Optometrists can receive incentive payments if they participate with Medicare, use a certified EHR system, and use that system in a “meaningful” way.

Time is running out to begin participating in the Medicare Electronic Health Records Incentive Program if you want the maximum incentive payment of $44,000 over five years. Medicare-eligible professionals must participate by 2012, according to Centers for Medicare and Medicaid Services (CMS). However, doctors who join by 2014 are eligible for a reduced stimulus payment.

That’s the carrot. The stick comes in 2015 and later, when providers who don’t successfully demonstrate meaningful use will have what CMS calls “payment adjustments” in their Medicare reimbursement—that is, a percentage subtracted from their normal payments. Doctors whose EHR systems are Medicare-approved will get their normal reimbursements.

Medicare will only provide stimulus payments to physicians who use an EHR certified by the Certification Commission for Health Information Technology. That’s a no-brainer since major ophthalmic software providers—Compulink Business Systems, Inc., Integrity Digital Solutions, LLC, EMRlogic Systems Inc., and Eyefinity—all have systems that meet this standard.

“Meaningful use” has other key elements. One being providers must meet a set of 15 core measures, ranging from capturing demographics on more than half of patients to completing a security risks analysis. The second is they must meet five of 10 so-called menu measures. As Mary Ann Fitzhugh, vice president of marketing for Compulink, explains, “It’s about the delivery of better education materials for patients, use of e-prescribing, and the collection of patient information in a database where it can be more easily shared in the future between providers and emerging network of federal and state health information exchanges.”

“Meaningful use” may require alterations to patient workflow. “In addition to e-prescribing more than 40% of all medication prescriptions, doctors will need to document vital signs on at least 50% of all patients, and provide educational materials to at least 10% of patients,” says Kyle Smith, MD, founder and chief medical officer of Integrity Digital Solutions.

The task is not impossible. Eyefinity recently announced the first four doctors who demonstrated meaningful use on a certified beta-test version of OfficeMate®/ExamWRITER®. “These doctors have proven that achieving meaningful use is possible and the government stimulus funds are both real and attainable,” James Kirchner, OD, Eyefinity’s chief professional officer, says.

While the stimulus payments may be enticing, at least one optometric technology guru doesn’t think the payments are the only reason to adopt EHR. “The stimulus money is absolutely the worst reason for doing this,” says Scot Morris, OD, of Eye Consultants of Colorado in Conifer. Going for the stimulus payments only makes sense for a practice with a large Medicare population, he says. That said, Dr. Morris strongly advocates EHR. The year three Medicare stimulus payment is $8,000, an amount the typical practice can match “just by getting rid of your printer,” Dr. Morris says.

Remember, the stimulus schedule spreads payments over five years for providers who demonstrate meaningful use this year and next, but then cuts that back to four and three years for those who get online in 2013 or 2014, respectively—­­with a proportional reduction in payments. For example, a doctor whose first year of meaningful use is 2014 will get $24,000 in payments.

Richard M. Kirkner is Editor- At-Large for Ophthalmic Office.



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