Home Forums Discussions General Discussion What a surprise! EHR incentives take a hit.

Reported on Medscape yesterday

Sequester Will Cut Medicare EHR Bonuses

Robert Lowes
Mar 06, 2013


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Medicare incentive payments for meaningful use of electronic health records (EHRs) will suffer a 2% cut beginning April 1 just like Medicare physician reimbursement under a federal budget sequester of $85 billion through October 1, the Centers for Medicare & Medicaid Services (CMS) said yesterday.

The EHR bonus in 2013 under Medicare is $15,000 for first-time recipients who have demonstrated that they use EHRs in ways that improve the quality of care and lower its cost. A 2% reduction of that amount would come to $300.

The bonus is $12,000 for clinicians who received their first incentive payment in 2012 and $8000 for those who began receiving the payments in 2011, the first year of the program.

The maximum amount in Medicare bonuses that a clinician can receive is $44,000 over 5 years.

A CMS official disclosed the bonus reduction yesterday during the annual conference of the Health Information and Management Systems Society (HIMSS) in New Orleans, Louisiana, according to Robert Doherty, senior vice president of governmental affairs and public policy at the American College of Physicians, in an interview with Medscape Medical News.

In government parlance, a sequester means an automatic, across-the-board budget cut. The current $85 billion sequester, which applies to defense as well as domestic spending, stems from the failure of Congress to enact legislation in 2011 to reduce the budget deficit by roughly $1.2 trillion. Lawmakers earlier had agreed that if they could not reach such a deal, then a sequester at the same level would kick in on January 1, 2013. The prospect of arbitrary budget cuts for every branch of government was intended to pressure Congress to pass a more discriminating deficit-reduction plan.

Over the New Year's holiday, Congress postponed the sequester until March 1, when it took effect after Republicans and Democrats again stalemated over the best way to get federal finances in order.

The first installment of the sequester ? $85 billion worth ? affects the remaining 7 months of fiscal 2013, when ends September 30. Spending will decrease during this time by roughly 9% for domestic programs and 13% for defense programs. Social Security, Medicare benefits, and Medicaid are spared this budget axe.

Lawmakers crafted the sequester to go a little easier on Medicare reimbursement to healthcare providers, reducing it by only 2%.

The 2% cut will not affect EHR incentive payments that clinicians can earn under Medicaid as opposed to Medicare, because the former program is not subject to sequestration

Shocked,just shocked! sarc font now off.

I am thinking barber shop or pizza restaurant.

Being Italian both work for me. It's usually a cash business.

Guys are keeping their hair shorter today.

Everybody loves pizza.

Who's in?

I am in just as long as you don't put any SWEDISH MEAT BALLS on that pizza!!!!!

As a systems guy, I see this as another indicator of a system that is out of control, and is giving warning signals of failure.

Whether we are talking about a vehicle temperature gauge, diagnostic blood work, blood pressure, heart rate, or balance sheet, we are all familiar with what a system looks like when it is failing/going out-of-control.

It remains to be seen how/when the system will fail, but as more Doctors (Groups, SNFs, Hospitals) exit the system because of mounting dis-incentives, the system will become increasingly unstable. The carrots are all but gone, and most Doctors get tired (or wary) of the bat quickly, so more will leave.

We are mostly past the politics of this, and quickly moving into pressing math that everyone will need to factor for their individual circumstances.

I have asked some folks already to present when we get together next (hopefully this fall) about different business models they are pursuing. Talking about how to structure a business so that a Physician can continue to practice seems more useful than another does of Meaningless Use.

From a link on the Academy of Pediatrics, most physicians will not realize a profit after 5 years, obviously these do not include AC users.

http://www.beckershospitalreview.co...40000-in-5-years-after-ehr-adoption.html

Nor will there be any pineapple on the pizza!

Just as long as there can be one with BBQ Chicken. [Yep, one of the first ones gone after the straight pepperoni or cheese when we bought a stack from the local's pizza place in Tahoe].

Yes, but first you must drink the kool aid !!!