EHR Demonstration Includes Small Practices

About 400 small to medium sized primary care practices have the opportunity to receive incentive payments in an electronic health record (EHR) demonstration meant to encourage adoption and implementation of the much-touted health information technology (HIT).

The incentives are tied to the selected practices’ performance on an office system survey reflecting use of EHRs and the reporting and performance of clinical quality measures.

Practices participating in the demonstration are solo practitioners consisting of a single provider with one individual National Provider Identifier (NPI) and unique tax identification numbers (TINs) and multi-provider practices with up to 20 or more providers. The Centers for Medicare & Medicaid Services (CMS) says the average practice size for those practices participating in the demonstration is approximately 3.6 providers.

The demonstration will run through May 31, 2014. The actual processing of incentive payments will begin summer of 2010 and will extend into 2015, well beyond the demonstration’s termination date. Incentive payments will be made, in general, once or twice per year per practice. Due to various factors, however, payments may be processed in multiple, successive batches or files. Incentive payments earned under the demonstration will be made to the practice and not to the individual providers at the practice who are participating in the demonstration. Not all practices will earn incentives in each year of the demonstration.

Payments made under the demonstration will have no impact on regular Medicare fee-for-service claims processing. Moreover, practices participating in the demonstration will be eligible to participate in other incentive programs (ie, E-prescribing, Physicians Quality Reporting Initiative (PQRI), and American Recovery and Reimbursement Act (ARRA) EHR-based incentives, etc.) to the extent they would otherwise qualify.

Practices participating in the demonstration are in the following states and Medicare Administrative Contractor (MAC) jurisdictions:

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Demonstration Site

Specific Locations

Maximum # Practices/Site

MAC Jurisdiction

Louisiana

Statewide

104

J 7 – tbd

Maryland and Washington, DC

Statewide; District-wide

127

J 12 – Highmark Medicare Services

Pennsylvania – Pittsburgh area

Allegheny, Armstrong, Beaver, Butler, Fayette, Greene, Indiana, Lawrence, Somerset, Washington & Westmoreland Counties

138

J 12 – Highmark Medicare Services

South Dakota – and selected counties in bordering states

South Dakota – Statewide

Minnesota – Big Stone, Clay Cottonwood, Jackson, Lincoln, Lyon, Murray, Nobles, Pipestone, Redwood, Rock, and Yellow Medicine counties

Iowa – Buena Vista, Clay Dickinson, Emmet, Lyon, O’Brien, Osceola, and Sioux counties

North Dakota – Dickey

43

J 3 – South Dakota, North Dakota (Noridian Administrative Services)

J 5 – Iowa (Wisconsin Physicians Health Insurance Corp.)

J 6 – tbd

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