Participation in Healthcare Incentive Programs Not-So Optional

In an article that appears on the website titled “What you don’t do in 2015 will cause 9% CMS penalties in 2017,” EMR Advocate and Meaningful Use Audit Expert Jim Tate educates us on the possible penalties to providers and practices who don’t become meaningful users of certified EHR technology.

With the wave of healthcare incentive programs designed to motivate healthcare professionals to provide quality care and reporting on specific sets of patient medical information, many health systems and eligible professionals are enjoying reimbursements and incentive payments that are greatly augmenting their bottom line.  However, the initiatives are numerous and may be difficult to navigate, especially for individual providers or smaller practices.  There are various criteria for qualification and eligibility, and each incentive program comes with its own set of rules and deadlines.  Many EPs are unaware of penalties that exist for lack of participation in these programs, and they may feel like they’re in over their heads.

Tate informs us that failure to achieve Meaningful Use will bring a 2% penalty in 2016 “with a 1% annual increase up to 5%.”  Then there’s PQRS (Physician Quality Reporting System), which brings Medicare reimbursements to participating providers, but also threatens reimbursement reductions of 2% in 2016 for incomplete 2014 data.  And don’t forget about that sneaky Value-Based Modifier, or VBM, which (according to Tate) “many providers are not aware of,” and which is connected to PQRS.  The article tells us, “Beginning in 2016, eligible providers (EPs) in groups with 10 or more EPs will be subject to a penalty based on performance.  In 2017, this will include all EPs, not just those in larger groups.”

Cumulatively, these penalties total a staggering potential 9% in 2017 based on this year’s participation.  Tate’s advice to EPs and physician groups? Take stock of your current participation in the Meaningful Use, PQRS, and VBM programs.  The good news is, it’s not too late – steps can still be taken to meet requirements and offset your risk of being penalized.  Whether you already have certified EHR technology, want to switch technology vendors, or need to implement CEHRT and start abstracting historical patient clinical data to report for these initiatives, contact us today for assistance with evaluating your current situation and best-case scenario.  We’ll help you save time, cut costs, and increase revenue by protecting the payments you deserve.

The original article on 2017 penalties can be seen here.