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Government outlines objectives for electronic health record incentive program


Dermatologists are one step closer to understanding how to access the electronic health record (EHR) incentive payments promised in the federal American Recovery and Reinvestment Act (ARRA). Enacted in February 2009, ARRA provides incentives for physicians who demonstrate "meaningful" use of a certified EHR system.

Key Points

The incentive payments to be doled out to physicians who are meaningful users of certified EHR systems are tied to Medicare and Medicaid. Dermatologists can receive up to $44,000 over a five-year period from Medicare, beginning with an initial payment of $18,000 in 2011.

The Medicare payments are linked to a maximum of 75 percent of allowable charges. In other words, dermatologists who receive at least $24,000 in Medicare-allowed charges in 2011 can receive the maximum subsidy of $18,000 for that year. Medicaid offers a higher total payment - up to $63,750 - but dermatologists must have 30 percent of their patient encounters with Medicaid recipients to qualify.

The ARRA outlined the general terms of qualification, but left a lot of the details to the newly created Office of the National Coordinator of Health Information Technology (ONCHIT).

On Dec. 30, 2009, ONCHIT released the details of "meaningful use" and addressed issues related to the program. The proposal sets out the following objectives for the incentive program:
1. Improve quality, safety and efficiency and reduce health disparities;
2. Engage patients and families in their healthcare;
3. Improve care coordination;
4. Improve population and public health;
5. Ensure adequate privacy and security protections for personal health information.


The incentives program will last just five years - 2011 to 2015. Physicians who do not implement an EHR will be penalized with reduced Medicare payments beginning in 2015.

For the first payment year, the reporting period will be any continuous 90-day period. Beginning in the second payment year, the entire year is required.

ONCHIT admitted that the government is not prepared to accept electronic submission of criteria in 2011. Thus, only attestation is necessary for 2011. Eligible physicians would be asked identify the certified EHR technology they are using and the results of their performance on all the measures associated with the objectives of "meaningful use."

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