Information Affecting Reimbursement

In February, the ACC conducted two surveys to learn more about cardiologists’ experiences with the federal Electronic Health Record (EHR) Incentive Program, one of cardiologists and the other of cardiology practice administrators. The survey of cardiologists was conducted as a follow-up to a similar survey conducted in summer 2011.

Approximately one-third (33%) of cardiologists and 44% of practice administrators surveyed reported successful attestation to the federal EHR Incentive Program in 2011. Of those, about half (49%) have received an incentive payment for 2011. This translates into a 22% successful participation rate in 2011 and seems to mirror the latest numbers released by the Centers for Medicare and Medicaid Services (CMS) in May1, indicating that 3,884 physicians identified as cardiologists successfully participated in the program.

The timing of this survey and the reimbursement cycle might explain the lower numbers of payment recipients who attested. Based on the payment formula, professionals are not eligible for the full payment until approximately 60 days after the close of the attestation period. As of May, CMS has paid out more than $887 million to more than 51,000 physicians. Focusing on cardiologists, nearly 4,000 practitioners have received over $69 million in Medicare EHR incentive payments.

This latest survey also indicates an increase from 2011 in the number of CV practices planning to participate in the EHR Incentive Program. The majority of cardiologists (58%) and practice administrators (82%) indicated they are participating or plan to participate this year. Broken down by practice type, 71% of survey respondents in independent practices said they intended to participate in 2012, compared to 50% of respondents affiliated with a hospital or medical school.

The push to increase EHR adoption is evident in cardiovascular practice. Two-thirds (68%) are operating EHR systems in their practice that have been in place for one or more years. There is also no dominant EHR player with Allscripts, EPIC, NextGen, and GE Centricity all vying for leadership. The EHR systems in general received moderate satisfaction ratings from users.

Although some practitioners felt that participating in the EHR Incentive Program was relatively easy, others disagreed, citing challenges in creating synergies across EHR systems as well as the amount of staff resources necessary to support successful attestation. Therefore, it is not surprising when asked what the ACC could do to better support this process, cardiologists suggested:

  • Providing an evaluation of different EHRs or “Consumer Reports” type vendor contrast

  • Better integration of guidelines into EHR functionality, metrics and reporting

  • Simplified instructions on enrollment, requirements, reporting, and attestation

Clearly, the EHR Incentive Program has had an impact on how many cardiology practices manage their records and maintain their databases. While infrastructure changes and learning curves for these new technology-driven procedures vary from practice to practice, in the end, having more timely, accurate and improved record-keeping procedures will have an impact that benefits physicians, patients and practices.

This article appeared in the July 2012 CardioSurve Newsletter.




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