Meaningful Use Subsidies for Health Care Providers, Impacted Areas

Physicians and hospitals each have a list of objectives to qualify for subsidies. For physicians, the goals include:

  • Incorporate at least 50 percent of all lab tests in the electronic medical record (EM).
  • Use the EMR to send preventive care reminders to at least half of all patients over age 50.
  • Record and chart vital signs for all patients over age 2, including blood pressure and BMI.
  • Maintain a list of medications prescribed to 80 percent of all patients.
  • Generate patient lists by condition, such as hypertension, for quality improvement.
  • Make sure that at least 80 percent of patients can obtain their electronic health records within 48 hours.
  • Check insurance eligibility for at least 80 percent of all patients.
  • Implement five clinical decision-support rules that are a high clinical priority.
  • Submit at least 80 percent of all claims to public and private payers electronically.
  • Provide at least 10 percent of all patients timely access to electronic health records.
  • Provide clinical summaries for at least 80 percent of all patient visits.
  • Use CPOE systems for 80 percent of all prescriptions.

For a full list of goals for physicians and hospitals, go to the www.federalregister.gov web site or use this direct link: http://edocket.access.gpo.gov/2010/E9-31217.htm.

Source: Medicare and Medicaid Programs; Electronic Health Record Incentive Program.

Physicians who demonstrate the required use for 90 days in 2011 can qualify for the first of several promised payments. In subsequent years they must demonstrate meeting the meaningful use rules for all 12 months. The way these payments are arranged, a doctor can actually start in either 2011 or 2012 and under the federal schedule still qualify for the full $44,000 in subsidies available per physician.

Key Impacts on Health Care Providers By Category

While the feral government wants to speed along adoption, providers will be challenged to grapple with some of the issues below:

  • Staff Education & Training
  • BusinessProcess Analysis of Health Plan Contracts
  • Coverage Determinations, & Documentation
  • Changes to Superbills
  • IT System Changes
  • Increased Documentation Costs
  • Cash Flow Disruption

Michael F. Arrigo

Michael Arrigo brings four decades of experience in the software, financial services, and healthcare industries. In 2000, Mr. Arrigo founded No World Borders, a healthcare data, regulations, and economics firm with clients in the pharmaceutical, medical device, hospital, surgical center, physician group, diagnostic imaging, genetic testing, health IT, and health insurance markets. His expertise spans the federal health programs Medicare and Medicaid and private insurance. He advises Medicare Advantage Organizations who provide health insurance under Part C of the Medicare Act. Mr. Arrigo serves as an expert witness regarding medical coding and medical billing, fraud damages, as well as electronic health record software for the U.S. Department of Justice. He has valued well over $1 billion in medical billings in personal injury liens, medical malpractice, insurance fraud cases. The U.S. Court of Appeals considered Mr. Arrigo's opinion regarding loss amounts, vacating, and remanding sentencing in a fraud case. Mr. Arrigo provides expertise in the Medicare Secondary Payer Act, Medicare LCDs, anti-trust litigation, medical intellectual property and trade secrets, HIPAA privacy, health care electronic claim data Standards, physician compensation, Anti-Kickback Statute, Stark law, the Affordable Care Act, False Claims Act, and the ARRA HITECH Act. Arrigo advises investors on merger and acquisition (M&A) diligence in the healthcare industry on transactions cumulatively valued at over $1 billion. Mr. Arrigo spent over ten years in Silicon Valley software firms in roles from Product Manager to CEO. He was product manager for a leading-edge database technology joint venture that became commercialized as Microsoft SQL Server, Vice President of Marketing for a software company when it grew from under $2 million in revenue to a $50 million acquisition by a company now merged into Cincom Systems, hired by private equity investors to serve as Vice President of Marketing for a secure email software company until its acquisition and multi $million investor exit by a company now merged into Axway Software SA (Euronext: AXW.PA), and CEO of one of the first cloud-based billing software companies, licensing its technology to Citrix Systems (NASDAQ: CTXS). Later, before entering the healthcare industry, he joined Fortune 500 company Fidelity National Financial (NYSE: FNF) as a Vice President, overseeing eCommerce solutions for the mortgage banking industry. While serving as a Vice President at Fortune 500 company First American Financial (NYSE: FAF), he oversaw eCommerce and regulatory compliance technology initiatives for top ten mortgage banks and led the Sarbanes Oxley Act Section 302 internal controls IT audit for the company, supporting Section 404 of the Sarbanes Oxley Act. Mr. Arrigo earned his Bachelor of Science in Business Administration from the University of Southern California. Before that, he studied computer science, statistics, and economics at the University of California, Irvine. His post-graduate studies include biomedical ethics at Harvard Medical School, biomedical informatics at Stanford Medical School, blockchain and crypto economics at the Massachusetts Institute of Technology, and training as a Certified Professional Medical Auditor (CPMA). Mr. Arrigo is qualified to serve as a director due to his experience in healthcare data, regulations, and economics, his leadership roles in software and financial services public companies, and his healthcare M&A diligence and public company regulatory experience. Mr. Arrigo is quoted in The Wall Street Journal, Fortune Magazine, Kaiser Health News, Consumer Affairs, National Public Radio (NPR), NBC News Houston, USA Today / Milwaukee Journal Sentinel, Medical Economics, Capitol ForumThe Daily Beast, the Lund Report, Inside Higher Ed, New England Psychologist, and other press and media outlets. He authored a peer-reviewed article regarding clinical documentation quality to support accurate medical coding, billing, and good patient care, published by Healthcare Financial Management Association (HFMA) and is published in Healthcare IT News.

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