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Health Information Technology (HIT) Update Reprinted with permission by Alameda-Contra Costa Medical Association This is an update to help SCCMA/MCMS members navigate the process of adopting health information technology (HIT) and optimize their opportunity to obtain federal subsidies, should you choose to seek those funds:

Overall Timeline Beginning in 2011, qualifying physicians (see below) may start receiving federal subsidies for HIT usage, and have up until the end of 2012 to qualify to receive the full subsidy that is available. As described below, final rules defining the eligibility requirements have finally been promulgated and should be fully implemented in the next few months so that physicians can begin to adopt them, if desired. Physicians who adopt qualifying HIT in 2013 and beyond would have smaller amounts of federal subsidies available to them. Starting in 2015, physicians participating in the Medicare program face penalties if they have not yet implemented a qualifying EMR system. Details regarding these incentives and penalties are discussed below.

Resources/Activities From Organized Medicine •

In the next few months, we will be announcing the availability of federally-funded services designed to assist physicians with the purchase and adoption of qualified EMR systems. Included among the services that will be offered are: general education on EMR adoption and federal programs available to assist with such adoption; pre-negotiated deals with a small number of EMR vendors that include standardized purchase and support agreements; assistance with medical practice analysis to identify suitable EMR systems and develop implementation plans for the practice, and; assistance meeting federal “meaningful use” requirements (discussed below) to qualify for the federal subsidies that are offered. These services are made available as a result of CMA efforts to form an organization – the California Health Information Partnership & Services Organization (CALHIPSO) – that obtained approximately $32 million in federal stimulus funds to assist physicians with HIT adoption in California. CALHIPSO’s services are designed to assist physicians in any specialty and medical practice setting, and subsidies are specifically provided to fund these services for primary care physicians in groups of 10 or less.

The CMA will soon be announcing its completion of a yearlong vetting process of approximately 10 EMR systems, some of which may offer preferred pricing rates to CMA members. CMA will also offer a tool to assist physicians with EMR system selection.

Information on HIT adoption is available on both the SCCMA/ MCMS and CMA websites (; www., and educational programs will continue to be provided in the near future.

Status of Federal Activities and Subsidies to Promote HIT Adoption As previously reported, the federal stimulus legislation allocates funds to help promote HIT adoption both through programs to assist physicians with the adoption process and direct subsidies for HIT usage to physicians participating in the Medicare and/or Medicaid programs. The program to assist physicians with the adoption process will be announced in the next few months, as discussed above under “Resources From Organized Medicine.” Following is a summary of how to qualify for the subsidy for using EMR system.

Federal Financial Incentives for HIT Adoption The stimulus legislation takes a carrot and stick approach to encouraging physicians to adopt HIT. The carrot is direct subsidies for demonstrating qualified use of HIT (discussed below) as follows: of up to $44,000 to physicians who are not hospitalbased who participate in the Medicare program, and; up to $63,750 to physicians who are not hospital-based, and whose practice is comprised of at least 30% (by patient volume) of Medicaid patients (20% if they are pediatricians). If physicians qualify under both the Medicare and Medicaid programs, they will select which one to access. Physicians cannot receive incentives from both programs. “Hospital-based” physicians, for whom these incentive payments are not intended because they are expected to utilize HIT within the hospital where they practice, are defined as physicians for whom 90% of their patient encounters occur in inpatient and emergency department settings. The bonus payments may be paid out beginning in 2011 if physicians meet qualifications for IT usage at that time, and can continue up to 2016. To ensure that physicians


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