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Medical Coding News Archives

Electronic Health Records Demonstration

June 24, 2008:
A new demonstration project will reward physician practices that deliver high-quality care supported by the adoption of electronic health records.

On June 10, 2008, the Centers for Medicare and Medicaid Services (CMS) announced the selection of 12 community partners to help implement the new initiative. The community partners will help CMS reach out to communities to recruit eligible primary care physician practices and educate them about the electronic health records (EHR) demonstration.

CMS’s five-year goal is to have practices implement and adopt EHRs and health information technology (HIT) to improve the quality of care and change the way medicine is practiced and delivered. Not only does Medicare win through major financial savings, but beneficiaries win because of HIT’s ability to improve care.

The secretary of the Department of Health and Human Services has directed CMS to develop this demonstration initiative using the Medicare waiver authority in order to reward the delivery of high-quality care and the adoption of EHR. The Certification Commission for Healthcare Information Technology (CCHIT) and its networks is the recognized certification authority for EHR. All participating physician practices will be required to have a CCHIT-certified EHR by the end of the second year.

The physician practices are required to use the EHR to perform specific core functionalities that can improve patient care and trigger a core incentive payment based on performance of the quality measures. They will also receive an advanced bonus based on the relative amount of HIT functionality used to manage care. These functionalities include:
  • Clinical documentation
  • Ordering of lab tests
  • Recording lab tests
  • Ordering prescriptions
Payment for the first year will be provided to participating practices based on CCHIT-certified EHR functionalities used to manage the patients’ care with a higher payment for use of the EHR, such as facilitating care management of activities, record sharing among providers of care, etc.

The second year will be based on participating physician practices using CCHIT-certified EHRs and reporting clinical quality measures. They, too, will receive additional payments based on EHR functionalities employed by their practices.

Payment for the third through the fifth years will be based on performance on the designated clinical quality measures, with an additional bonus each year based on the degree to which their practice has utilized the EHR in changes and improvements in operating their practices.

Recruitment of the first four phase I physician practice sites will begin in the fall of 2008, followed by recruitment for phase II sites one year later.

Janice Randall-Payne, B.S., CPC, CPC-H, CPC-I, CCS-P, CPAR, PCS
Clinical/Technical Editor


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