Wednesday, December 20, 2006

Fantasy Reimbursements

There are now many proposals by CMS regarding health information and their ability to gather data from EMRs, claims information and other sources from both hospitals and medical practices.

Not many of these have been worked out financially for the providers or the hospitals. Most of the proposals require software changes or running a parallel system to track the information they are requesting. For physicians this will cost far greater than the 1.5% proposed increase CMS is proposing as an "incentive". Most practices don't even have EMRs at all. Those without the digital EMR will be forced to workout a paper trail that again increases the paperwork burden to providers.

Here are some of the particulars. (from Health IT News, via

According to Thomas B. Valuck, MD, medical officer and senior advisor for the Centers for Medicare & Medicaid Services, CMS will administer the recent legislation providing a 1.5 percent incentive to physicians who participate in a new pay-for-performance plan, patterned after the one already in place for hospitals.

Valuck said it is going to be difficult to estimate the impact the incentive will have on physicians given the number of variables in the revenue picture: “The problem with the 1.5 percent incentive is that doctors will raise the question, ‘does $1.50 on $100 of billing cover the costs of reporting? ’”

Congress on Dec. 9 passed legislation that would increase physicians' pay -- beginning in the second half of 2007 -- if they voluntarily submit quality data measures to CMS using IT.
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