Public And Private Financial Incentives

In a healthcare world that operates on stringent budgets and margins, we begin to see the need for a higher capacity healthcare delivery system. This in turn puts pressure on the healthcare organizations to ensure higher standards of patient care, and compliance with the reform provisions. However, these are the harsh realities of today’s healthcare environment, a setting in which value does not always equal quality. The use of technology can help to amend some of this by providing higher capacity care without compromising quality; this can be done with the use of such technology as electronic health records (EHRs). This paper will aim to address how EHRs influence healthcare today by expanding upon topics such as funding sources, reimbursement methods, economic factors, socioeconomic factors, business influences, and cost containment.

The American Recovery and Reinvestment Act (ARRA) of 2009 identified three main components of meaningful use: the use of a certified EHR in a meaningful manner, electronic exchange of health information to improve quality of care, and the use of technology to submit clinical outcomes and quality measures (Heath Resources and Service Administration, n.d.). ARRA includes many measures to modernize our nation’s infrastructure, with the “Health Information Technology for Economic and Clinical Health (HITECH) Act” being an example. The HITECH Act is an effort led by Centers for Medicare and Medicare Services (CMS) in support of electronic health records and meaningful use (Centers for Disease Control and Prevention, CDC 2016). According to Galbraith (2013), the HITECH Act aims to promote the use of EHRs by providing over $27 billion in monetary incentives for health care providers that become “meaningful users”. CMS uses these core objectives to determine if a health care provider has satisfied meaningful use and is eligible to receive financial incentives (Galbraith, 2013).

The Medicaid EHR Incentive Program will provide incentive payments to eligible professionals and eligible hospitals as they adopt, implement, upgrade, or demonstrate meaningful use of certified EHR technology in their first year of participation and demonstrate meaningful use for up to five remaining participation years. The Medicaid EHR Incentive Program is voluntarily offered by individual states and territories and may begin as early as 2011, depending on the state. Eligible professionals can receive up to $63,750 over the six years that they choose to participate in the program. Eligible hospital incentive payments may begin as early as 2011,

Under the provisions of the American Recovery and Reinvestment Act of 2009 (ARRA, or the Stimulus Act”), certain eligible providers are eligible for financial incentives for following and documenting “meaningful use” of a certified electronic medical record system. According to the HRSA, “in July 2010, the Centers of Medicare & Medicaid Services (CMS) published a final rule which established three phases of the EHR Incentive Program. The three stages of Meaningful Use are designed to support eligible professionals and hospitals with implementing and using EHRs in a meaningful way to help improve the quality and safety of the nation’s healthcare system.” The end point here is not that having an electronic medical record will allow for a

The American Recovery and Reinvestment Act made an investment in the year 2009 to encourage the adoption and implementation of the electronic health records (EHRs)(Cite). EHRs incentive payments were authorized through Medicare and Medicaid to clinicians and hospitals when they privately and securely used EHRs for achieving improvements in care delivery by the Health Information Technology for Economic and Clinical Health Act (HITECH). The healthcare organizations are expected to demonstrate meaningful use of EHRs. This rule of meaningful use has been implemented to strike a balance between acknowledging the urgency of adopting EHRs for improving the healthcare system and identifying the challenges that would be put forth

Prior to the federal mandate of EHR, research continued to show the fallacies of the healthcare system like the report published from the Institute of medicine, stating that “medical errors are the 8th leading cause of deaths in the U.S. and cost approximately forty billion dollars a year” (Overview, 2012). This was one of many indicators that healthcare needed to be reformed and in 2009, the president signed the American Recovery and Reinvestment Act or HITECH Act, which mandated that all healthcare providers must comply and begin to transition to electronic medical records (EMR) and demonstrate “meaningful use.” This act set up a timeline, which established that practices and hospitals needed to be up and running with EMR in order to continue receiving reimbursements from federal programs like Medicaid and Medicare.

“The HITECH Act seeks to change that situation by providing each person in the United States with an EHR. In addition, a nationwide health information technology (HIT) infrastructure will be developed so that access to a person’s HER will be readily available to every healthcare provider who treats the patient, no matter where the patient may be located at the time treatment is rendered” (McGonigle & Mastrian, 2015).

“Go Paperless and Get Paid” is how the Office of the National Coordinator for Health Information Technology (ONC) presents the incentives for electronic health records. The United States Department of Health and Human Services (U.S. Department of HHS) distributed more than $160 billion dollars to “improve and preserve health care, health information technology, community health, and prevention initiatives” (United States Department of Health and Human Services [HHS], 2014e). Likewise, the ONC offers “Health IT Adoption Programs” through the Health Information Technology for Economic and Clinical Health (HITECH) Act, seeking to advance the American health care delivery system and to improve patient care through an unique investment towards health information technology (HHS, 2014d). Additionally, the American Recovery and Reinvestment Act of 2009 allows the Centers for Medicare & Medicaid Services (CMS) to reward eligible hospitals and professionals with monetary incentives as they implement, adopt, or upgrade and demonstrate meaningful use of certified electronic health record (EHR) technology (HHS, 2014b). The Electronic Health Records Improvement Act (H.R. 1331) introduced by the United States House of Representative Diane Black is a bill to further improve the nation’s health care adoption of health information technology.

In July 2010 CMS Centers of Medicaid and Medicare services published a final rule which established three phases of the EHR Incentive Program. The Medicare and Medicaid EHR Incentive Program provides financial incentives for the “meaningful use” (MU) of certified Electronic Health Record technology to improve patient care. 36$ billion was authorized.

So much so that our political leaders and President Barack Obama have created a stimulus package called the American Recovery and Reinvestment Act of 2009. Within this legislature, improvements to our healthcare industry and systems have been made with long-term financial savings in mind. As technology and uniformed data was becoming the standard in healthcare, the Health Information Technology for Economic and Clinical Health Act has accelerated the speed. “The number of certified EHR vendors in the United States has increased from 605,6 to more than 10007 since mid-2008” (Sitting and Singh, 2012). Healthcare organizations now have no choice but to invest in a new

In efforts to reform the United States healthcare system and create a nationally unified data exchange system the federal government has established an incentive program to eligible professionals and hospitals. The federal government has turned to certified electronic health record (EHR) technology to help facilitate the process of broadening health IT infrastructures. The federal government views EHR system used in meaningful ways as the key to reforming the healthcare systems. Meaningful use of the EHR systems can also improve the overall quality of healthcare, insure patient safety, as well as reduce the cost of healthcare to individuals (Bigalke & Morris, 2010, p. 116).

Over the previous eight years, there has been a significant investment of private and public funds to upsurge the adoption of Electronic health records (EHRs) across the nation. The extensive adoption and “meaningful use” of electronic health records is a national priority. EHRs come in various forms and can be utilized in distinct organizations, as interoperating systems in allied health care units, on a regional level, or nationwide. The benefit of utilizing an EHR depends heavily on provider’s uptake on technology. Benefits related to electronic health records are numerous and may have clinical, organizational and societal outcomes. However, challenges in implementing electronic health records has attained some attention, the implementation

The Health Information Technology for Economic and Clinical Health (HITECH) Act, part of the American Recovery and Reinvestment Act of 2009 (ARRA), is legislation aimed at the adoption and “meaningful use” of health information technology. CMS was authorized to establish incentive programs for eligible Medicare and Medicaid providers who adopt, implement, upgrade, or “meaningfully use” certified electronic health records (EHR). The term “meaningful use” is an acknowledgement that improved health care is not the product of technology but a method to exchange and use health information to support clinical decisions at the point of care.

The requirement is that eligible professionals and hospitals should be able to demonstrate “meaningful use” of certified EHRs in order to qualify for incentive payments under the Medicare EHR Incentive Program (“How to attain,” 2013). Practices who do not adopt EHR may be penalized in the form reduced Medicare reimbursements (Bendix, 2016).

Instead of using paper based records, technology allows physicians to use the electronic medical record (EMR) that improves the quality of programs. By using the EMR, this is not easy nor is it low cost. Physicians’ have to use this method as their daily task. There are some barriers that has been identified with the use of the EMR by the physicians we will discuss. There will be some suggestions made that might can help the policy interventions to overcome the barriers. This will include the support system of work/practice including electronic clinical data exchange, and financial rewards for quality improvement. (Sim, 2004)