The recent release (July 16, 2010) of the “Final Rule” regarding Meaningful Use criteria and EHR (Electronic Health Records) Financial Incentives has certainly prompted lots of questions from many chiropractors about how to obtain stimulus dollars for their EHR / EMR systems and what they need to do to qualify.

Below is a summary of some key points regarding EHR eligibility for those of you who don’t care to read the original documents or fact sheets on Meaningful Use and EHR Financial Incentives in their entirety:

• Meaningful Use Criteria which establish eligibility for financial incentives are for EHR Certified programs only. Translation: if your EHR is not certified, you may not receive any financial stimulus.  Many EHR companies are advertising that they are “eligible” for certification, although this is not the same as being certified.  Buyer beware!

• You know only need to complete 20 of the 25 Meaningful Use Objectives/Measures as defined in the Final Rule issued by CMS.  Even though you may “defer” 5 of these requirements, this is still an ambitious list for most practitioners in order to qualify for the funds. (See my previous blog post “The 25 Meaningful Use Criteria for Chiropractic EMR Systems” for a full list of criteria)

• The completion of these Objectives/Measures fulfills Stage 1 requirements only (which make you eligible for the financial incentive portion).  Stage 2 and Stage 3 objectives exist, but the exact requirements and penalties are not as well defined.

• Chiropractors are Eligible Professionals that may qualify for the EHR financial incentives

• Chiropractors may be eligible for EHR financial incentive payments as early as 2011; payments can proceed for up to 5 years.

• The total financial payments that chiropractors are eligible to receive is a maximum of  $44,000 over a 5 year period or equal to 75% of Medicare allowable charges for covered professional services furnished by the chiropractor in an eligible year.  This is perhaps the biggest criteria EHR companies fail to mention.  In other words, in one given year, you can receive up to $18,000 IF (and only if) you provide at least $24,000 worth of covered services (based on allowable charges) to Medicare patients.  On the other hand, if you have a small Medicare practice, your eligible financial incentives will be reduced accordingly and capped at 75% of the allowable charges for your covered services (which, in chiropractic, is CMT only).  Do the math to see if your practice qualifies for anywhere near the $44K amount.

The Bottom Line

My final opinion is not changed by the “final rule” criteria.  I would highly recommend that most offices switch to some form of electronic health records.  However, this advice is NOT based on the presumption that you are doing so to capture any potential financial stimulus incentives.  Rather, migrate to EHR because of its potential to improve your documentation, level of care and overall recordkeeping.

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