CMS encourages EHR use for Medicare quality reporting

Healthcare providers will have the option to use electronic health record systems to report Medicare quality and electronic prescribing measures to CMS in some of its pay-for-performance programs next year, according to an announcement by the Centers for Medicare and Medicaid Services.

The revisions are designed “to promote adoption and use of electronic health records and to provide both eligible professionals and CMS with experience on EHR-based reporting,” CMS said in the Oct. 30 announcement.

They run parallel to efforts by the Office of the National Coordinator for Health IT to set up additional incentives for providers to measure and submit data measuring the quality of their treatments.

According to CMS, providers could use EHRs to submit information for the CMS’s Physician Quality Reporting Initiative (PQRI) program, which pays an incentive to eligible physicians and other healthcare professionals who report on specific quality measures for care for Medicare patients.

Providers also will be able to report e-prescribing usage through qualified EHR systems or registries, according to CMS. Currently, providers’ reports about e-prescribing are based on patient medical claims.

Under the fee schedule rule, providers for the first time will be able to count quality data submitted through electronic health record systems toward their eligibility for a PQRI incentive payment, CMS said.

Next year, those payments will be equal to 2 percent of their total estimated allowed charges for the reporting periods, CMS said. The final rule will appear in the Nov. 25 Federal Register.

The rule also streamlines reporting of e-prescribing and focuses on the actual use of e-prescribing by the provider. In 2010, providers will use one code for e-prescribing, but they “need to report this code at least 25 times during the reporting period to be considered a successful electronic prescriber,” CMS said.

The Medicare fee schedule puts into practice provisions of the Medicare Improvement for Patients and Providers Act of 2008, which established a program for incentive payments for e-prescribing over five years. In 2012, CMS will impose penalties on providers who are not “successful e-prescribers.”

CMS to allow EHR reporting for PQRI, e-prescribing bonuses in 2010

The new Medicare Part B fee schedule for 2010 is encouraging doctors to adopt EHRs by, for the first time, allowing practices to use real clinical data from EHRs and e-prescribing systems to report quality measures for the Physician Quality Reporting Initiative (PQRI) and e-prescribing incentive programs. The change, according to CMS, is “to promote adoption and use of electronic health records and to provide both eligible professionals and CMS with experience on EHR-based reporting,” Government Health IT reports.

Whether the incentive payments are large enough to spur many practices to switch to EHRs ahead of the 2011 debut of the federal stimulus program is uncertain, however. PQRI participants can earn 2 percent on top of their total Medicare Part B fees for reporting quality data in 2010, and another 2 percent for writing electronic prescriptions. The e-prescribing bonus drops to 1 percent in 2011 and penalties for not e-prescribing begin in 2012. CMS is trying to simplify reporting of e-prescribing by requiring a single code to be eligible for the bonus next year.

E-prescribing 'could cut cost of human negligence'

Electronic prescribing systems that reduce the possibility of human error could cut clinical negligence claims by more than 70 per cent, according to US hospital chain Banner Health.

The company, which has worked with national IT programme supplier Cerner to evaluate the impact of its electronic prescribing system, said systems that reduced the possibility of human errors such as illegible handwriting or misrecorded doses had led to a 72 per cent reduction in the cost of clinical negligence claims at one of the group’s hospitals.

The National Patient Safety Agency has estimated that 9 per cent of patient safety incidents relate to medication errors, which together constitute some 20 per cent of all clinical negligence claims against the NHS.

In 2007-08, the NHS Litigation Authority paid out approximately £64m in damages for cases involving misprescribing.

Banner Health’s system director for care transformation Judy Van Norman told HSJ: “Some clinical leadership in the hospitals are interested and enthused about being involved but the resources at the individual hospital level to really lead the adoption of this is a frustration.”