Medicare opt-out and stimulus money for EMR

October 3, 2009

Yes, I agree – if you haven’t

already purchased an EMR, it would be prudent to wait until the rules are

published. 30% of your practice must be Medicaid in order for you to qualify

for the Medicaid incentive.

Pratt

Office Manager

Oak Tree Internal Medicine P.C

www.prattmd.info

From:

[mailto: ] On

Behalf Of alcald3000

Sent: Friday, October 02, 2009

3:05 PM

To:

Subject:

Re: Medicare opt-out and stimulus money for EMR

,

Thanks for that link. It will be a good site to keep

monitoring. As of right now, the criteria are still

undefined as to what constitutes a qualifying EMR.

It would be pretty crazy for a provider to commit to

spending money on an EMR until these criteria are

defined. It also sound like if you are looking for

the Medicaid incentive, as opposed to the Medicare

incentive, it will be even longer, by their own admission,

before they will have any criteria in place by which

you'd be able to judge whether your EMR would qualify.

> > > >

> > > > Sharon:

> > > > I have been thinking along the same lines. However, I am

only

> " non-par "

> > > as

> > > > opposed to the opt out status. ($ is only available to

those who are

> > > > participating)

> > > >

> > > > What I could not figure out was how the calculation would

be done on

> the

> > > > money for the IT from the stimulus. I know it is a percentage

of what

> you

> > > > bill to Medicare annually. However, which year will they

use?? If one

> is

> > > > just starting up a practice, there would be no billables to

look at.

> > > After

> > > > the first year of the stimulus money availability, it

appears the

> maximum

> > > > amounts go down. I assume that year #1 is the same for

everyone. Or is

> > > > year #1 the first year you apply?

> > > >

> > > > I'll bet knows the answer.

> > > >

> > > > Ramona

> > > >

> > > > Ramona G. Seidel, MD

> > > >

> > > > www.baycrossingfami lymedicine. com<http://www.baycross

> <http://www.baycrossingfamilymedicine.com/>

ingfamilymedicine.com/>

> > > >

> > > > Your Bridge to Health

> > > >

> > > > NOTE NEW ADDRESS AND PHONE NUMBER:

> > > >

> > > > 269 Peninsula Farm Road

> > > > Suite F

> > > >

> > > > Arnold,

MD 21012

> > > >

> > > > 410 518-9808

> > > >

> > > > _____

> > > >

> > > > From: Practiceimprovement 1yahoogroups (DOT)

> com<%40yahoogroups.com>

> > > > [mailto:Practiceimprovement 1yahoogroups (DOT)

> com<%40yahoogroups.com>]

> > > On Behalf Of Sharon

> > > > Sent: Thursday, October 01, 2009 5:28 PM

> > > > To: Practiceimprovement 1yahoogroups (DOT)

> com<%40yahoogroups.com>

> > > > Subject: [Practiceimprovemen t1] Medicare opt-out and

stimulus money

> for

> > > EMR

> > > >

> > > > My Medicare opt-out is up for its two year renewal. I've

been

> > > contemplating

> > > > whether or not to " opt-in " to try to take

advantage of the stimulus

> money

> > > > for EMR. I do a membership/retainer practice. People pay an

annual or

> > > > monthly fee for all services. I'd have to change my medical

services

> > > > agreement for the Medicare folks (and make the fee for

non-covered

> > > > services). I'm trying to decide if it would be worth it.

> > > >

> > > > Marty, ,

or others have thoughts on the hassle factor/benefit of

> > > this?

> > > >

> > > > I hate to pass up free money to help improve my IT, but I

don't want

> to

> > > > torture myself either. Thanks in advance.

> > > >

> > > > Sharon

> > > >

> > > > Sharon

McCoy , MD

> > > >

> > > > Renaissance Family Medicine

> > > >

> > > > 10 McClintock

Court, Irvine, CA

92617

> > > >

> > > > Phone: ; Fax:

> > > >

> > > > Email: SharonMD@ ...

> > > >

> > > > website: www.SharonMD. com <http://www.sharonge

> <http://www.sharongeorgemd.com/>

orgemd.com/>

> > > >

> > >

> > > --

> > > Graham Chiu

> > > http://www.synapsed irect.com

<http://www.synapsed

> <http://www.synapsedirect.com/>

irect.com/>

> > >

> > > Synapse - the use from anywhere EMR.

> > >

> > > --

> > > Graham Chiu

> > > http://www.synapsed irect.com

<http://www.synapsed

> <http://www.synapsedirect.com/>

irect.com/>

> > >

> > > Synapse - the use from anywhere EMR.

> > >

> > > --

> > >

> > > If you are a patient please allow up to 24 hours for a reply by

email/

> > > Remember that e-mail may not be entirely secure/

> > > MD

> > >

> > > ph fax

> > > impcenter.org

> > >

> > > --

> > > Graham Chiu

> > > http://www.synapsed irect.com

<http://www.synapsed

> <http://www.synapsedirect.com/>

irect.com/>

> > >

> > > Synapse - the use from anywhere EMR.

> > >

> > > --

> > >

> > > If you are a patient please allow up to 24 hours for a reply by

email/

> > > Remember that e-mail may not be entirely secure/

> > > MD

> > >

> > > ph fax

> > > impcenter.org

> > >

> >

> > --

> > Graham Chiu

> > http://www.synapsed <http://www.synapsedirect.com>

irect.com

> > Synapse - the use from anywhere EMR.

> >

>

October 3, 2009

I also use eMD’s and therefore

appreciate your input ever that much more!

Ramona

Ramona G. Seidel, MD

www.baycrossingfamilymedicine.com

Your Bridge to Health

NOTE NEW ADDRESS AND PHONE NUMBER:

269 Peninsula Farm Road

Suite F

Arnold, MD 21012

410 518-9808

From: [mailto: ] On Behalf Of Pratt

Sent: Friday, October 02, 2009

12:18 PM

To:

Subject: RE:

Re: Medicare opt-out and stimulus money for EMR

Ramona,

I would calculate how much you anticipate being able to bill

Medicare. If the meaningful and certified terms are announced by 12/31/09

– and your system will qualify, then forecast how much you anticipate

billing to Medicare, take 75% of that and decide if it’s worth it.

We fully anticipate our system (e-MDs) will be

“qualified.” We anticipate a potential of about $7500 in

stimulus money the first year. That’s well worth it to us since we

already paid for the EMR and are already participating with Medicare.

It’s like free money J Not to mention the fact that our EMR will be completely paid

for before we ever see a dime of stimulus money, it’ll really be a nice

bonus.

Pratt

Office Manager

Oak Tree Internal Medicine P.C

www.prattmd.info

From:

[mailto: ]

On Behalf Of RGMS

Sent: Thursday, October 01, 2009

7:22 PM

To:

Subject: RE:

Re: Medicare opt-out and stimulus money for EMR

Jean:

It is because you mean so much to so many!

So, the question for me is: is it worth going “par” for

2010 to be “eligible” for some of the stimulus money? And

will they really define the “meaningful” and

“certified” terms by end of ’09?

Ramona

Ramona G. Seidel, MD

www.baycrossingfamilymedicine.com

Your Bridge to Health

NOTE NEW ADDRESS AND PHONE NUMBER:

269 Peninsula Farm Road

Suite F

Arnold, MD 21012

410 518-9808

From:

[mailto: ]

On Behalf Of

Sent: Thursday, October 01, 2009

10:04 PM

To:

Subject: Re:

Re: Medicare opt-out and stimulus money for EMR

that

sounds good

so it cannot be true

I FEEL meaningful....

On Thu, Oct 1,

2009 at 9:59 PM, Graham Chiu <compkarorigmail>

wrote:

Spend nothing and you will still get the stimulus funding if you use your emr

menaningfully and it is certified.

Neither of these latter two are defined yet.

On Fri, Oct 2, 2009 at 2:48 PM, <jnantonuccigmail>

wrote:

but how much do i have to spend to get the new emr

that will be certified

-by who/

and have meaningful use

which is still hazy

I bill plenty of medicare

Medicare is my life but the devil is in the details I'm waiitn til the

penalites start or til someone clears up alot of stuff.

On Thu, Oct 1, 2009 at 9:37 PM, Graham Chiu <compkarorigmail>

wrote:

https://www.cms.hhs.gov/apps/media/press/factsheet.asp?Counter=3466 & intNumPerPage=10 & checkDate= & checkKey= & srchType=1 & numDays=3500 & srchOpt=0 & srchData= & keywordType=All & chkNewsType=6 & intPage= & showAll= & pYear= & year= & desc= & cboOrder=date

If you bill $8k in Medicare in 2010, then'll you'll be

eligble to receive $6k in subsidies if you can demonstrate meaningful use

with a certified EMR.

On Fri, Oct 2, 2009 at 2:26 PM, RGMS <rgms01verizon (DOT) net>

wrote:

This is what I was afraid

of: Are there any IMPs who are seeing

enough Medicare in network to bill $25,000 next year? The

thing that makes no sense to me is the 75% that is thrown into this

stuff. If one has to bill 25K (or 24K) then 75% will always be the max

amount ($18,000). If a physician bills $8,000 in 2010, he/she is not

eligible for 75% or $6,000?

Devil in the details!

Ramona G. Seidel, MD

www.baycrossingfamilymedicine.com

Your Bridge to Health

NOTE NEW

ADDRESS AND PHONE NUMBER:

269 Peninsula Farm Road

Suite F

Arnold, MD

21012

410

518-9808

From:

[mailto: ]

On Behalf Of Graham Chiu

Sent: Thursday, October 01, 2009

9:06 PM

To:

Subject: Re:

Re: Medicare opt-out and stimulus money for EMR

" The ARRA statute

sets aside up to $44,000 Medicare billing reimbursement per doctor over a

5-year period to purchase an EMR. You have to be in private practice and

not be an employee of a hospital because hospitals will also have their own

form of eligibility.

In order to qualify, you would have to

have billed Medicare at least $25,000 in 2010, to be eligible and to receive up to $18,000 in 2011.

Also, you must be computerized and show what is now being called

" meaningful use " of an ARRA certified EMR.

To receive the $18,000, your reimbursement eligibility will be calculated on

75% of submitted allowable charges to Medicare from 2010. For example,

let's say you billed Medicare $50k in 2010, 75% of the first $24k would give

you the maximum $18k for that year. This is an excellent deal because the

government has already set aside the funds. This reimbursement will

continue for the next 5 years. "

Here's a link to the article Craig mentioned for those

who don't belong to AAFP:

http://www.nxtbook.com/nxtbooks/aafp/fpm_20090708/index.php?startid=19

Seto

South

Pasadena, CA

Here's a recent FPM article by the tech folks at

AAFP. It's a pretty good article.

http://www.aafp.org/fpm/20090700/19will.html

Craig

>

> Sharon:

> I have been thinking along the same lines. However, I am only

" non-par " as

> opposed to the opt out status. ($ is only available to those who are

> participating)

>

> What I could not figure out was how the calculation would be done on the

> money for the IT from the stimulus. I know it is a percentage of what you

> bill to Medicare annually. However, which year will they use?? If one is

> just starting up a practice, there would be no billables to look at. After

> the first year of the stimulus money availability, it appears the maximum

> amounts go down. I assume that year #1 is the same for everyone. Or is

> year #1 the first year you apply?

>

> I'll bet knows the answer.

>

> Ramona

>

> Ramona G. Seidel, MD

>

> www.baycrossingfamilymedicine.com

>

> Your Bridge to Health

>

> NOTE NEW ADDRESS AND PHONE NUMBER:

>

> 269 Peninsula Farm

Road

> Suite F

>

> Arnold,

MD 21012

>

> 410 518-9808

>

> _____

>

> From:

> [mailto: ]

On Behalf Of Sharon

> Sent: Thursday, October 01, 2009 5:28 PM

> To:

> Subject: Medicare opt-out and stimulus money

for EMR

>

> My Medicare opt-out is up for its two year renewal. I've been

contemplating

> whether or not to " opt-in " to try to take advantage of the stimulus

money

> for EMR. I do a membership/retainer practice. People pay an annual or

> monthly fee for all services. I'd have to change my medical services

> agreement for the Medicare folks (and make the fee for non-covered

> services). I'm trying to decide if it would be worth it.

>

> Marty, ,

or others have thoughts on the hassle factor/benefit of this?

>

> I hate to pass up free money to help improve my IT, but I don't want to

> torture myself either. Thanks in advance.

>

> Sharon

>

> Sharon

McCoy , MD

>

> Renaissance Family Medicine

>

> 10 McClintock

Court, Irvine,

CA 92617

>

> Phone: ; Fax:

>

> Email: SharonMD@...

>

> website: www.SharonMD.com

>

--

Graham Chiu

http://www.synapsedirect.com

Synapse - the use from anywhere EMR.

--

Graham Chiu

http://www.synapsedirect.com

Synapse - the use from anywhere EMR.

--

If you are a patient please allow up to 24 hours for a reply by email/

Remember that e-mail may not be entirely secure/

MD

115

Mt Blue Circle

Farmington

ME 04938

ph fax

impcenter.org

--

Graham Chiu

http://www.synapsedirect.com

Synapse - the use from anywhere EMR.

--

If you are a patient please allow up to 24 hours for a reply by email/

Remember that e-mail may not be entirely secure/

MD

115

Mt Blue Circle

Farmington

ME 04938

ph fax

impcenter.org

October 3, 2009

I have eMDs too, and I find it definitely worth it, even if I never get any ARRA

money (which I wouldn't count on, with federal deficits looming). I think you

should only do it if it will otherwise help your practice.

Some of the variables that would need to be looked at is, how fast can you type

vs. dictate or write, how many pts you see in a day, how many meds the pts are

on, and how complex your patients are. I have always seen quite complex pts in

an IM/lots of geriatrics practice. And I can type fast. And I see about 18

patients per day. The EMR lets me document lots of problems quickly and

thoroughly. This lets me code a level 4 visit (99214) most of the time. I have

had a certified coder look at my notes, and she concurs. I'm sure I couldn't

hand write level 4 visits most of the time, even though I do level 4 work most

of the time (if not level 5). I find that I can earn a fairly decent living,

even with the insurance companies, if I code 18 level 4 visits per day.

Also, it lets me print out alot of Rx's at once, and what's even cooler is the

ability to email via SureScripts, all the Rx refills with just the press of a

button. I love that. That saves a ton of MA time, or in micro-practice, it would

save the doctor's time.

Also, we don't need a medical record person. Saves alot of money right there.

So to summarize, I would say just get an EMR if you have other reasons to do it

other than the ARRA money. Just the money and time you'll save will probably

make it worth it. That's what I thought, anyway.

Harter MD

Phoenix AZ

> >

> > Sharon:

> > I have been thinking along the same lines. However, I am only " non-par " as

> > opposed to the opt out status. ($ is only available to those who are

> > participating)

> >

> > What I could not figure out was how the calculation would be done on the

> > money for the IT from the stimulus. I know it is a percentage of what you

> > bill to Medicare annually. However, which year will they use?? If one is

> > just starting up a practice, there would be no billables to look at. After

> > the first year of the stimulus money availability, it appears the maximum

> > amounts go down. I assume that year #1 is the same for everyone. Or is

> > year #1 the first year you apply?

> >

> > I'll bet knows the answer.

> >

> > Ramona

> >

> > Ramona G. Seidel, MD

> >

> > www.baycrossingfamilymedicine.com

> >

> > Your Bridge to Health

> >

> > NOTE NEW ADDRESS AND PHONE NUMBER:

> >

> > 269 Peninsula Farm Road

> > Suite F

> >

> > Arnold, MD 21012

> >

> > 410 518-9808

> >

> > _____

> >

> > From: <mailto:%40yahoogroups.com>

>

> > [mailto: <mailto:%40yahoogroups.com>

> ] On Behalf Of Sharon

> > Sent: Thursday, October 01, 2009 5:28 PM

> > To: <mailto:%40yahoogroups.com>

>

> > Subject: Medicare opt-out and stimulus money for

> EMR

> >

> > My Medicare opt-out is up for its two year renewal. I've been

> contemplating

> > whether or not to " opt-in " to try to take advantage of the stimulus money

> > for EMR. I do a membership/retainer practice. People pay an annual or

> > monthly fee for all services. I'd have to change my medical services

> > agreement for the Medicare folks (and make the fee for non-covered

> > services). I'm trying to decide if it would be worth it.

> >

> > Marty, , or others have thoughts on the hassle factor/benefit of this?

> >

> > I hate to pass up free money to help improve my IT, but I don't want to

> > torture myself either. Thanks in advance.

> >

> > Sharon

> >

> > Sharon McCoy , MD

> >

> > Renaissance Family Medicine

> >

> > 10 McClintock Court, Irvine, CA 92617

> >

> > Phone: ; Fax:

> >

> > Email: SharonMD@

> >

> > website: www.SharonMD.com

> >

>

> --

> Graham Chiu

> http://www.synapsedirect.com

> Synapse - the use from anywhere EMR.

>

> --

> Graham Chiu

> http://www.synapsedirect.com

> Synapse - the use from anywhere EMR.

>

> --

>

> If you are a patient please allow up to 24 hours for a reply by email/

> Remember that e-mail may not be entirely secure/

> MD

>

> ph fax

> impcenter.org

>

> --

> Graham Chiu

> http://www.synapsedirect.com

> Synapse - the use from anywhere EMR.

>

> --

>

> If you are a patient please allow up to 24 hours for a reply by email/

> Remember that e-mail may not be entirely secure/

> MD

>

> ph fax

> impcenter.org

>

October 3, 2009

Sharon,

If your practice is what you want it to be, then do not spoil it

by taking (hundreds of) Medicare patients in order to fulfill the criteria for the

stimulus money. Doctors have been giving up autonomy for money for years and

that is why 58% would quit medicine if given the chance. If you feel your

practice is financially faltering and you need an infusion of more patients or

you particularly like elderly patients, then go for it. But do not let the beauty

of the spinach entice you to taste the toxic stew unless you are starving and

there is no other food around.

I know I accept insurance and therefore have been drinking the

stew for years, but I realize how it zaps my strength and had initiated a

cancerous growth that will almost certainly force me to stop practicing

medicine early. Nearly every week I ponder the idea of breaking from the

insurance industry. The reality is my practice would not financially survive. My

patients don’t want to/can’t pay more than a simple co-pay. The

federal stimulus will help my bottom line. Increasing primary care pay will

help my bottom line. But, the stupid stupid stupid administrative stuff is what

kills and that is what you accept when you sign on the dotted Medicare line.

Insurance contracts should come with a skull and crossbones on the front page

(open at your own risk).

From:

[mailto: ] On Behalf Of Sharon

Sent: Friday, October 02, 2009 12:55 PM

To:

Subject: RE: Re: Medicare opt-out and stimulus

money for EMR

The FP Management article is

helpful. My real question is the how to decide if it’s worth it?

Which I know is rhetorical, but wonder what some thoughts are from people who

have thought through the opt in/opt out question.

Sharon

From:

[mailto: ]

On Behalf Of Pratt

Sent: Friday, October 02, 2009 9:18 AM

To:

Subject: RE: Re: Medicare opt-out and stimulus

money for EMR

Ramona,

I would calculate how much you anticipate

being able to bill Medicare. If the meaningful and certified terms are

announced by 12/31/09 – and your system will qualify, then forecast how

much you anticipate billing to Medicare, take 75% of that and decide if

it’s worth it.

We fully anticipate our system (e-MDs) will

be “qualified.” We anticipate a potential of about $7500 in

stimulus money the first year. That’s well worth it to us since we

already paid for the EMR and are already participating with Medicare.

It’s like free money J

Not to mention the fact that our EMR will be completely paid for before we ever

see a dime of stimulus money, it’ll really be a nice bonus.

Pratt

Office Manager

Oak Tree Internal Medicine P.C

www.prattmd.info

From:

[mailto: ]

On Behalf Of RGMS

Sent: Thursday, October 01, 2009 7:22 PM

To:

Subject: RE: Re: Medicare opt-out and stimulus

money for EMR

Jean:

It is because you mean so much to so many!

So, the question for me is: is it worth going

“par” for 2010 to be “eligible” for some of the

stimulus money? And will they really define the “meaningful”

and “certified” terms by end of ’09?

Ramona

Ramona G. Seidel, MD

www.baycrossingfamilymedicine.com

Your Bridge to Health

NOTE NEW ADDRESS AND PHONE NUMBER:

269 Peninsula Farm Road

Suite F

Arnold, MD 21012

410 518-9808

From:

[mailto: ]

On Behalf Of

Sent: Thursday, October 01, 2009 10:04 PM

To:

Subject: Re: Re: Medicare opt-out and stimulus

money for EMR

that sounds good

so it cannot be true

I FEEL meaningful....

On

Thu, Oct 1, 2009 at 9:59 PM, Graham Chiu wrote:

Spend nothing and you will still get the stimulus funding if you use your emr

menaningfully and it is certified.

Neither of these latter two are defined yet.

On Fri, Oct 2, 2009 at 2:48 PM,

wrote:

but how much do i have to spend to get the new emr

that will be certified

-by who/

and have meaningful use

which is still hazy

I bill plenty of medicare

Medicare is my life but the devil is in the details I'm waiitn til the

penalites start or til someone clears up alot of stuff.

On Thu, Oct 1, 2009 at 9:37 PM, Graham Chiu

wrote:

https://www.cms.hhs.gov/apps/media/press/factsheet.asp?Counter=3466 & intNumPerPage=10 & checkDate= & checkKey= & srchType=1 & numDays=3500 & srchOpt=0 & srchData= & keywordType=All & chkNewsType=6 & intPage= & showAll= & pYear= & year= & desc= & cboOrder=date

If you bill $8k in Medicare in 2010, then'll you'll be

eligble to receive $6k in subsidies if you can demonstrate meaningful use

with a certified EMR.

On Fri, Oct 2, 2009 at 2:26 PM, RGMS

wrote:

This is

what I was afraid of: Are there any IMPs who are seeing enough

Medicare in network to bill $25,000 next year? The thing that makes

no sense to me is the 75% that is thrown into this stuff. If one has to

bill 25K (or 24K) then 75% will always be the max amount ($18,000). If a

physician bills $8,000 in 2010, he/she is not eligible for 75% or $6,000?

Devil in

the details!

Ramona G.

Seidel, MD

www.baycrossingfamilymedicine.com

Your

Bridge to Health

NOTE

NEW ADDRESS AND PHONE NUMBER:

269

Peninsula Farm Road

Suite F

Arnold,

MD 21012

410

518-9808

From: [mailto: ]

On Behalf Of Graham Chiu

Sent: Thursday, October 01, 2009 9:06 PM

To:

Subject: Re: Re: Medicare opt-out and stimulus

money for EMR

" The

ARRA statute sets aside up to $44,000 Medicare billing reimbursement per doctor

over a 5-year period to purchase an EMR. You have to be in private

practice and not be an employee of a hospital because hospitals will also have

their own form of eligibility.

In order to qualify, you would have to have billed Medicare at least $25,000 in 2010, to be eligible and to receive up to

$18,000 in 2011. Also, you must be computerized and show what is now

being called " meaningful use " of an ARRA certified EMR.

To receive the $18,000, your reimbursement eligibility will be calculated on

75% of submitted allowable charges to Medicare from 2010. For example,

let's say you billed Medicare $50k in 2010, 75% of the first $24k would give

you the maximum $18k for that year. This is an excellent deal because the

government has already set aside the funds. This reimbursement will

continue for the next 5 years. "

Here's a link to the article Craig mentioned for

those who don't belong to AAFP:

http://www.nxtbook.com/nxtbooks/aafp/fpm_20090708/index.php?startid=19

Seto

South Pasadena, CA

Here's

a recent FPM article by the tech folks at AAFP. It's a pretty good article.

http://www.aafp.org/fpm/20090700/19will.html

Craig

>

> Sharon:

> I have been thinking along the same lines. However, I am only

" non-par " as

> opposed to the opt out status. ($ is only available to those who are

> participating)

>

> What I could not figure out was how the calculation would be done on the

> money for the IT from the stimulus. I know it is a percentage of what you

> bill to Medicare annually. However, which year will they use?? If one is

> just starting up a practice, there would be no billables to look at. After

> the first year of the stimulus money availability, it appears the maximum

> amounts go down. I assume that year #1 is the same for everyone. Or is

> year #1 the first year you apply?

>

> I'll bet knows the answer.

>

> Ramona

>

> Ramona G. Seidel, MD

>

> www.baycrossingfamilymedicine.com

>

> Your Bridge to Health

>

> NOTE NEW ADDRESS AND PHONE NUMBER:

>

> 269 Peninsula Farm Road

> Suite F

>

> Arnold, MD 21012

>

> 410 518-9808

>

> _____

>

> From:

> [mailto: ]

On Behalf Of Sharon

> Sent: Thursday, October 01, 2009 5:28 PM

> To:

> Subject: Medicare opt-out and stimulus money for

EMR

>

> My Medicare opt-out is up for its two year renewal. I've been

contemplating

> whether or not to " opt-in " to try to take advantage of the

stimulus money

> for EMR. I do a membership/retainer practice. People pay an annual or

> monthly fee for all services. I'd have to change my medical services

> agreement for the Medicare folks (and make the fee for non-covered

> services). I'm trying to decide if it would be worth it.

>

> Marty, , or others have thoughts on the hassle factor/benefit of this?

>

> I hate to pass up free money to help improve my IT, but I don't want to

> torture myself either. Thanks in advance.

>

> Sharon

>

> Sharon McCoy , MD

>

> Renaissance Family Medicine

>

> 10 McClintock Court, Irvine, CA 92617

>

> Phone: ; Fax:

>

> Email: SharonMD@...

>

> website: www.SharonMD.com

>

--

Graham Chiu

http://www.synapsedirect.com

Synapse - the use from anywhere EMR.

--

Graham Chiu

http://www.synapsedirect.com

Synapse - the use from anywhere EMR.

--

If you are a patient please allow up to 24 hours for a reply by email/

Remember that e-mail may not be entirely secure/

MD

ph fax

impcenter.org

--

Graham Chiu

http://www.synapsedirect.com

Synapse - the use from anywhere EMR.

--

If you are a patient please allow up to 24 hours for a reply by email/

Remember that e-mail may not be entirely secure/

MD

ph fax

impcenter.org

October 3, 2009

RE Will EMR stimulus money help or hurt you.

I also agree makes NO SENSE to install a high cost product JUST to get stimulus money.

BUT, if a tech product HELPS you save staffing, AND helps you be more efficient, AND helps you keep up with less stress on yourself, that's a valid reason.

Caution on the costs of long-term investment, though, upgrades, etc.

AND, be SURE your backups work and are triplly redundant if you are paperless.

Matt, Solo FP in Western PA

SOAPware user since 1997; all notes since Dec 2004 when I went solo

Medicare opt-out and stimulus money for EMR> > > > > > My Medicare opt-out is up for its two year renewal. I've been contemplating> whether or not to "opt-in" to try to take advantage of the stimulus money> for EMR. I do a membership/retainer practice. People pay an annual or> monthly fee for all services. I'd have to change my medical services> agreement for the Medicare folks (and make the fee for non-covered> services). I'm trying to decide if it would be worth it.> > > > Marty, , or others have thoughts on the hassle factor/benefit of this?> > > > I hate to pass up free money to help improve my IT, but I don't want to> torture myself either. Thanks in advance.> > > > Sharon> > Sharon McCoy , MD> > > > Renaissance Family Medicine> > 10 McClintock Court, Irvine, CA 92617> > Phone: ; Fax: > > Email: SharonMD@...> > website: www.SharonMD.com>

-- Graham Chiuhttp://www.synapsedirect.comSynapse - the use from anywhere EMR.

-- If you are a patient please allow up to 24 hours for a reply by email/Remember that e-mail may not be entirely secure/ MD ph fax impcenter.org

-- Graham Chiuhttp://www.synapsedirect.comSynapse - the use from anywhere EMR.

-- If you are a patient please allow up to 24 hours for a reply by email/Remember that e-mail may not be entirely secure/ MD ph fax impcenter.org

October 3, 2009

This is Al Borges analysishttp://www.hcplive.com/mdnglive/articles/PC_Medicare_HIT_mandate

RE Will EMR stimulus money help or hurt you.

I also agree makes NO SENSE to install a high cost product JUST to get stimulus money.

BUT, if a tech product HELPS you save staffing, AND helps you be more efficient, AND helps you keep up with less stress on yourself, that's a valid reason.

Caution on the costs of long-term investment, though, upgrades, etc.

AND, be SURE your backups work and are triplly redundant if you are paperless.

Matt, Solo FP in Western PA

SOAPware user since 1997; all notes since Dec 2004 when I went solo

Medicare opt-out and stimulus money for EMR> > > > > > My Medicare opt-out is up for its two year renewal. I've been contemplating> whether or not to " opt-in " to try to take advantage of the stimulus money> for EMR. I do a membership/retainer practice. People pay an annual or> monthly fee for all services. I'd have to change my medical services> agreement for the Medicare folks (and make the fee for non-covered> services). I'm trying to decide if it would be worth it.> > > > Marty, , or others have thoughts on the hassle factor/benefit of this?> > > > I hate to pass up free money to help improve my IT, but I don't want to> torture myself either. Thanks in advance.> > > > Sharon> > Sharon McCoy , MD> > > > Renaissance Family Medicine> > 10 McClintock Court, Irvine, CA 92617> > Phone: ; Fax: > > Email: SharonMD@...> > website: www.SharonMD.com>

-- Graham Chiuhttp://www.synapsedirect.comSynapse - the use from anywhere EMR.

-- If you are a patient please allow up to 24 hours for a reply by email/Remember that e-mail may not be entirely secure/ MD ph fax impcenter.org

-- Graham Chiuhttp://www.synapsedirect.comSynapse - the use from anywhere EMR.

-- If you are a patient please allow up to 24 hours for a reply by email/Remember that e-mail may not be entirely secure/ MD ph fax impcenter.org

-- Graham Chiuhttp://www.synapsedirect.comSynapse - the use from anywhere EMR.

October 4, 2009

Sharon,Like you, I am currently opted out of Medicare and coming up on my two year renewal. I guess I had assumed that the amount of money that I could get from Medicare wouldn't be worth it with the relatively low number of Medicare patients that I had seen in the past, but to help me decide, I came up with an Excel worksheet (see attachment) to help figure out if it would be worth it for me to opt back in to Medicare. If you can't download it from this message, I have also posted it in the "Files" section of the PracticeImprovement1 web site.You can plug in 3 variables:1. How many Medicare patients you have2. How many visits a year they will make to you3. How much money Medicare will pay (allow) per visitIt will calculate how much money you might get from the EHR stimulus program over 5 years, as well as how many Medicare patients you would need to see in order to collect the maximum amount of EHR stimulus money.Even based on my low number of 17 (the number of Medicare patients I had when I opted out in 2007), at 3 patient visits/year and an estimated $90 allowable per visit, I would get approximately $16,000 over 5 years. If I were buying a new expensive EHR, I might reason that this could help pay for it. But since I already have an EHR, it does seem like free money. So I will have to think about whether it is worth the hassle of going back to Medicare for. Hmmmm. SetoSouth Pasadena, CAMy Medicare opt-out is up for its two year renewal. I’ve been contemplating whether or not to “opt-in” to try to take advantage of the stimulus money for EMR. I do a membership/retainer practice. People pay an annual or monthly fee for all services. I’d have to change my medical services agreement for the Medicare folks (and make the fee for non-covered services). I’m trying to decide if it would be worth it. Marty, , or others have thoughts on the hassle factor/benefit of this? I hate to pass up free money to help improve my IT, but I don’t want to torture myself either. Thanks in advance. SharonSharon McCoy , MD

1 of 1 File(s)

EHR Stimulus worksheet.xls

October 4, 2009

Matt---

I'm with you. I do not have EMR and would like to have it but not for $20 K.

My IPA said they had a system for that cost. They didn't know anything

about stimulus money.

What exactly is " certified " EMR? Certified by whom?

Ellen

Dr Levin wrote:

>

> RE is it worth getting a " certified " EMR?

> Oh, but is it " certified? "

> A certified system costs from $25K up, as well as support.

> I'm all for using technology that HELPS ME GET THE JOB DONE, but I'm

> NOT for " bloatware " and data lock in.

> My suspicion is that ultimately there will be a fully interfaced

> system for records that is online.

> My focus remains and will continue to be using technology solutions to

> support my practice functioning BETTER and more EFFICIENTLY, but NOT

> to complete some administrivia goal. Remember that technology itself

> ADDS to complexity, AND cost. Never forget to add these when you

> commit to a path that reportedly " saves " you money. If I have to

> commit to a commercial system, if there is major technological support

> (server upkeep, high capacity data transfers, backups, maintenance),

> YOU and only you need to determine the financials here.

> Note also that I outsource billing because it works for me for a %;

> that's outsourcing, folks!!!

> Matt in Western PA

> Solo FP since Dec 2004

> SOAPware user since 1997, all charts since 2004

> Appointmentquest.com for appts

> RelayHealth.com for secure messaging

> Allscripts.com (community purchase through hospital) for ePrescribing

> McKesson logon for hospital lab/reports

>

> * Re: Medicare opt-out and

> stimulus money for EMR [1 Attachment]

>

> Sharon,

> Like you, I am currently opted out of Medicare and coming up on my

> two year renewal. I guess I had assumed that the amount of money

> that I could get from Medicare wouldn't be worth it with the

> relatively low number of Medicare patients that I had seen in the

> past, but to help me decide, I came up with an Excel worksheet

> (see attachment) to help figure out if it would be worth it for me

> to opt back in to Medicare. If you can't download it from this

> message, I have also posted it in the " Files " section of the

> PracticeImprovement1 web site.

>

> You can plug in 3 variables:

> 1. How many Medicare patients you have

> 2. How many visits a year they will make to you

> 3. How much money Medicare will pay (allow) per visit

>

> It will calculate how much money you might get from the EHR

> stimulus program over 5 years, as well as how many Medicare

> patients you would need to see in order to collect the maximum

> amount of EHR stimulus money.

>

> Even based on my low number of 17 (the number of Medicare patients

> I had when I opted out in 2007), at 3 patient visits/year and an

> estimated $90 allowable per visit, I would get approximately

> $16,000 over 5 years. If I were buying a new expensive EHR, I

> might reason that this could help pay for it. But since I already

> have an EHR, it does seem like free money. So I will have to think

> about whether it is worth the hassle of going back to Medicare

> for. Hmmmm.

>

> Seto

> South Pasadena, CA

>

>>

>> My Medicare opt-out is up for its two year renewal. I’ve been

>> contemplating whether or not to “opt-in” to try to take advantage

>> of the stimulus money for EMR. I do a membership/retainer

>> practice. People pay an annual or monthly fee for all services.

>> I’d have to change my medical services agreement for the Medicare

>> folks (and make the fee for non-covered services). I’m trying to

>> decide if it would be worth it.

>>

>> Marty, , or others have thoughts on the hassle factor/benefit

>> of this?

>>

>> I hate to pass up free money to help improve my IT, but I don’t

>> want to torture myself either. Thanks in advance.

>>

>> Sharon

>>

>> Sharon McCoy , MD

>>

>

> ------------------------------------------------------------------------

>

> ------------------------------------------------------------------------

> Sharon,

> Like you, I am currently opted out of Medicare and coming up on my

> two

> year renewal. I guess I had assumed that the amount of money that I

> could get from Medicare wouldn't be worth it with the relatively low

> number of Medicare patients that I had seen in the past, but to help

> me decide, I came up with an Excel worksheet (see attachment) to help

> figure out if it would be worth it for me to opt back in to Medicare.

> If you can't download it from this message, I have also posted it in

> the " Files " section of the PracticeImprovement1 web site.

>

> You can plug in 3 variables:

> 1. How many Medicare patients you have

> 2. How many visits a year they will make to you

> 3. How much money Medicare will pay (allow) per visit

>

> It will calculate how much money you might get from the EHR stimulus

> program over 5 years, as well as how many Medicare patients you would

> need to see in order to collect the maximum amount of EHR stimulus

> money.

>

> Even based on my low number of 17 (the number of Medicare patients I

> had when I opted out in 2007), at 3 patient visits/year and an

> estimated $90 allowable per visit, I would get approximately $16,000

> over 5 years. If I were buying a new expensive EHR, I might reason

> that this could help pay for it. But since I already have an EHR, it

> does seem like free money. So I will have to think about whether

> it is

> worth the hassle of going back to Medicare for. Hmmmm.

>

> Seto

> South Pasadena, CA

>

> >

> > My Medicare opt-out is up for its two year renewal. I’ve been

> > contemplating whether or not to “opt-in” to try to take

> advantage of

> > the stimulus money for EMR. I do a membership/retainer practice.

> > People pay an annual or monthly fee for all services. I’d have to

> > change my medical services agreement for the Medicare folks (and

> > make the fee for non-covered services). I’m trying to decide if it

> > would be worth it.

> >

> > Marty, , or others have thoughts on the hassle

> factor/benefit of

> > this?

> >

> > I hate to pass up free money to help improve my IT, but I don’t

> want

> > to torture myself either. Thanks in advance.

> >

> > Sharon

> >

> > Sharon McCoy , MD

> >

>

Attachment: vcard [not shown]

October 4, 2009

EllenThere are currently *no* certified EMRs out there because the CMS have not released the certification criteria.CMS is to be advised by ONCHIT, who should have something to say by the end of the year.