Incentive payments for e-prescribers

Posted: September 23rd, 2009 | Author: George Getty III | Filed under: Incentives | No Comments »

In its bid to entice more providers to shift to electronic prescribing, the Centers for Medicare and Medicaid Services (CMS) has started this year incentive payments of up to 2 percent to physicians and other eligible professionals who use the technology

	2009	2010	2011	2012	2013	Beyond
Incentive	2%	2%	1%	1%	0.5%	None
Penalty	None	None	None	1%	1.5%	2%

For 2009, to be a “successful e-prescriber,” eligible professionals must report the e-prescribing quality measure through their Medicare Part B claims on at least 50 percent of applicable cases during the reporting year.

Under the Medicare E-prescribing Incentive Program, prescribers using a “qualified e-prescribing system” will receive incentive payments from Medicare beginning Jan. 1, 2009. The 2-percent reward will drop to 1 percent in 2011, then down further to 0.5 percent two years later, and go away after 2013.

The program, which is part of the Medicare Improvements for Patients and Providers Act of 2008, will slap those who do not adopt the electronic system with penalties – 1 percent in 2012, 1.5 percent in 2013, and 2 percent in 2014 and each subsequent year.

In addition, claimants should be an “eligible professional” whose estimated allowed Medicare Part B charges for the e-prescribing measure codes are at least 10% of their total Medicare Part B allowed charges. For more information, visit the CMS E-prescribing Incentive Program.

In general, an eligible professional is one of the following: physician, physical or occupational therapist, qualified speech-language pathologist, nurse practitioner, physician assistant, clinical nurse specialist, certified registered nurse anesthetist, certified nurse midwife, clinical social worker, clinical psychologist, registered dietitian, nutrition professional and qualified audiologist.

According to CMS, the e-prescribing incentive is similar to the Physician Quality Reporting Initiative in that reporting periods are one year in length. The incentive is based on the covered professional services furnished by the eligible professional during the reporting year.

Meanwhile, the U.S. Department of Health and Human Services said that eligible professionals may be exempted from the reduction in payment “if it is determined that compliance with requirement for being a successful prescriber would result in significant hardship.

In a Medscape news report, Dr. David Brailer, chairman of Health Evolution Partners and and former National Coordinator for Health Information Technology, said that cost is barrier for many physicians to purchase and install electronic health systems.

“The incentives will turn that business case around. My expectation is that the payments will be in excess of what we anticipate physicians’ costs to be.”

The government said Medicare is expected to save up to $156 million over the five-year course of the program in avoided adverse drug events.

The HHS pointed out estimates that as many as 530,000 adverse drug events are reported every year by Medicare beneficiaries while the Institute of Medicine said that more than 1.5 million Americans are injured each year by drug errors.

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