Resource Centers:(News, information, and tools to support your practice)
September 2010
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The $44,000 question: industry insider responses (Ken Schenley)
This is in reference to Melissa Heyboer’s article, “The $44,000 question,” which appeared in Issue 13, 2010. The following is Ken Schenley’s responses in their entirety.
Question 1: How will this affect the chiropractic office? i.e., do you think this program is beneficial?
A: The $44,000 incentive program was established to promote use of “Certified EHR” technology, with the goal of improving overall patient care. It is being tied to Medicare, so for a Chiropractor to benefit, he or she must submit at least $25,000 in Medicare annually. For some, it will be a winner, while for others, it might be unattainable. The Chiropractor will have to meet “Meaningful Use”, and there are 15 Core items and another 5 Menu items that will be required. Many of these items fall outside the Scope of Practice for a Chiropractor. The practice will have to purchase a Certified EHR to be able to request the incentive, at a very high financial cost, even though many of the features will be essentially unused. In addition to the purchase price and ongoing costs, there is also the time element of gathering information and making sure it is reported to the government. If the result is improved patient care, then it will be beneficial in the long run. Just not sure everyone is ready to jump through so many hoops at this time!
Question 2: What do chiropractor’s need to take advantage of this incentive? How much will it cost, as far as time and money, to implement?
A: To take advantage of the incentive, practices will need to Upgrade their current software solution to a Certified EHR. Although there is currently no official body doing the certification, there are about 10 companies that have applied to be a certifying entity. So eventually, all of the Medical Records and EHR players in Chiropractic will likely have a “Certified EHR” available to their Chiropractic clients. There will certainly be an initial cost and ongoing costs, and estimates are currently that start-up will range from $10,000 to as high as $50,000. The items of ”Meaningful Use” include such things as getting Vitals for every patient on every visit, calculating BMI (body
Question 3: Will all chiropractic offices qualify? Can cash-based practices benefit?
A: No all Chiropractors will qualify for the incentive. You will need to submit to Medicare at least $25,000 per year. So the incentive is not for everyone. However, the goal is to implement a quality EMR that helps improve patient care and protects the Chiropractor. The top software solutions offer so much more than the ability to gain the incentive. All Chiropractors should jump on the EMR bandwagon, if for no other reason to maintain computerized charts and records for every patient.
Question 4: When can chiropractors expect to receive payments?
A: As long as you have a Certified EHR and use it in a meaningful manner (again, we are talking major expense and major hoops you will need to jump though), then it is expected that you can begin receiving incentive payments in 2011 or 2012, depending on when you start the process.
Question 5: What questions should chiropractors ask their providers (insurance and software) to ensure they are being compliant?
A: The most important thing you need to know is that your current software solution will “be there” for you, for the long run. If you want to try and receive the incentive, make sure your software company can explain their own “Road Map” to upgrading their system to help you achieve the items of Meaningful Use. Will they be Certified? Also, make sure you are prepared for the costs, as they relate to purchases and also staffing. Lastly, be sure to ask your Software Company to explain their methodology in detail. For example… Is the software installed locally? Are they fully HIPAA complaint? How are backups handled and at what costs? How long have they been in business?
Question 6: What new products or services do you think will come out of this incentive?
A: The interesting thing about this incentive program is that Patient Charting (Documentation) is a requirement, but not an element of Meaningful Use. The government has stated, as recently as July 2010, that all good software solutions must provide a means for keeping good records. So whether you go for the incentive or not, there will be lots of improvements to the Documentation marketplace. Look for iPads and Slates and other portable devices to hit the Chiropractic market in the coming months.
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