Sunday, May 1, 2011

Medicare Incentive: Hurry Up and Wait or Just Hurry Up?

After the opening day of acceptance of physician attestations for Medicare's meaningful use incentive, American Medical News posted an article posing the question whether physicians should wait to register themselves for the program or not.  One would think, "Sure, why not?  Let's get that incentive money rolling in!" but it might not as simple as it looks. 

Good Things Come To Those Who Wait

The article in American Medical News points out that physicians who attest today would need to still prove they meet Meaningful Use Stage 2 criteria next year.  The thing is, Stage 2 criteria is still in its proposal stage and has not yet been officially posted by the Centers for Medicare & Medicaid Services (CMS).  When will Stage 2 be officially defined?  Well...we're not sure yet.  Most likely by the end of the summer this year.  That means the physician has from now until April of next year to meet Stage 2's requirements with just a general idea to go off of.  Once the final draft of the definitions are posted, that leaves maybe, what, 7 or 8 months to make sure everything is in place?  Do you see how the question whether to wait might be an issue?
Everyone likes free money, but physicians really shouldn't feel rushed to attest as soon as humanly possible.  They actually have until the end of 2012 to register to receive the full amount -  $44,000 for Medicare or $63,750 from Medicaid.  Why not wait until the Stage 2 requirements are officially posted and then kill two birds with one stone by implementing EHR technology and practices that meets Stage 2?  Physicians will still receive incentive payments for five years like those who attested in 2011.  Waiting could save money, time and headaches by not having to makes changes in software and hardware if Stage 2's final draft differs greatly from the proposal.  

Just Do It (Now)

On the contrary, some don't see the point in waiting for the meaningful use Step 2 official requirements to come out.  The article referenced to a Rhode Island doctor, Douglas Foreman, DO,  who said he didn't see a reason in waiting.  He wasn't worried about qualifying for Stage 2's requirements and doesn't think other physicians should worry either.  For those who have already implemented an approved EHR system, such as the Methodist Health System in Dallas and the Detroit Medical Center, one could see why they wouldn't bother waiting to register.  According to the proposed criteria, not much changes between Stages 1 and 2.  The difference  is mainly the percentage of patients required to be on the electronic system.  So far, it appears that not a lot of additional software or hardware is required for Stage 2.  The only big difference is the implementation of patient portals for patients to use and giving them access to their own health records in a timely fashion.  This shouldn't be such a significant difference to deter physicians who have already implemented approved EHR systems from really wanting to delay attesting for their Medicare incentive until next year.

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