How Many Will Actually Collect ARRA EMR Stimulus Money?

In my last post Michael Milne made the following comment that I think was worth discussing:

I firmly believe that less than 5% of all doctors who do buy a “certified” EMR are going to collect.

For example, how many here, or even heard of someone, have actually collected the e-prescribing incentive?

I think that 5% is a low estimate of who will collect on the EMR stimulus money. Although not that much lower. What do you think?

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John Lynn

John Lynn

John Lynn is the Founder of the, a network of leading Healthcare IT resources. The flagship blog, Healthcare IT Today, contains over 13,000 articles with over half of the articles written by John. These EMR and Healthcare IT related articles have been viewed over 20 million times.

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  • The statistic that I have been looking for is how many physicians in small private practice (1 to 5 docs) meet the required percentages for medicaid or medicare? And what is the exact definition of “safety net provider”. I think there is still a good deal of ambiguity about who qualifies outside of the EMR requirement.

    The HHS seems to be very committed to giving away the money so I think they are going to clear this up but if I had to guess based on the way it is right now, my guess is less than 20% and if you break it out to doctors in large clinics and hospitals vs small practices, the small practices will probably be under 5%

    In other words, about the same percentages and breakdowns that we’ve seen with EMR thus far – which begs the question… if the only people that end up getting the stimulus money are ones that already had an EMR, then why pay them – they were doing it anyway?

  • Russ,
    Your statistic of those that meet the required percentages for medicare and medicaid is interesting. The other 2 important factors to look at is how many providers will use a certified EHR and how many will be able to show “meaningful use” of that EHR. Many are going to end up not qualifying because of these things. Kind of like with the ePrescribing.

    I agree with your question and assertion. One of the big winners will be those who already have an EHR. So, the money won’t really be going to increase EHR adoption. Misplaced funds?

  • Payment of 2009 MIPPA ePrescribing Incentives will be made AFTER the reporting period ends (that is, not until 2010). The just-released updated rule for 2010 makes it much easier to be a “successful ePrescriber.” The only remaining G-code for eRx is G8443, and indicates that at least one prescription for the visit billed was prescribed electronically. Eligible visits now include home care and skilled-nursing facility visits, and this G8443 needs to be submitted only 25 times during 2010 to qualify the prescriber for the incentive. In addition, if a physician or practice uses a registry for other incentive submissions (PQRI), they will be able to use the registry for ePrescribing, also. Finally, there are special requirements for large group practices that will make it easier and more financially advantageous for them to participate in MIPPA.
    DISCLAIMER: I am Chief Medical Officer of DrFirst. We provide stand-alone ePrescribing, and also the ePrescribing functionality behind 80 eHealthcare partners’ products.

  • Peter,
    Sounds like we need to have you do a guest post on the changes to the stimulus money. I’ve heard that they were quite the challenge to obtain, but it sounds like some of the changes might make it a bit easier?

    I’ll drop you an email and see if you’re interested.

  • We believe that it will be tough to grab that ARRA funding because there are so many points of failure in the process. Finding the right EMR provider, making sure that provider can deliver a system that meets CCHIT standards, implementing the system in your office and then using it enough to qualify. Lots of work to do there. Unless your EMR provider is guaranteeing a certified EMR system at this point in time we believe that your chances of landing the ARRA dollars are slim.

    Mitochon Systems

  • Steve,
    Actually doctors don’t have to find an EMR system that meets CCHIT’s standards. They need to find an EMR that meets HHS’s standards (which are yet to be released).

    However, you’re analysis is likely for many people. That’s why I’ve been preaching the gospel of implementing an EMR on the basis of the various EMR Benfits: and then use the EMR stimulus money as a bonus if everything goes right.

  • I think it is important to note the stimulus money is paid out in installments. If you miss the first and largest amount (12-14 thousand dollars) in 2010 because you did not meet the qualifying number the during the first period, that this money is gone. Every year that goes by un-qualified is money taken away from the initial 44 grand. So if the provider waits until the last year like so many are doing because of any uncertainties they will collect the smallest amounts (a couple of grand).

  • David,
    You’re right that the stimulus is paid out in installments. However, you can miss the first year (2011) and still qualify for the entire $44k of stimulus if you adopt in 2012. In 2013 if you adopt you can get up to $39k and if you adopt in 2014 you can still get $35k. So, the amount does drop each year you delay, but not as significant as you’re describing.

    You can see the full chart on slide 3 of the presentation I’ve embedded here:

  • I am just a practicing podiatrist but I believe a few of you are a little off the mark. First of all I believe the code changed to G8553 when the requirement changed from 50% to 25 submissions. Secondly, the systems will probably have to be certified. HHS has not clarified if they will do it or if CCHIT will set the standards and if the standards will have anything to do with CCHIT. But given the way CCHIT came to be, it seems pre-ordained. Lastly, the most likely “gotcha” for money, is probably the HL7 requirements. The program insists that we share information through a central clearinghouse that will standardize information for redistribution and collect data from your records to assess the frequency and associations of codings for the purposes of developing protocols and establishing reimbursement. In essence, we are being given an incentive to buy the rope that we get to give to Ins Co and MC to hang us with. No-one knows who is setting these up or who is paying for them, but I would expect a nice fee to connect to whatever comes to be.

  • Marc,
    All of the indications have been clear that HHS will be developing their own criteria and not using the CCHIT criteria. Now it is possible that HHS will use some of the standards that CCHIT created in their criteria. Although, I think we can be certain that HHS will want to kind of make their mark in having a different criteria. CCHIT is likely to be a body that certifies the HHS criteria.

    I don’t think it’s still clear who/how you’ll have to share information to show “meaningful use.” I think the stage 1 specifications won’t likely include a clearinghouse, but I might be proven wrong. The issue you talk about becomes a real issue in stage 2 and 3 meaningful use I think.

    There is a definite fear that all the data sharing is “buying the rope they use to hang you.” The question I have is whether insurance companies will follow Medicare’s lead and do the same thing?

    I’m not so sure there will be a fee for connecting. Possible, but I’d say unlikely. Will be interesting to see.

  • Hi Marc. I too am a podiatrist with a private podiatry practice in Brisbane. Given the recent plethora of ‘Podiatrists behaving badly’, I understand why some podiatrists might be getting a persecution complex. There is a document called “Report to the Professions’ that details who has been done for what and how much. Does anyone know when the HHS details will be made final? Cheers from down ‘that’ end. Stephanie

  • The details are made final. EMRs are beginning Submission through 2 organizations, The Drummond group and CCHIT. The regular CCHIT certification can be used for PQRI but a seperate certification is necessary for HITECH funds. You should discuss with your vendor as to what 3rd party modules such as surescipts and patient portals will be necessary to meet requirements for guaranteed stimulus reimbursement, if your vendor offers any such guarantee. If you have not purchased software yet, KLAS has a list of vendors most likely to meet certifications

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