able to sustain increased employment.”

The other big slice of the health care stimulus package is the $764 million coming to Massachusetts for over the next two years.

Funds will be used primarily to maintain services-securing jobs, meeting health care standards and safety net services, with $190 million going to offset fiscal 2009 budget holes, according to Health and Human Services.

Stimulus money provide a nationwide increase in federal matching dollars to Medicaid/Federal Medical Assistance Percentage funds of 6 percent, with potential increases depending on the state’s unemployment rate during the stimulus period.

Massachusetts receives an increase from 50 percent in federal matching dollars to 56.2 percent. Given the state’s shaky unemployment rate, which rose to 7.4 percent in March – a full point since December – the commonwealth could see an increase as high as 11.6 percent in the medical assistance dollars.

In fiscal 2010, $255 million would go to securing jobs and health care services provided by the state. The breakdown for this portion of funds is as follows:

• $160 million for hospitals
• $10 million to community health centers
• $45 million to nursing homes
• $15 million to community mental health $20 million to the “Community First” initiative, which transitions those with mental and intellectual disabilities from institutional care to community-based care $5 million to other health care providers $222 million toward maintaining coverage and eligibility for members of the state’s MassHealth and Commonwealth care health insurance programs.
• Finally, $97 million would help protect safety-net services by maintaining or restoring portions of funds to the Departments of Mental Health, Developmental Services, Commissions and Veterans, Children and Families, Youth Services, Public Health and MassHealth.

HIMSS defines ‘meaningful use’ of EMRs for Medicare incentives

So, soon providers will get incentives for putting EMRs into place–but as is usually the case, there’s a catch. To get Medicare incentive payments, it’s not enough to simply roll out the technology; hospitals and physicians will have to prove that they’ve made “meaningful use of certified EHR technology.”

This “meaningful use” includes using the technology to exchange electronic health data to improve care quality and submitting care quality measures to HHS. Not only that, hospitals and doctors will need to meet these requirements within a specified time frame.

So, what’s a group of providers to do if they want to get the incentive payments? HIMSS has a few suggestions:

• Rely on CCHIT as the certifying body for EMRs.
• Adopt metrics that can demonstrate meaningful use, and make them increasingly more stringent over two years or so.
• Work with HITSP and IHE to make sure systems are interoperable.
• Close the existing gap between “certified EHR technologies,” “best of breed,” and “open source” technologies. (now there’s a tall order

Any way you look at it, providers have their hands full in meeting the stimulus deadlines, which include October 1, 2010 for hospitals and January 1, 2011. Interoperability, in particular, is likely to be something of a nightmare.