How many organizations are targeting BOTH the inpatient Medicare/Medicaid incentive AND the ambulatory EMR incentive?
It will be alot of work to have both systems meet 'meaningful use' definitions (whatever they will be).
We will attempt to do both - there is too much money on the table to ignore.

VCU Health System is aiming for both acute care (medicare and medicaid) and ambulatory care (some medicare, some medicaid). It requires a leap of faith as our 85 academic medical center's clinic are owned and operated by the hospital. The language of the ARRA specifies "non-eligible professionals" as radiologist, pathologies and anesthesiologies. What about the family practice doctor in the hospital-owned clinic? Wouldn't we want to encourage integrated deliver system of acute/ambulatory care?

At this point, the dollars are so compelling, we would likely re-organize the 551 practice plan physicians in order to activate 2011 incentives should HHS Sec Sebelius interpret "site of service" literally.

Anyone else with IDN suffering the same predicament?

Alistair

OK...my first try and my message got wiped out.

Alistair,
I hope all is well. My best guess is that the intent will be to NOT compensate any physician using an hospital supplied EHR while working for the hospital in any capacity in any venue. Anesthesiologists/ED physcians/and pathologists are just examples...

For those who haven't read the actual document, here goes:
"No incentive payment may be made under this paragraph in the case of a hospital-based eligible professional...the term 'hospital-based eligible professional' means, with respect to covered professional services furnished by an eligible professional during the EHR reporting period for a payment year, an eligible professional, such as a pathologist, anesthesiologist, or emergency physician, who furnishes substantially all of such services in a hospital setting (whether inpatient or outpatient) and through the use of the facilities and equipment, including qualitified electronic health records, of the hospital."

Here's what I don't know:
1) What happens to the physician who has received funds from a hosptial to purchase an EMR in a private office? I suspect they'll receive the full incentive payment. If so, I doubt any hospital will assist physicians with the first $44,000 cost of a system. Plus, the price point of an office EMR will drop below the 44k threshold in any event...who'd pay more?
2) What about a Foundation model, so prevalent in California? I suppose it will depend upon how the Foundation documents are drawn up and who actually owns the EMR asset.

Ben

Actually, hospital employed physicians do qualify as long as they are using an ambulatory EHR. Use of only an inpatient EHR will not qualify for the $44,000 for medicare or the $69,000 for medicaid.

Of couse, ER, radiologist, pathologies and anesthesiologies do not qualify.

But why woulod ER physicians not qualify?