Physician Practices become a large Healthcare-IT market in USA

As per my study here is a summary of Obama’s EMR and EHRS Incentive package:

1. $ 2B for developing standards, EMR installation grants and EHRS @ RHIR [I guess new name for RHIO]
2. $ 21B as incentives on EMR adoption. This is the net cost after anticipated savings of $ 15B are subtracted from the total spend of $ 36B on incentive payments.

Incentives will be given to providers with:

1. Use of a certified EMR product complete with ePrescribing capability as determined appropriate by the Secretary of HHS
2. The EMR is connected to the EHRS/ HIE for the electronic exchange of PHI
3. Complies with submission of reports on clinical quality measures
   

The incentives are for the ambulatory space and are paid on a per Physician basis. Hospitals are not eligible with certain exceptions. Provider can claim this incentive thru Medicare or Medicaid depending on their practice mix.

MEDICARE:

1. Physicians operating in a "provider shortage area" will be eligible for an incremental increase of 10% in their bonus payments.
2. Physicians operating entirely in a hospital environment, such as anesthesiologists, pathologists and ED physicians, are ineligible.
3. Beginning in 2015, physicians not demonstrating meaningful use will have their Medicare fee schedule reduced.

For further details you can refer FAQs on AllsrciptsMisys website; There is a table that gives the details of the amount physicians will receive each year through Medicare.

MEDICAID:

A healthcare provider is eligible for incentive payments from Medicaid who:

1. is not hospital-based and has at least 30 percent of the professional’s patient volume coming from Medicaid patients;
2. who is a pediatrician, who is not hospital-based, and who has at least 20 percent of the patient volume coming from Medicaid patients;
3. practices predominantly in a FQHC or rural health clinic and has at least 30 percent of the professional’s patient volume coming from Medicaid patients;
4. is a children’s hospital, or an acute-care hospital that is not described in clause (1) and that has at least 10 percent of the hospital’s patient volume coming from Medicaid patients.

Incentive payments will be based on a calculation that factors the physician’s Medicaid mix in combination with up to $25,000 the first year and $10,000 each subsequent year for five years, all multiplied by 85%. The highest potential for Medicaid payments is $63,750. Additionally, physicians filing under Medicaid must first demonstrate EHR usage by 2015 and will not be eligible for payments after 2021.

HOSPITALS:

Eligible hospitals such as children’s hospital, or an acute-care hospital can get $2 million base payment plus a figure derived from the discharge volume.

Critical Care Hospitals are not eligible for the incentives described above. Instead, they will be allowed to expense the acquisition cost of Health-IT in a single year for Medicare payment instead of depreciating it over a number of years.

For eligible hospitals not demonstrating meaningful EHR use by 2015, three-quarters of the anticipated percentage increase in the fee schedule shall instead be reduced by 33 1/3 percent for fiscal year 2015, 66 2/3 percent for fiscal year 2016, and 100 percent for fiscal year 2017 and each subsequent fiscal year. This reduction will be reevaluated each year, and a hospital can return to a normal fee schedule as soon as EHR use is demonstrated.

ADVANTAGES:

1. Therefore the Small Physician practices suddenly have become a very large Healthcare-IT market in USA! The power base has shifted. I remember the book ‘Power Shift’ by Alvin Toffler.
2. Obama has put life back into Public Sector Health plans - Medicare and Medicaid! WOW This is the work of a genius.

Above is a simplified version of the incentive package. There is more devil in the details. For those who want to go deeper, there is a good analysis provided in FAQ on AllscriptsMisys website.