Sunday, February 26, 2012

Age of Primary Care has arrived: enhanced reimbursement announcements

I guess this what happens when Geeks and Primaries are working together.
HIT and PCMH have generated the evidence for enhanced reimbursement. sv

Here are the announcements from Aetna, Anthem and United.

Aetna (CT/NJ):

Primary care providers who participate in Aetna’s networks, who have been recognized by the National Committee for Quality Assurance (NCQA)* as a PCMH, and who are not participating in other quality incentive programs with Aetna will receive a quarterly Coordination of Care payment for each commercial (non-Medicare) Aetna member in their care. The NCQA-recognized PCMH practices are recognized for providing a number of services, including:

Improved access to care, such as the ability to reach health professionals outside normal business hours;
Proactive and planned preventive care (screenings, physicals, labs);
Improved access through non-face-to-face visits (e-mail, web, phone); and
Access to nurses and other health care professionals, allowing more focused physician visits.

According to the Wall Street Journal, the reimbursement could be an extra $2-$3 per patient per month.

Anthem (NY):

The new program will also incorporate best practices from Empire’s successful medical home pilot, and build on the demonstrated value of those programs. For instance, one of our New York pilots have shown an 12-23% decrease in acute inpatient admissions and an 11-17% decrease in total ER visits for the pilot population, while improving compliance with evidence‐based treatment and preventative care guidelines.

Through Empire’s new patient-centered primary care program, participating physicians will be able to earn additional revenue in the following ways:
General increase to the regular fees paid to physician practices for specific services.
Payment for “non‐visit” services currently not reimbursed, with an initial focus on compensation for preparing care plans for patients with multiple and complex conditions.
Opportunity for shared saving payments for quality outcomes and reduced medical costs.

To participate in the shared savings, physician practices must meet plan quality requirements, which include, for example, quality standards established by organizations such as the National Committee on Quality Assurance, the American Diabetes Association, the American Academy of Pediatrics and others. Those primary care physicians, however, who maintain or improve quality may earn 30 percent to 50 percent more than they earn today through the shared savings model. Over time, Empire estimates the program could substantially improve quality and member health, potentially reducing trend in overall medical costs by as much as 20% by 2015.

Thursday, February 23, 2012

HIMSS12 Update: New York Successes

Another great HIMSS conference is drawing to a close. Record registrations and membership.
Many useful educational sessions and diverse vendors. And of course there was Farzad's, our leader on the road that has not been fully mapped but promises a better future for the delivery of healthcare.
Tonite NYC DOH PCIP and Hudson River Healthcare will be honored at the awards dinner while our own Dr Holly Hunter services as HIMSS Board Vice-Chair.
Let's hear it for New York!!!
CMS proposes definition of stage 2 Meaningful Use

Some take home points:

1) Stage 1 extended to 2014, gives the vendors more time to bake in the functionality and reporting features

2) More sub-specialty options available



FOR IMMEDIATE RELEASE                                           Contact: CMS Media Relations Group
February 24, 2012                                                                                                              (202) 690-6145

CMS PROPOSES DEFINITION OF STAGE 2 MEANINGFUL USE OF CERTIFIED ELECTRONIC HEALTH RECORDS (EHR) TECHNOLOGY The Centers for Medicare & Medicaid Services (CMS) today announced a proposed rule for Stage 2 requirements for the Medicare and Medicaid Electronic Health Record (EHR) Incentive Programs. Under the Health Information Technology for Economic and Clinical Health (HITECH) Act, part of American Recovery and Reinvestment Act of 2009, eligible health care professionals (EPs), eligible hospitals and Critical Access Hospitals can qualify for Medicare and Medicaid incentive payments when they adopt certified EHR technology and use it to demonstrate "meaningful use" of that technology by achieving objectives set by CMS.

The fact sheet summarizes CMS' proposed requirements for Stage 2 of the Medicare and Medicaid EHR Incentive Programs and highlights:

*        Changes to Stage 1 Criteria for Meaningful Use

*        Greater Applicability to Specialists

*        Stage 2 Reporting of Clinical Quality Measures

*        Payment Adjustments and Exceptions

*        Extension of Stage 1

In this proposed rule, CMS proposes several changes to existing Stage 1 criteria for meaningful use. Some of these changes would be optional for use by providers in Stage 1 but would be required for use in Stage 2. Other changes would not take effect until providers have to meet the Stage 2 criteria.
CMS' proposed rule may be viewed here:
Additional information on the Medicare and Medicaid EHR Incentive Programs can be found at
Click here to read the entire CMS Fact Sheet issued today (2/23):
# # #

Monday, February 20, 2012

Rite Aid and OptumHealth Introduce NowClinicSM Online Care Services in Detroit

Virtual visits continue to evolve. Please let us know if you would use this type of service in your practice. sv

NowClinic services are supported through a technology platform provided by American WellTM, ( the industry leader in telehealth solutions.

OptumHealth is part of Optum, a leading information and technology-enabled health services company dedicated to making the health system work better for everyone. OptumHealth is a leader in population health management, helping 60 million Americans navigate the health care system, finance their health care needs and achieve their health and well-being goals. OptumHealth supports the physical, mental and financial health of individuals with solutions offered through employers, health plans, public sector programs and health care providers. Visit or for more information. For more information about NowClinic, visit
HIMSS 2012 Begins today. Helpful links

Remember what happens in Vegas, should not, should not stay in Vegas!

Attend the presentations, make your network connections and then bring them back home and share as much as possible. This is a rare opportunity to meet such a diverse group of people, companies and institutions.

Please post your comments about the event here. sv

HIMSS 2012 is mobile

Twitter Cheat Sheet, track the Tweets!

HIMSS 2012 News

HIMSS 2012

Sunday, February 19, 2012

Arkansas, Delaware, Montana, New Jersey, New York, North Dakota Launched Their Medicaid EHR Programs November 2011

On November 7th, the Medicaid Electronic Health Record (EHR) Incentive Program launched in Arkansas, Delaware, Montana, New Jersey, New York, North Dakota. This means that eligible professionals (EPs) and eligible hospitals in these six states will be able to complete their incentive program registration. More information about the Medicaid EHR Incentive Program can be found on the Medicare and Medicaid EHR Incentive Program Basics page of the CMS EHR website.

If you are a resident of Arkansas, Delaware, Montana, New Jersey, New York, North Dakota, and are eligible to participate in the Medicaid EHR Incentive Program, visit your State Medicaid Agency website for more information on your state's participation in the Medicaid EHR Incentive Program. Click on a State below to access its website.

New Jersey
New York
North Dakota

As of November 7th, 39 states have launched Medicaid EHR Incentive Programs and through October, 23 states have issued incentive payments to Medicaid EPs and eligible hospitals who have adopted, implemented, or upgraded certified EHR technology. CMS looks forward to announcing the launches of additional states' programs in the coming months.

For a complete list of states that have already begun participation in the Medicaid EHR Incentive Program, see the Medicaid State Information page on the CMS EHR website.

Friday, February 17, 2012

NYAM Author Night Series - Medical Informatics: An Executive Primer, 2nd Edition

Sponsors: New York Academy of Medicine, maxIT, HIMSS NYS, Columbia University's Mailman School of Public Health, & Columbia's Center for Advanced Information Management

Date: Wednesday, March 21, 2012

Time: 5:30PM: Check-in and Refreshments, 6:00-7:00PM: Presentation, 7:00-7:30 PM Networking

Location: The New York Academy of Medicine, 1216 Fifth Avenue at 103rd Street, New York, NY 10029


Moderator: Ken Ong, MD, MPH, CMIO of New York Hospital Queens

Abha Agrawal, MD, FACP, Medical Director of Kings County Hospital Center in Brooklyn, NY

Rachel Block, Deputy Commissioner for Health Information Technology Transformation in the New York State Department of Health

Curtis Cole, MD, Chief Information Officer for Weill Cornell Medical College in New York City

Deborah Johnson-Ingram, Senior Program Manager on the Performance Improvement Team with Primary Care Development Corporation (PCDC) in New York City

Joseph Kannry, MD, Lead Technical Informaticist on the EMR Clinical Transformation Group at Mount Sinai

Glenn Martin, MD, Director of Medical Informatics for the Queens Health Network (QHN) in New York, a winner of the Nicholas E. Davies Award of Excellence

Jason Shapiro, MD, MA, Associate Professor and Chief of the Division of Informatics in the Department of Emergency Medicine at Mount Sinai

Mytri Pritam Singh, MPH, Executive Director of Implementation at the Primary Care Information Project (PCIP), a Bureau within the New York City Department of Health and Mental Hygiene (NYC DOHMH)

Alan Silver, MD, MPH, Medical Director at IPRO, a non-profit healthcare assessment and quality improvement company

Salvatore Volpe, MD, FAAP, FACP, CHCQM, Physician Liaison and Clinical Champion for the NYC DOH Primary Care Information Project and NYC REACH (Regional Extension Center)

Additional Information

Registration Information
Cost: Free, but advance registration required

Register now

Friday, February 10, 2012

Medicare and Medicaid EHR Incentive Programs One Year Milestone

Like a train, it may have been slow to start; but now it is gaining momentum.
This is the last year to get the full Medicare Incentive Payment, so call your local RECs and AMA to get help with choosing, implementing and using EHRs. SV

January 3rd Marked the One Year Milestone for the Medicare and Medicaid EHR Incentive Programs
January 3rd was the one year anniversary of the start of registration for the Medicare and Medicaid Electronic Health Record (EHR) Incentive Programs. Over the past year, there has been a tremendous amount of interest in the incentive programs as providers across the country have implemented EHRs. Year one highlights include:

43 states have started their Medicaid EHR Incentive Programs
Over 176,000 people have registered for the Medicare and/or Medicaid EHR Incentive Programs
Over $2.5 billion has been paid in incentive payments to eligible professionals (EPs) and eligible hospitals and critical access hospitals (CAHs) across the country

RECs List


Tuesday, February 07, 2012

The Medicare EHR Incentive Program: Last day to attest for 2011 (Calendar Year)

February 29, 2012 is the last day for eligible professionals to register and attest to receive an Incentive Payment for calendar year (CY) 2011.

The Medicare EHR Incentive Program will provide incentive payments to eligible professionals, eligible hospitals, and CAHs that demonstrate meaningful use of certified EHR technology.

Participation began in 2011.

Eligible professionals can receive up to $44,000 over five years under the Medicare EHR Incentive Program. There's an additional incentive for eligible professionals who provide services in a Health Professional Shortage Area (HSPA).

To receive full Medicare benefits, you will need to be using your EHR in a meaningful manner by October 1, 2012.

Important! For 2015 and later, Medicare eligible professionals, eligible hospitals, and CAHs that do not successfully demonstrate meaningful use will have a payment adjustment in their Medicare reimbursement.

Please contact your State Medical Societies, Specialty Medical Societies, the AMA and your local Regional Extension Centers for details.


Regional Extension List

Saturday, February 04, 2012

2012 PharmEHR Summit March 20 & 21, Philadelphia

Delivering Bio/Pharmaceutical Marketing and Regulatory Results Using Electronic Health Records (EHRs):
Messages to Physicians at the Point of Prescribing and Care

Philadelphia Hyatt at the Bellevue, March 20-21, 2012

For more information, please contact PDR Network representative Thomas Eck at (201) 358-7424 or via email at

This exclusive, invitation-only event will feature industry-leading speakers from Bio/Pharma; the federal government, including Janet Woodcock, MD, Director, Center for Drug Evaluation and Research, FDA; and EHR vendor firms, including Glen Tullman, CEO of Allscripts, the country’s largest EHR vendor.

Industry leaders will discuss, demonstrate and design practical means to deliver drug safety, risk management, patient support, marketing services and regulatory messages within physician workflow via EHRs. Key areas of discussion will include:
• EHR adoption and the powerful impact on physician decision-making: “The New MD Desktop”
• Regulatory and brand message integration into the new physician workflow
• Improving prescription fulfillment and medication adherence

About the PharmEHR® Summit

Tuesday, March 20
11:00 AM
Arrivals & Lunch

12:00 PM
Welcome and 2011 EHR Look-back

12:30 PM
EHRs: What, Why and Where
EHR Adoption, Drivers and Impact

1:30 PM
Impact of EHRs on the Medical-Legal- Regulatory Framework and the ‘Duty-to-Warn’ Landscape

2:15 PM
Break (15 minutes)

2:30 PM
ePrescribing Adoption, Formulary Compliance

3:15 PM
Integrating EHRs into the Product Marketing Lifecycle

4:15 PM
EHRs – Payer's Perspective

5:00 PM

5:30 PM
Top 100 Wine Tasting

7:00 PM
Dinner Key Note: EHRs - Now and the Near Future
• Glen Tullman, CEO, Allscripts

Wednesday, March 21
7:00 AM

7:45 AM
Welcome & Agenda

8:00 AM
What EHRs Currently Offer Pharma

9:00 AM
What Pharma Wants from EHRs and Their Users

10:00 AM
Break (15 minutes)

10:15 AM
EHRs and Adverse Drug Event Reporting and Follow-up

11:00 AM
EHR Patient Connectivity: Driving Medication Adherence and Safety

12:00 PM

1:00 PM
Day Two Key Note: EHRs and FDA Goals: Safety and Adherence
• Janet Woodcock, MD, Director, Center for Drug Evaluation and Research, FDA

1:45 PM
Bringing REMS and Adherence to Life with EHRs

2:30 PM
Closing Remarks/Meeting Adjourns

PDR Network recognized early the significant impact of EHR adoption on the bio/pharmaceutical industry. In addition to leading in the integration of drug-related services into EHRs, PDR Network founded the PharmEHR® Summit – the only national meeting of senior executives from bio/pharma and EHRs. Each year, this invitation-only meeting explores emerging strategies for bio/pharmaceutical marketing, regulatory and other core business objectives.

In hosting the annual PharmEHR® Summit, PDR Network reinforces its commitment as a strategic leader and trusted partner within the healthcare community.

PDR Network