Friday, November 20, 2009

By Bernie Monegain, Healthcare IT News

A bill that provides loans of up to $350,000 for physicians and $2 million for medical groups to buy electronic health record systems or other healthcare information technology is likely to benefit solo and small group practices the most, according to investment bank Piper Jaffrey.

On Wednesday, the House of Representatives approved HR 3014, sponsored by Rep. Kathleen A. Dahlkemper (D-Pa.), chairman of the House Small Business Regulations and Healthcare Subcommittee. The Small Business Health IT Financing Act would authorize the Small Business Administration to oversee a $10 billion loan program for healthcare providers.

The bill now faces Senate action.

“The smaller provider market is the greatest beneficiary of this, giventhe limits on the loan size,” said Sean Wieland, Piper Jaffrey’s senior research analyst, in a brief. “A five-doc group can get a max loan for $2 million. A 100-doc group can also get a max loan for $2 million. Therefore, we think it will accelerate adoption levels in the five-doc-and-under market.”

“It’s apparent that the government is making the ambulatory sector the enter of their efforts,” Wieland said.

The brief, written by Wieland and research analyst Nohan A. Naidu, also notes that athenahealth is well positioned to benefit from the program.The Watertown, Mass.-based provider of Web-based electronic health record and practice management services for physicians “is best positioned to take share in this segment because of their in-the-cloudapproach to both practice management and clinicals,” Wieland said.

Allscripts-Misys Healthcare Solutions and Quality Systems, Inc,. are also well positioned to gain market share in this sector, Wieland noted.

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x = Average number of patients per provider per day

y = % of patient who are Medicare

z = Average submitted allowable per Medicare patient

a = Working days per year for the provider

(.75(a(z(y*x)))) = Eligible Medicare submitted allowable charges

Exampe:  Providers see’s 20 patients per day, 30% are Medicare and the average submitted allowable per Medicare patient is 55.00.  This provider works 240 days per year.  Based on this provider:  20 * .30 = 6 Medicare patients per day,  6 * 55 = $330 Medicare allowable charges per day, $330.00 * 240 = $79,200 * .75 = $59,400.  This provider would be eligiable for $18,000 in 2011 if all the “meaningful use” criteria is met.

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Dr. David Blumenthal, the national health IT coordinator, said yesterday his office will explain “in the coming weeks” how it will define a “certified” electronic health record,” which providers must purchase in order to qualify for new federal health IT incentive payments.

In an e-mail message, Blumenthal gave a preview of what further guidance providers should expect in coming months as his office works with the Centers for Medicare and Medicaid Services to finalize the set of requirements for “meaningful use.”

Under the health IT stimulus legislation, providers who are meaningful users of certified health IT will be eligible to receive increased Medicare and Medicaid payments.

“As efforts advance, we will turn our attention to other necessary supporting programs, some of which you will hear more about in the coming weeks, including defining what constitutes a ‘certified’ EHR, which is one of the requirements to qualify for Medicare and Medicaid incentives,” Blumenthal said.

Blumenthal said his office will also outline programs aimed at smoothing the transition process and identify steps that physicians and hospitals can take now to promote adoption of EHRs. 

While awaiting the CMS rule, he urged providers to become “as familiar as possible” with the discussion of meaningful use criteria in the recommendations of the Health IT Policy and Standards committees, two panels advising Blumenthal.

The policy committee completed its second set of recommendations on meaningful use in July. They are online.

“Be assured you will not be alone as you seek to adopt an EHR system,” Blumenthal wrote, citing grants for regional extension centers that would assist providers in establishing an EHR system.

The public will be able to comment on the definition, and CMS will consider those comments before the rule is finalized in early 2010. Any formal definition of meaningful use will include specific activities that health care providers need to perform to qualify for the incentives, he said. 

Eligible physicians can receive up to $44,000 over five years under Medicare or $63,750 over six years under Medicaid for being meaningful users of certified EHRs.  Hospitals could receive up to four years of financial incentive payments under Medicare beginning in 2011, and up to six years of incentive payments under Medicaid beginning in October 2010.

http://govhealthit.com/newsitem.aspx?tid=10&nid=72159

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Two key laws – the Federal Information Security Management Act (FISMA) and the Health Insurance Portability and Accountability Act (HIPAA) – are a particularly steep hurdle to electronic record sharing among federal agencies and private sector providers, they said.

The combined technical requirements of the laws mean organizations must often take more than 200 steps – from doing risk assessments to setting up access controls – to assure their information and systems are safeguarded.

“And that is not a scalable model for the country,” said Vish Sankaran, program director of the Federal Health Architecture office, which is managing the Connect project. He made his remarks at a forum hosted Nov. 5 by market research firm Input Inc.

 “A small practitioner’s office would not have the infrastructure to manage all the security controls,” Sankaran added. “And we can’t have the government having to check that all these systems are compliant.”

Under HIPAA, healthcare providers and plans must protect patient information. And under the FISMA, federal agencies must safeguard, monitor and document that their networks and systems are secure.   

Federal agencies would like to exchange health information with private providers, Sankaran said. For instance, many veterans and military service members seek treatment from private providers, and their federal health programs want to receive updated information about patient medications and tests.    read the rest of the article http://govhealthit.com/newsitem.aspx?nid=72350

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