Home Forums Discussions Meaningful Use How is MU going?

I have to admit I have not kept up with the MU business for some time. Frankly, I've been busy with my practice since we were all discussing it coming out. I don't know if I have time to read through the entire thread, and I do not see any 'sticky posts' with current a current summary of the status. I am still using one of the version 5 AC. I am wondering:

How is the version 6 running in day to day practice, and would you go back if you could just push a button?

How much money are you really going to get?

How much more work in your day is it to chart the MU?

Do you feel like a whipping boy now that you are using it?

After struggling with MU I am seriously considering dropping Medicare assignment. I cannot see as many people a day, I cannot maintain eye contact, I forget things that used to be second nature because my style of practicing has been completely overturned and even though I am virtually 100% compliant with all of the core items and the majority of the menu and CAQ items, I will not qualify because the data is not entered to the satisfaction of the Federal government. We are getting royally screwed.

I have done the MU and attestation (9/21/11). Seven weeks and no money.

I just love the government.

I attested and got the money about 2 months later. I'll be honest, I put 98% of the MU crap on my staff's shoulders. They did a super job and made attestation easy. Now, next year, if they add more requirements and crap, we may just completely forgo it. Sometimes it's just not worth the trouble. I'm going to use a portion of the MU money for Christmas bonuses especially since they did all the work for it anyway.

Can I ask how much they are providing?

What happens if you attest/qualify the first year and then drop out of MU?
Does the government ask for the money back?

I am torn on MU. I know EMR's are the way we will practice in the future yet to do MU means spending a ton more time on documentation and not necessarily to the improvement of care for the patient.
A good spreadsheet/problem sheet/summary sheet (printed) still works better for me then going through all the prevention screens. That is one complaint I have with AC (using it since 2008 and now using ver 6.09). I can't find a simple free text or easily formatted screen to enter patient summary information in the format that works for me. Problem lists based on ICD 9 codes don't help you enter the details/nuances of someone's diagnoses. And I'm not that old in practice - just old school.

How about just using the past medical history block, especially if MU is not the issue? AC is, at it's heart, just a database, and most of the fields are just text fields. You are free to make the program serve you in any way that pleases you.

Leslie.....you said it better than I ever could. MU changes the way you practice. I am also strangled in a visit. Most of the time my patients see my back typing into a computer...I hate that and apologize on each vist, but I call it Dr. Obama in a box and they all laugh and understand...I attested 10/26 and still no money...it takes me an extra 8 hours a week for charting...and I see about 140 patients a week...If you are ever in Findlay, Ohio lets do lunch....todd

Thanks, Todd.

I have had version 6 for a few months and like it better than 5. The only extra work my staff has is filling in the race in demographics and the height, which we normally did not do. Once you set up all of your choices in the wizard, it calculates for you. I position myself in the room to face the pt while typing and they like seeing what their electronic chart has to offer. We constantly use the Updox patient portal and can send summaries of the visit or test results for them to review. AC has made meeting MU as simple as it can be made. I just do not like where this is going in terms of government and insurance access to "private" files.

I have been using 6.11 since shortly after it came out. No speed issues in my XP machines, but no real problems before after turning off speed accel (I have not bothered to turn it on, did not notice much of a difference otherwise) It does seem faster than 6.08 ( I skipped a couple)

One thing I noticed is intermittently it does not remember the Sig to previously prescribed meds. Other than that, no issues. No printing problems,

I did sign up at CMS, but the State of Illinois Medicaid is not up to speed at this time. I'll be ready when they are.

AC works pretty well - MU is a bit of a pain, but after you get used to it the HM things do well to force you to check on dates for mammograms, colonoscopies, flu shots, etc. I must admit the check was nice to help buy new equipment - was a pain, but unfortunately I don;t think the requirements will go away. So you should capitalize while there is money.

ok...so I see they sent me a test deposit for MU at 0.00 dollars..any ideas on how much I can expect and when...trying to plan the office christmas party....I want to hire a guy who plays saxaphone as a Clinton impersonator...seems appropriate...meaningful use you know......

Congratulation to you! I attested Oct.6, still waiting for the MU money. Haven't received the test deposit yet. My status is "sent to PFC, initial" long time ago. How long does it take?

OK, got a note that the authorized a payment and sent it to the contractor. I attested 10/26...so how much longer shuld it take to see a deposit (i.e. real $$)...

I am in the process of "attesting"; ? the numerator/denominator...are they asking how many patients (number?) Are we to go back and physically count every pt we have sent in MU code?

Run the wizard in AC first and it will give you all of the numerators and denominators you need. The wizard makes the whole process a snap.

Medicare says 6-8 weeks from attestation date to get deposit. I attested on 9/26 and got deposit on 11/25.

Successfully attested today! It took only about 20 minutes or so, with the help of our Virginia HIT regional extension center rep. I do think Amazing Charts made it an easy process. Now begins the breath holding for the check....

Finished the attestation process first week of October, received the direct deposit into my account early this week. Not a horrible process, AC makes it easy. Didn't get any help from the REC's since early on they required a fee which was subsequently dropped. Thank you Dr. Obama, and AC of course.

It took me about 8 weeks after attesting - had a state rec contact me but really found that I did not need them.

I finally met the criteria for 90 days of successful "meaningful use." Using Amazing charts version 6.1.2 on Windows 7 Pro peer to peer. Ironically I went to attest yesterday and the CMS meaningful use server was down!

I attested last week. Am I supposed to do something so the check will eventually get deposited electronically? I don't recall seeing anything about it on the CMS site.

Successfully registered and attested today. Took about 1 hour. Pretty straightforward, although on some screens they switched the order of the numerator and denominator just to make it a little tricky.

Attested 10/26, just got the deposit today....I framed the receipt....Merry Christmas to all.

I started the attestation process today, will complete it tomorrow.
The MU wizard makes the attestation easy.
I have found clicking all those boxes does not distract me from patients any longer, and I make my staff do much of the blue click boxes.
I'm eager to get the 1st payment of $18,000 in order to reinvest in some of our aging computers. Being more cognizant of the yellow button in the top right corner, I'm making certain patients are up to date on colonoscopies, mammo's, aspirin therapy, and smoking cessation counseling. All in all, not a terrible thing. Plus they are willing to pay us for it. Wait 5 years and CMS will start deducting 2-5% of our reimbursements if we don't participate....yuck.

To address John Howland's question above, they say on one of the CMS websites that "Payments to Medicare EPs will be made to the taxpayer identification number (TIN) selected at the time of registration, through the same channels their claims payments are made. The form of payment (electronic funds transfer or check) will be the same as claims payments."

My office manager and I had a long talk today about this. Why are they offering us this money in exchange for changing the way we practice? We already practice good medicine! We already use a great EMR. Why can't they just fund their present obligations under Medicare without adding this great burden? Why would doctors take this money and in turn have to make their lives hell? In the future, surely it won't be a carrot, but a stick, and you will have to practice their way or get no money! I think we decided I won't be selling my soul to the devil over this. I'm doing fine without their money, and if they push too hard, no more!

I completely agree with the stupidity of this program Boondoc. If I continue to participate with Medicare, I'm concerned about the penalties for not participating in these programs. The CMS website reports that by 2015 if providers are not participating in MU, they will start penalizing. The penalties will start at 2% and increase up to 5% penalties after the 3rd year of non-participation. They have reserved the right to increase the ceiling penalty. In our practice we do a lot of Medicare business, about 30% of our gross. It would be tough to handle those losses.

Although I swore I would never jump through these stupid hoops I did change the way I practice (for the worse) and I did attest. With every patient, I inform them why I can no longer maintain eye contact and why the visit takes so long without spending very much of it directly engaged in the interaction with the patient. I also inform them that, should this MU continue down the planned road where penalties will be assessed, I will no longer accept Medicare. I am, in effect, warning them. The responses from the patients have been very vocal....they are incensed at how the government has intruded into their doctor/patient relationship. I tell them, "then please write your Congressperson". Whether they do or not I do not know. But, at least they have been forewarned.

I agree completely Leslie and I've told patients the same, write your congressperson. I know one that has actually written a letter, but I am certain most don't. It's human nature to complain and do nothing about it.

I would be curious which features of the MU data collection is taking so much time away from your encounters, and which features remove your eye contact. Those are VERY important parts of the doctor/patient exchange. I found that challenging at first, but I've been able to assign some of these tasks to my staff. By dividing the work load, we've been able to retake control of my office visit (which at first felt completely in the control of MU data collection).

As you can see, I've been strongly debating with myself and staff whether to do MU. I suspect that within 5 years I will be getting hammered with cuts on Medicare if I'm not doing it, and the present cash 'carrot' will have turned into a 'stick.' I very well may have to opt out of Medicare at that time if they are going to cut our low payments even more. We physicians always just 'take it,' HMO payments, Medicare cuts, etc. We are not allowed to unionize or collectively decided to not take a certain insurance in our town. However, the insurance companies can monopolize and control regions all they want. The government also chooses to 'adjust' my charges. The real question, is how long doctors will just 'take it', and when we will decided to act like other professionals, such as our lawyer friends.

I agree with you Boondoc and plan to drop Medicare also if it gets to that point. But here is my prediction. After forcing all of this bureaucratic stuff down our throats, Medicare and the other insurance companies really won't give a hoot whether we drop out or not....not until enough constituents cry bloody murder. So, rather than revoke all of this legislation and eliminate all the government agencies and employees created to oversee it, the Federal and State governments ( who are being lobbied by the large insurance companies)would be more likely to enact NEW legislation making it mandatory for doctors to accept Medicare and Medicaid in order to obtain our state medical licenses and federal DEA licenses. Go back and read some of my predictions about AC....I have a pretty good track record. (I also predicted many years ago, when the county in which I live wanted to increase property taxes to fund the local library, that physical libraries would become obsolete...that people would be reading their books electronically. The county commissioners laughed at me but they are not laughing now).

Leslie:
Now I'm convinced of your ability to prognosticate. Got any stocks you want to recommend?

Darn it, Jon, it doesn't seem to work with financial matters, as you well know!

I read on CMS website that the cash carrot will turn into a stick 2015. There will be a minimum 2% penalty for non-participation which has future cuts as high as 5%, just as there is with ERx currently.

If doctors weren't so darn independent, we could unite and effect positive change. The problem with us is that we all have the "way I'd do it" mentality because we were all trained to be independent thinkers and scientific analysts. I am convinced that if every doctor in America said, "on July 1st, we are not going to work unless you fix this problem with healthcare," and we did not staff the E.D.'s, the ICU's, the surgical suites, and the medical clinics the problems in our healthcare system could be fixed by July 2nd.

Leslie, I hope this is one prediction of yours that does not come true.

The MU stick is 5%, providing at least 75% of MD's have adopted certified EMRs by 2017. if NOT, then "the Secretary" (HHS) has the power to increase the decrease.

Nephros, I believe you! Your description sounds a bit like Al Gore. "Increase the Decrease"....What's up should be down and what's down should be up! This way, our political pundits can say they voted for an increase for us, even when it means a decrease. I do love my country!

LOL. Maybe I will get an increase and therefore I will increase my service to them! I wonder if Al Gore is still flying around in his private jet talking about the environment.

I thought Al Gore also invented the internet...