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Learning about ARRA, HITECH, & ONCHIT

ARRA

What is ARRA?
ARRA stands for the American Recovery and Reinvestment Act of 2009. Also commonly referred to as the “stimulus plan,” ARRA was signed into law by President Obama on February 17, 2009. The Act plans to invest $59 billion in health care initiatives, including $19 billion in healthcare information technology (HITECH).

What does ARRA mean to you?
Under the HITECH provisions in ARRA, physicians and medical practices can qualify for $44,000 or more in incentives if they can demonstrate “meaningful use” of an electronic health record by 2011. Practices that do not implement an EHR by 2015 will be penalized with Medicare reimbursement cuts.

What has President Obama said about ARRA?
President Obama had this to say about his administration’s plan to invest in healthcare information technology:

"When everything is digitalized, all your records - your privacy is protected, but all your records on a digital form - that reduces medical errors. It means that nurses don't have to read the scrawl of doctors when they are trying to figure out what treatments to apply. That saves lives; that saves money; and it will still ensure privacy."

To read the full text of the American Recovery & Investment Act visit http://www.recovery.gov/Pages/home.aspx

HITECH Act of 2009

What is HITECH?
On February 17, 2009, President Obama signed into law a $789 billion dollar economic stimulus package, formally known as the American Recovery and Reinvestment Act, or ARRA. Included in ARRA legislation is the Health Information Technology for Economic and Clinical Health (HITECH) Act, also known as HITECH. HITECH allocates $19 billion to hospitals and physicians who demonstrate “meaningful use” of electronic medical records.

HITECH also provides funds for the Office of the National Coordinator for Health Information Technology (ONCHIT). Originally founded in 2004, this office oversees health information technology (HIT) standards, implementation strategies and impact assessment. ONCHIT has set goals for “the utilization of an electronic health record for each person in the United States by 2014” and the development of a nationwide health information technology infrastructure that allows for the electronic use and exchange of information.”

What does HITECH mean to you?

Under HITECH, physicians can qualify for up to $44,000 in Medicare bonus incentives if they demonstrate “meaningful use” of an Electronic Health Record. The definition of “meaningful use” is still being worked out by ONCHIT but will likely include e-prescribing, chart sharing and quality of care measurements. Practice Fusion has participated in the public process by which “meaningful use” criteria are being discussed, and our EHR is guaranteed to meet these criteria.

The charts below show the timeline for Medicare and Medicaid bonus payouts under HITECH. As shown in the first table, a physician who can demonstrate “meaningful use” of an EMR in 2011 would be eligible to receive $18,000 from Medicare for the first year and $44,000 total through 2015. Incentives are reduced for adoption after 2012. Physicians whose practices feature a high volume of Medicaid patients can qualify for up to $65,000 in incentives.

Beginning in 2015, physicians who elect not to use an EHR will be penalized, starting with a 1% Medicare fee reduction. Those who do not adopt an EHR after 2017 will face a 3% Medicare fee reduction.

Yr of Adoption Medicare HITECH Incentive Timeline
2011 $18,000
2012 $12,000 $18,000
2013 $8,000 $12,000 $15,000
2014 $4,000 $8,000 $12,000 $15,000
2015 $2,000 $4,000 $8,000 $8,000
2016 $2,000 $4,000 $8,000
Total $44,000 $44,000 $39,000 $31,000

Yr of Adoption Medicaid HITECH Incentive Timeline No Adoption
2011 $25,000
2012 $10,000 $25,000
2013 $10,000 $10,000 $25,000
2014 $10,000 $10,000 $10,000 $25,000 1% penalty
2015 $10,000 $10,000 $10,000 $10,000 $25,000 2% penalty
2016 $10,000 $10,000 $10,000 $10,000 $25,000 3% penalty
2017 $10,000 $10,000 $10,000 $10,000
2018 $10,000 $10,000 $10,000
2019 $10,000 $10,000
2020 $10,000

Yr of Adoption Bonus Penalty
2009 2.0%
2010 2.0%
2011 1.0% -0.5%
2012 0.5% -1.0%
2013 -2.0%

What is the Health Information Technology Extension Program?

The HITECH Act also provides guidance and funding for establishing at least 70 regional centers to help promote EHR adoption. Regional centers will offer "technical assistance, guidance, and information on best practices to support and accelerate health care providers' efforts to become meaningful users of Electronic Health Records (EHRs)." Over 100,000 primary care providers will be supported by the regional centers. An excerpt from the "Health Information Technology Extension Program: Regional Centers Cooperative Agreement Program" document "Support should specifically focus on helping providers select the highest-value option, defined as that which offers the greatest opportunity to achieve and maintain meaningful use of EHRs and improved quality of care at the most favorable cost of ownership and operation, including both the initial acquisition of the technology, cost of implementation, and ongoing maintenance and predictable needed upgrades over time." Learn more about the Regional Centers on the HHS Website

ONCHIT

What is ONCHIT?

ONCHIT, the Office of the National Coordinator for Health Information Technology, was founded in 2004 as part of the Department of Health and Human Services, and received a massive boost in funding under the American Reinvestment and Recovery Act of 2009. The office has been tasked with coordinating the implementation and use of health information technology under HITECH.

What does ONCHIT mean to you?

ONCHIT will set the definition for “meaningful use” of electronic health record programs before December, 31, 2009. Proof of “meaningful use” is required for practices and providers to receive $44,000 or more in incentives for using an electronic health record system.