Meaningful Use’ Compliant EHR Technology Implementation – specialists’ perspective

“While specialist practitioners, such as Radiologists, Psychiatrists, Chiropractors, Urologists, etc. can claim exemptions and exclusion of certain objectives set out in the Meaningful Use Clause by CMS, they are not treated preferentially as far as documenting clinical processes using approved and compliant EHR software is concerned:  their responsibility for reporting clinical data using Certified EHR Technology and EHR modules remains as mandatory as for general practitioners.”

There has hardly been anything that has got as much an attention as the CMS’ Meaningful Use criterion for medical practitioners – a program for eligible practitioners to be able to qualify for Medicare incentives upon meeting a certain set of core objectives set out in the Meaningful Use Clause under the ARRA. Although CMS has laid down guidelines for general practitioners, who serve the bulk of Medicare beneficiaries, yet their specialist colleagues – such as Radiologists, Psychiatrists, Chiropractors, Urologists, etc. – are not out of the CMS’ Meaningful Use ambit; after all they too are indispensable to CMS’ initiative towards an efficient healthcare environment. But, because their service-composition and documenting varies from general practitioners, specialists’ requisite compliance with core objectives set out in the Meaningful Use Clause under the ARRA gets a little different.

Recognizing the diverse nature of specialists, CMS has allowed for certain exceptions and exemptions from complying with certain objectives that does not owe allegiance to these specialist practices. Therefore, of the 20 mandatory objectives to be met out a possible list of 25, specialist practitioners can still seek exemptions on the ground of being unique fields of medicine. Consequently, their mandatory objective-list ultimately becomes less than 20; while CPOE, eRx, Vital Signs, Smoking Status, Electronic Copy of Health Information, and Clinical Summaries are usually allowed exemptions from Meaningful Use objectives, the following exclusions may still be claimed under substantiated evidence: Drug Formulary Checks, Clinical Lab Test Results, Patients Reminders, Patient Electronic Access, Medication Reconciliation, Summary Care Record, Immunization Registries Data Submission, and Syndromic Surveillance Data Submission.

While specialist practitioners, such as Radiologists, Psychiatrists, Chiropractors, Urologists, etc. can claim exemptions and exclusion of certain objectives set out in the Meaningful Use Clause by CMS, they are not treated preferentially as far as documenting clinical processes using approved and compliant EHR software is concerned:  their responsibility for reporting clinical data using Certified EHR Technology and EHR modules remains as mandatory as for general practitioners. Thus, everything points towards sourcing and implementing EHR software’s that best serve unique needs of diverse practices while also being compliant with the CMS mandate on Certified EHR Technology for achieving Meaningful Use criterion bench-mark.

Despite the market being replete with numerous EHR software – a prior advisory on judicious selection is always advisable as any hasty selection can have multiple repercussions: adverse impact on clinical documenting, practice management, and revenue generation. Given the prevailing scenario, Medicalbillersandcoders.com proven credentials in advising and implementing certified EHR software platforms –  Medisoft , Misys Tiger, Eclinicalworks, Advanced MD, Office Ally, Sage Medical Manager, GE centricity, Lytec, Altapoint, Dentrix being some its leading names in an exhaustive portfolio innovative and futuristic models – for diverse clients comprising Allergy, Anesthesiology, Cardiology, Dermatology, ENT, Endocrinology, Family Med, GI, Geriatrics, Internal Medicine, Long-Term Care, Multi-Specialty, Neurology, Neurosurgery, OB/Gynecology, Occupational Medicine, Ophthalmology, Optometry, Orthopedics, Pediatrics, Plastic Surgery, Podiatry, Psychiatry, Psychology, Pulmonology, Rheumatology, Surgery, SurgicalCenter, Urgent Care, Urology, and the rest.

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Doctors contemplate opting out due to continued Medicare hassles

Physician participating in the Medicare program are scheduled to face a 27.4% cut in their payments, effective 1^st January, 2012, and with providers anyway complaining about current reimbursement rates, the cut is likely to considerably impact both patients as well as doctors adversely. As a result of the cut the Medicare physician conversion factor will decrease to $24.67, approximately $15 less than it was in 2001. In this scenario, the Association of American Physicians and Surgeons reports that various physicians are declining to take on new Medicare patients and many are thinking about cancelling enrollment from the program.

Medicare hassles:

Since the past 10 years physicians and Congress have been grappling with similar situations; however the difference which is pushing doctors to consider opting out is the severity of the cut and the escalating costs of a permanent solution, and few can continue to operate in an environment where revenues are cut by 27% while costs continue to rise at a rate of 3% or higher. An internal medicine physician in New London whose approximately 80% patients are covered by Medicare, with this cut is likely to lose about one-third of his revenues, possibly forcing him to restructure his entire practice.

Another issue that has created problems for Medicare beneficiaries and their medical providers for years is the sluggishness of the claims process and the payment process. Medicare doctors in three western states – California, Hawaii and Nevada, are in a situation where Medicare’s payment backlog has created a multimillion dollar problem.  Various doctors have not been paid since February, a backlog of almost 10 months,  forcing some doctors to have to drop some or all of their Medicare patients while others are on the verge of declaring bankruptcy or have already done so.

Physicians’ current & upcoming scenario:

President of the New London County Medical Society said that the prolonged uncertainty about Medicare reimbursement rates has motivated some doctors to take an early retirement. A survey by the Medicare Payment Advisory Commission (MedPAC) indicates that by 2025 there will not be enough primary care physicians. Additionally, this cut comes at a time when physicians face potential penalties associated with  HIPAA 5010 , electronic prescribing, ICD-10, PQRS and electronic health records which are difficult to adhere to in a time of dramatically falling revenue.

However, even though physicians are pushed to consider other options, in the next 20 years senior citizens requiring Medicare will rise, and doctors who can sustain the current pressures and adapt to the reforms have a vast potential for growth. The physicians need to face this challenge of payment cuts by making their system more efficient; reduce their extra administrative burdens and revamp their revenue cycle giving them a competitive edge. Medicalbillersandcoders.com can optimize physicians’ billing process and reimbursement cycle, which will help doctors maintain their revenues as they tackle Medicare issues.

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