Promoting Quality & Safety in Oncology Electronic Health Records
Business Case for ePrescribing. Is it worth the effort?
Details of Medicare’s ePrescribing incentive are readily available online (ASCO and CMS). But there are two very important questions physicians are asking to determine whether to participate. 1) Given most of the oncology-specific vendors have not yet been certified for ePrescribing, what are the chances they will support me with this incentive? And 2) What’s the business case for participating – is it worth the effort?
1) Will your EHR vendor support you in ePrescribing?
Multi-specialty vendors with an oncology solution, including Epic, Cerner, Centricity, Allscripts, and NextGen have already met ePrescribing certification standards (http://www.surescripts.com/get-connected.aspx?ptype=physician) and are ready to support their providers in Medicare's ePrescribing reimbursement. In a poll we conducted with oncology-specific vendors, we learned that Varian, Impac, Rabbit, Ascent, and Altos already have, or plan to have an ePrescribing plan in place by January 2009 possibly by working with a certified third party, such as New Crop, Kryptiq, MedPlus (Quest Diagnostics EMR), or Smart ID Works.
2) Will it be worth the effort?
Not for all specialties, but oncology makes sense since a significant proportion of patients are Medicare beneficiaries. There’s hard data and soft data to support the business case for ePrescribing. So, what would the 2 percent incentive mean to you in real dollars? We put that question to SmartIDWorks, the oncology sponsor of National ePrescribing Patient Safety Initiative (NEPSI), www.oncologyerx.com. The answer: an average of $20,000 per provider.
“The payment is based on the professional services fees for part B billing not prescriptions,” says Andy Popp, chief development officer at SmartIDWorks. So the practice can take their total Medicare billings from the previous year, minus the drug charges, and multiply that number by 2%.
The formula to make your own determination is this:
Medicare Professional Service Fees (don’t include drug charges) X 2% = $ reimbursement
Soft data is more difficult to measure, but is measured in time. After initial change management and implementation, the savings come in reduced labor costs (fewer call backs, fewer chart pulls) and increased prescription volume, according to Patricia L. Hale, MD, PhD, FACP, Deputy Director, Office of Health Information Technology for New York State Department of Health. Dr. Hale addressed “The Business Case for Providers” at the National ePrescribing Conference in October, 2008. View details of her presentation at http://207.114.10.22/e-Prescribe/presentations/BusinessCase/BusinessCase-Hale1.HTM.
SureScripts/RxHub research compares time spent before and after ePrescribing:
Physician’s time
Before – 33 minutes
After – 13 minutes
Office staff’s time
Before: 82 minutes
After – 40 minutes
(http://207.114.10.22/e-Prescribe/presentations/BusinessCase/BusinessCase-Hale22.HTM)
Reduced labor costs are in addition to ePrescribing reimbursements.
What would $20,000 a year per provider do for your practice in 2009?
Carolyn Hartley
President, Physicians EHR, Inc
1) Will your EHR vendor support you in ePrescribing?
Multi-specialty vendors with an oncology solution, including Epic, Cerner, Centricity, Allscripts, and NextGen have already met ePrescribing certification standards (http://www.surescripts.com/get-connected.aspx?ptype=physician) and are ready to support their providers in Medicare's ePrescribing reimbursement. In a poll we conducted with oncology-specific vendors, we learned that Varian, Impac, Rabbit, Ascent, and Altos already have, or plan to have an ePrescribing plan in place by January 2009 possibly by working with a certified third party, such as New Crop, Kryptiq, MedPlus (Quest Diagnostics EMR), or Smart ID Works.
2) Will it be worth the effort?
Not for all specialties, but oncology makes sense since a significant proportion of patients are Medicare beneficiaries. There’s hard data and soft data to support the business case for ePrescribing. So, what would the 2 percent incentive mean to you in real dollars? We put that question to SmartIDWorks, the oncology sponsor of National ePrescribing Patient Safety Initiative (NEPSI), www.oncologyerx.com. The answer: an average of $20,000 per provider.
“The payment is based on the professional services fees for part B billing not prescriptions,” says Andy Popp, chief development officer at SmartIDWorks. So the practice can take their total Medicare billings from the previous year, minus the drug charges, and multiply that number by 2%.
The formula to make your own determination is this:
Medicare Professional Service Fees (don’t include drug charges) X 2% = $ reimbursement
Soft data is more difficult to measure, but is measured in time. After initial change management and implementation, the savings come in reduced labor costs (fewer call backs, fewer chart pulls) and increased prescription volume, according to Patricia L. Hale, MD, PhD, FACP, Deputy Director, Office of Health Information Technology for New York State Department of Health. Dr. Hale addressed “The Business Case for Providers” at the National ePrescribing Conference in October, 2008. View details of her presentation at http://207.114.10.22/e-Prescribe/presentations/BusinessCase/BusinessCase-Hale1.HTM.
SureScripts/RxHub research compares time spent before and after ePrescribing:
Physician’s time
Before – 33 minutes
After – 13 minutes
Office staff’s time
Before: 82 minutes
After – 40 minutes
(http://207.114.10.22/e-Prescribe/presentations/BusinessCase/BusinessCase-Hale22.HTM)
Reduced labor costs are in addition to ePrescribing reimbursements.
What would $20,000 a year per provider do for your practice in 2009?
Carolyn Hartley
President, Physicians EHR, Inc
Comment
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Comment by Bobbi Buell on December 10, 2008 at 5:58pm -
We asked Daniel Green of Medicare to clarify what the basis of the e-prescribing incentive was and, additionally, we asked what the (less than) 10% eligibility cut-off was based on.
We received an answer from the following person, who hopefully knows what they are talking about:
Kim Sullivan
Physician Performance Information Center
IFMC
6000 Westown Parkway
West Des Moines, IA 50263
Here are the questions and answers..Understand that Physician Fee Schedule (PFS) services include anything paid on the physician fee schedule. Labs and drugs are not paid on the PFS.
Question: What are the services the incentive is calculated on? Is it all
Physician Fee schedule services (no drugs no labs); Physician Fee Schedule minus technical components or just E/M?
Answer: The incentive is calculated based on allowed charges for all Physician Fee Schedule (PFS) covered services furnished January 1, 2009 through December 31, 2009. However, to report the e-prescribing measure, an eligible professional need only report one of the G-codes specified in the numerator for the measure for at least 50% of the claims containing the CPT E/M codes specified in denominator for the measure.
Question: What are the services the 10% cut off is calculated on? Same as above?
Answer: Yes, the 10% cut-off is calculated based on allowed charges for all Physician Fee Schedule (PFS) covered services furnished January 1, 2009 through December 31, 2009. For example, if your allowed charges for all PFS covered services furnished January 1, 2009 through December 31, 2009 equal $100,000, then at least $10,000 of those allowed charges must be for services billed using the CPT E/M codes specified in the denominator for the e-prescribing measure. Please see the 10/30/08 Medicare Fact Sheet on the CMS website for more info.
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Comment by Robert S. Miller, MD on December 10, 2008 at 5:23am - Carolyn, I am not clear how the chemo enters into this. You say the 2% doesn't apply to drug charges - what about drug administration charges? Or is it only physician work - E&M codes? Or other stuff too?
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