Saint Luke's Hospital of Kansas City has launched a partnership with Legal Aid of Western Missouri that puts an attorney and a paralegal inside the hospital to help indigent patients address legal issues adversely impacting their health.
Legal Aid began its first medical-legal partnership in Kansas City in 2007, but the Saint Luke's partnership is the first to use legal staff working full-time at a medical site. Amber Cutler, an attorney with Legal Aid, said that has been critical to the success of the four-month-old project.
"On site is best, not only because we are more accessible to the patients, but because we are more visible," Cutler says. "The referrers on staff forget we are here if we aren't on site. If they are seeing you, your presence reminds them 'Oh yeah, we have that resource that we can refer these people to.' It's a critical component."
Bonnie Johnson, RN, an attorney and director of risk management at Saint Luke's, said having an attorney or a paralegal inside the hospital walls also improves patient relations and expedites the discharge process.
"If they're here on staff, any time there is a consult for the medical-legal partnership, they can go directly to the patient's room, start building that trusting relationship during the intake interview and talk about what their obstacles and issues are," Johnson says. "That has been a great distinction from some of the other medical-legal partnerships that have popped up across the country."
Nationally, medical-legal partnerships for indigent patients have been around since 1993. MLPs integrate lawyers into the healthcare team to help patients deal with legal problems that directly or indirectly harm their health. The programs have been endorsed by the American Hospital Association, American Bar Association, American Medical Association and American Academy of Pediatrics. The Saint Luke's MLP is funded by a $150,000 annual grant awarded by the hospital's foundation.
Johnson says the Legal Aid staff handles a variety of concerns. That includes helping indigents sign up for Medicaid, establish legal guardians, find housing, and address safety issues such as domestic violence or mold in the home that could trigger adverse health events necessitating care in the emergency department.
"Our indigent patients often are uninsured or very under-insured, and are dealing with a lot of societal issues that affect their health," Johnson says. "The partnership makes great sense. If we can take some of the legal stresses off our patients they are going to be better patients who are more able to deal with their health issues if they aren't worrying about all of the other social barriers they face."
The Saint Luke's medical-legal partnership is based on the I-HELP model. I stands for income and insurance issues; H is for housing issues; E is for ensuring patient safety in domestic situations; L is for legal status; and P is for power of attorney and guardianship.
Cutler says she's done about 20-25 referrals a month since she started working as a contract vendor at Saint Luke's in January, and about half of the referrals have been housing-related.
She said the partnership takes a holistic view toward patients. "For example, we may agree to represent a disabled individual with an appeal for Social Security benefits," she said. "During the course of representation, we may also assist with an appeal for Medicaid health insurance. If we are successful, the patient gains an income source to secure stable housing and health insurance to obtain ongoing treatment improving his or her overall health. If we see a patient who's been referred to us by the social worker for one legal issue, we do a screening to see if there are other legal needs."
Johnson said having Legal Aid on site also has helped expedite guardianship and durable power of attorney procedures. "The financial impact is once you have a decision maker for the patient, we can act effectively and efficiently and provide timely care for the patient," she said.
"If they don't have a decision maker we don't know who to turn to so we make 500 phone calls. Maybe it's a family member that hasn't seen them in 20 years, and it takes longer to make decisions."
Once a decision-maker is appointed, Johnson said, a discharge plan can be built. "Nursing homes and long-term care facilities won't take a patient without a decision maker so they're here longer than they need to be while we are waiting for guardianship," she said.
The Centers for Medicare & Medicaid Services' "inconsistent payment guidance" erroneously allowed about $38 million for improperly documented imaging claims in hospital outpatient emergency departments in 2008, a Department of Health and Human Services Office of Inspector General audit has determined.
A breakdown of the erroneous payments included 19% of claims -- with a value of $29 million -- for interpretation and reports for computed tomography and magnetic resonance imaging and 14% of claims -- valued at $9 million -- for interpretation and reports for X?rays, the OIG audit found.
Of the allowed Medicare claims for CTs and MRIs in hospital outpatient EDs in 2008, the OIG audit found that:
12% ($18 million) did not have physicians' orders as part of the medical record
12% ($19 million) did not have documentation to support that interpretation had been performed
5% ($7.3 million) had overlapping errors
Of the allowed Medicare claims for X-rays in hospital outpatient EDs in 2008, the OIG audit found that
8.6% ($5.5 million) did not have physicians' orders as part of the medical record
8.2% ($5.4 million) did not have documentation to support that interpretation had been performed
3% ($1.9 million) of claims had overlapping errors
The audit also found that 12% ($19 million) of CT and MRI claims and 16% ($10 million) of X-ray claims were for interpretation and reports that, while not erroneous, were performed after beneficiaries left EDs, OIG said.
OIG blamed the overpayments on what it said was CMS' "inconsistent payment guidance on the timing for interpretation. In 2008, 71% of interpretation and reports for X?rays and 69% of interpretation and reports for CTs and MRIs did not follow one or more of the American College of Radiology-suggested documentation guidelines."
OIG recommended that CMS:
Educate providers on the requirement to maintain documentation on submitted claims,
Adopt a uniform policy for single and multiple claims for interpretation and reports of diagnostic radiology services to require that claimed services be contemporaneous or identify circumstances in which non-contemporaneous interpretations may contribute to the diagnosis and treatment of beneficiaries in hospital outpatient emergency departments
In its written response, CMS disagreed with the call to adopt a uniform policy for single and multiple claims, saying that it does not believe that a single billed interpretation must in all cases be contemporaneous with the beneficiary's diagnosis and treatment to contribute to that diagnosis and treatment.
However, OIG said a uniform policy requiring that the interpretation and report be contemporaneous with or contribute to the beneficiary's diagnosis and treatment could reduce unexplained complexity in what is already a complicated billing system for medical diagnostics.
CVS Pharmacy Inc. has agreed to pay the federal government and 10 states $17.5 million to settle False Claims Act claims that it overbilled Medicaid for prescription drugs, the Department of Justice said Friday.
CVS allegedly submitted inflated prescription claims to the federal government by billing Medicaid in Alabama, California, Florida, Indiana, Massachusetts, Michigan, Minnesota, New Hampshire, Nevada and Rhode Island for more than what CVS was owed for prescription drugs for so-called "dual eligible" Medicaid beneficiaries who were also eligible for benefits under a third-party insurance plan.
Rather than billing the government for what the insured would have been obligated to pay had the claims been submitted to a third-party insurer, CVS billed and was paid a higher amount by Medicaid, DOJ said in a media release.
CVS Pharmacy Inc., the retail division of Woonsocket, RI-based CVS Caremark Corp. operates more than 7,000 retail pharmacies in 41 states and the District of Columbia. The retailer issued a statement acknowledging the settlement, but "expressly" denied "engaging in any wrongful conduct and has settled the matter to avoid the expense and uncertainty of protracted litigation."
CVS said it did not intentionally overcharge any state Medicaid program. "The Company regularly receives reimbursement from Medicaid and believes it is in compliance with each state's billing requirements for dual-eligible patients. Dual-eligible patients with third-party insurance coverage comprise a small percentage of the Medicaid patient population and this matter involves only certain state Medicaid programs. The settlement involves the CVS/pharmacy retail business only and does not involve CVS Caremark's PBM or Medicare Part D businesses," the media release said.
Under the settlement, the retailer agreed to pay the United States $7.9 million and the states $9.5 million plus interest. CVS has also amended a corporate integrity agreement with the Department of Human Services, Office of Inspector General, which has been in effect since March 14, 2008, in connection with an earlier, separate settlement.
The amendment, which will be in effect for three years, will monitor CVS's implementation of correct billing procedures and the training and education of employees. An independent auditor will issue reports on CVS's compliance.
The allegations were brought to the government by Stephani LeFlore, a CVS pharmacist in St. Paul, MN, in a whistleblower lawsuit. LeFlore will receive a total of $2.5 million as her share of the settlement.
The Justice Department said it has used the False Claims Act to recover more than $5.5 billion since January 2009 in cases involving fraud against federal healthcare programs.
Everyone knows unhealthy behaviors can be costly. Now some of those costs have been calculated into dollars.
The Thomson Reuters Workforce Wellness Index estimates that employers spend an average of $670 annually per employee on medical care and pharmacy around six behavioral risk factors, with the top cost drivers identified as:
Obesity /body mass index ($400)
High blood sugar ($150)
Tobacco use ($100)
The remaining costs in the index were attributed to blood pressure, cholesterol, and alcohol use. Thomson Reuters tracked the behaviors from 2005-2009 using data from employer-sponsored health insurance plans. In 2009, about 14% of direct healthcare costs for the employed, privately insured population were associated with these six behavioral risk factors, the index showed.
Unfortunately, the index shows that the nation's workforce is not trending toward better health. Using a befuddling methodology that defies an easy explanation, Thomson Reuters said it fashioned an index where a score of 100 represents the "ideal state where there are no behavioral risk factors present in the population and no healthcare costs attributed to health risks." From 2005 to 2009, the index declined 2% from 86.4 to 84.4. Of course, the decline in overall health means an increase in health insurance costs for employers.
Despite the glum news, Raymond Fabius, MD, and CMO at Thomson Reuters, tells HealthLeaders Media he's "excited by the results."
"It actually shows that, for starters, there is a dollar cost related to unhealthy behaviors," Fabius says. "So this gives the HR directors some tangible figures to justify the investment of resources to reduce unhealthy behaviors in their workforce."
Fabius says he's also encouraged because the approximately 1.5 million employees at companies taking part in Thomson Reuters' MarketScan wellness promotion program are seeing improved health behaviors.
Using tools like biometric screenings, health assessments, and wellness coaches, Fabius says, employers can and are slowing healthcare cost increases. "So, the real message to employers and HR directors is that you can buck the national trend. You can actually make your workforce healthier over time through the use of appropriate resources and through the use of data tracking," Fabius says.
Remember, the $670 per employee in additional costs measures only medical treatment and pharmaceuticals. It does not include the costs of sick days and "presenteeism," where employees show up for work but are less productive owing to health issues. Factor that in, Fabius says, and the costs could be considerably higher.
Fabius says he's encouraged that many companies are incentivizing employees with richer healthcare benefits if they improve their health metrics. "There are some companies out there now that have basic, better, and best health plan and you can earn your way to the best health plan by completing a health risk appraisal, by doing biometric screenings, by working with health coaches, or working with care managers for chronic illnesses," he says. "Those are four good steps to move a company in a direction of building a culture of health."
It's not enough, however. "The idea is not just to make people aware of their health risks or chronic conditions but to give them resources to either reduce those risks or manage their chronic condition," Fabius says.
That process is expected to improve as data collection on healthcare behaviors improves. Fabius says he's gathering data that will identify future trends in healthcare behavior that will allow companies to plan ahead. "This allows HR directors to attend to issues upstream, and if you can prevent or reduce the unhealthy behaviors we know you can either prevent or delay the onset of chronic illness," he says.
If you're willing to look past the sales pitch from Thomson Reuters, Fabius makes a good point. With every new study, the data supports the common sense idea that wellness programs save money. In that respect, these are exciting times for HR, which will play a key role in devising wellness programs, and convincing everyone from the board room to the loading dock that it is money well spent.
Community Health Systems Inc.'s hostile takeover bid for Tenet HealthCare Corp. took another twist Monday morning when CHS reconfigured its buyout offer on its Dallas-based rival to $6 in cash per share.
The new bid was launched just three days after Franklin, TN-based CHS acknowledged that it was "cooperating fully" with a subpoena issued by the Department of Health and Human Services, which is investigating alleged billing irregularities in Medicaid and Medicare.
Tenet on Monday morning confirmed receiving the latest CHS bid, but said it was advising shareholders to take no action at this time.
It is not clear if the HHS subpoena stems from a complaint filed by Tenet in a Dallas federal court last week, alleging that CHS overbilled Medicare by as much as $377 million using medically unnecessary admissions that improved its bottom line and appeal to investors.
Even under a cloud of uncertainty, CHS Chairman/President/CEO Wayne T. Smith made it clear that he would push for the Tenet acquisition. "Converting our offer to all cash underscores our commitment to completing this transaction and renders Tenet's irresponsible and inaccurate lawsuit irrelevant to our offer. We are confident that our business practices are appropriate and we will respond in detail to Tenet's claims in due course," Smith said in a media release Monday morning announcing the new buyout offer.
In the previous offer, made in December, CHS offered $5 per share in cash and $1 per share in CHS common stock. Monday's offer was made in a letter to Tenet's Board of Directors, CHS said in a media release.
"Tenet shareholders should be outraged by the billions of dollars in shareholder value that the Tenet Board has destroyed for its own shareholders and the industry at large as a result of its reckless and self-serving allegations. We are confident that Tenet shareholders will hold the entrenched Tenet Board accountable for this scorched earth response to our acquisition proposal," Smith said in a media release.
"Despite the value-destroying defensive tactics employed by the Tenet Board, we remain ready to engage in constructive discussions to move this transaction forward without further delay. As we have made clear, we would welcome the opportunity to review any additional information Tenet can provide and are prepared to recognize any additional value it can demonstrate," Smith said.
In its filing Friday afternoon with the Securities and Exchange Commission, CHS said it received a subpoena, dated March 31, from the Office of Inspector General, related to an investigation of "possible improper claims submitted to Medicare and Medicaid."
"We do not know if the subpoena is related in any way to the allegations contained in the lawsuit styled Tenet Healthcare Corporation vs. Community Health Systems, Inc., et al. filed in the U.S. District Court for the Northern District of Texas on April 11, 2011. We are cooperating fully with the OIG in connection with this subpoena and are currently unable to predict the outcome of this investigation," CHS said.
CHS said the subpoena that came from the OIG's Chicago office "requests documents from all of our hospitals and appears to concern emergency department processes and procedures, including our hospitals' use of the Pro-MED Clinical Information System, which is a third-party software system that assists with the management of patient care and provides operational support and data collection for emergency department management and has the ability to track discharge, transfer, and admission recommendations of emergency department physicians."
The CHS notice, which was signed by CFO W. Larry Cash, said OIG also requested information about CHS' financial arrangements with emergency department physicians. CHS said the OIG's requests are similar to those made by the Texas Attorney General's Office last November in its civil investigation of CHS's Texas hospitals.
A federal jury has convicted Miami physician Rene De Los Rios, MD, on felony false claims and conspiracy counts for his role in a $23 million HIV injection and infusion Medicare fraud scheme, the Departments of Justice, and Health and Human Services announced jointly.
The conviction, handed up Thursday after a three-week trial, carries a maximum penalty of 10 years in prison and a $250,000 fine for the conspiracy count, and a maximum penalty of five years in prison for the four false claims counts. Sentencing will be June 27, federal prosecutors said.
Evidence at the trial showed that De Los Rios was hired by Damaris Oliva, the convicted owner of Metro Med of Hialeah Corp., a bogus HIV infusion clinic that charged for infusion therapies which were medically unnecessary or not provided, prosecutors said.
Prosecutors said Oliva paid De Los Rios $3,000 a week to order unnecessary tests, sign medical analysis and diagnosis forms, and authorize treatments to make it appear that legitimate medical services were being provided to Medicare beneficiaries. De Los Rios also signed patient charts, often without seeing the patient, indicating that injection and infusion treatments were medically necessary when he knew they were not, prosecutors said.
Evidence at trial showed that De Los Rios falsely diagnosed almost all of the patients at Metro Med with the same rare blood disorders to ensure maximum reimbursement from Medicare. De Los Rios also prescribed expensive medications, including Winrho, Procrit, and Neupogen to collect Medicare reimbursements.
From April 2003 through October 2005, Metro Med submitted approximately $23 million in false claims to the Medicare program for injection and infusion treatments, and was paid $11.7 million in claims. Oliva and three other defendants have already pleaded guilty to conspiracy to commit healthcare fraud.
WakeMed Health & Hospitals will break ground on its third hospital in Wake County this fall, the Raleigh, NC-based health system announced this week.
The $62 million, 90,000-square-foot, 61-bed acute care WakeMed North Hospital will be attached to the existing WakeMed North Healthplex, and is targeted for opening in October, 2013, with a focus on inpatient women's health services, including obstetric and gynecological services, and comprehensive preventive, diagnostic, and therapeutic care.
The Healthplex will continue to serve men and children through the existing freestanding emergency department, outpatient surgery, imaging, lab, and physician services, WakeMed said in a media release.
"Since opening in 2002, WakeMed North Healthplex's consumer-driven volumes have consistently outpaced projections, demonstrating the great demand for health care services in this community," Bill Atkinson, MD, WakeMed president/CEO said in a media release. "Currently WakeMed North Healthplex offers a full-service, 24/7 emergency department, ambulatory surgery center, imaging and laboratory services, and a host of additional clinical capabilities. The campus also features an 85,000 square foot medical office building."
Atkinson called transitioning the Healthplex site to a hospital "the next logical step as the infrastructure is already in place and the community has a critical mass of 262,000 residents living within a seven-mile radius of the facility. While the hospital will initially open with a women's focus, our plan is for it to continue to expand to meet the needs of women, men and children alike."
Construction of the North Hospital is expected to create 500 construction jobs and will increase the current 150 employees to 442 full-time equivalent employees with an average salary of $48,760 by the second year of hospital operation.
Private, not-for-profit WakeMed said it received approval to add 41 acute care beds to WakeMed North Hospital in 2009, in addition to the 20 acute care beds already approved for relocation from WakeMed Raleigh Campus.
California Insurance Commissioner Dave Jones has intervened in a whistleblower lawsuit against Sutter Hospitals for alleged false billing of what Jones said could be "hundreds of millions of dollars" for anesthesia services, his office has announced.
"Sutter's alleged fraud comes at the expense of the private health insurance industry, which initially pays for the services, but, ultimately, this unjust burden falls on the shoulders of California's consumers, who must foot the bill for inflated health care premiums," Jones said in a media release.
"We believe the amount of the fraudulent charges is in the hundreds of millions of dollars, if not more. As Insurance Commissioner, I will use the full resources of this Department to root out insurance fraud in all forms and hold all those who engage in such fraud fully accountable."
Sutter Health posted a statement on its website denying the allegations. "Sutter Health believes this case is without merit and that our anesthesia charges are appropriately billed. We intend to vigorously defend this matter," the statement read in part.
In a 23-page complaint filed in California Superior Court in Sacramento, Jones' office alleges that Sutter falsely used an anesthesia billing code to charge for services and supplies that patients and insurers had already paid for, either through other charges on the hospital bill or through the anesthesiologist's bill.
In some instances, the complaint alleges, the billing code was charged even though no anesthesiologist was in the operating room and general anesthesia wasn't provided. Jones' office is seeking unspecified monetary penalties and damages, and injunctive relief.
The suit was originally filed by Rockville Recovery Associates Limited, a New York-based auditor hired by The Guardian Life Insurance Company of America to identify fraudulent claims filed from 2002-2008. Rockville allegedly discovered the fraud after reviewing bills submitted to Guardian by Sutter Hospitals, including at an onsite audit at one of Sutter's facilities, the complaint alleges.
The defendants are Sutter and New York-based Multiplan, Inc., an intermediary whose agreements with Sutter allegedly prevented insurers from meaningfully auditing Sutter's bills. As a result, health insurers paid inflated claims and passed on the costs to consumers in higher premiums, the complaint alleges.
Based in Sacramento, not-for-profit Sutter Health operates 24 hospitals in Northern California, and accounts for more than one-third of the hospital revenue generated in the region.
In the media release, Jones pointed to a recent Los Angeles Times report that hospitals in Northern California's six most populous counties collect 56% more revenue per patient per day than in Southern California's six most populous counties. The article cited Sutter as the "driving force" of those higher costs.
Sutter Health said it remains "committed to compliant billing and charging practices. Our charges are transparent and available to the public and our contracts with health insurance plans are thoroughly negotiated with these sophisticated companies. Since these rates are negotiated, they cannot be fairly characterized as false after the fact."
Sutter said it has asked Rockville Recovery Associates Ltd. to provide evidence to support the allegations. "To date, they have produced nothing to suggest that any bills submitted by any Sutter hospitals were false or fraudulent," the Sutter statement read. "Our negotiated prices reflect Sutter Health's significant financial commitments to comply with California's costly seismic regulations bring lifesaving technology to the bedside and take care of increasing numbers of patients who are unable to pay."
Heart attack victims and other people in need of emergency care have a better chance of surviving in Cincinnati hospitals, where risk-adjusted mortality rates for patients admitted through the emergency department are the lowest in the nation, according to a study from HealthGrades.
HealthGrades Emergency Medicine in American Hospitals found large differences in mortality rates for patients admitted through the ED, both by hospital and by market area, based on an analysis of more than seven million Medicare patient records from 2007 to 2009.
The study focused on 12 of the most common medical emergencies, including heart attack, stroke, pneumonia, and chronic obstructive pulmonary disease, and included only cases admitted to the hospital from the emergency room, representing the continuum of a care. Hospitals performing in the top 5% in the nation were designated by Denver-based HealthGrades as Emergency Medicine Excellence Award hospitals.
"In the case of a medical emergency, patients need to get to the closest emergency room as fast aspossible. No exceptions," Rick May, MD, the study co-author and HealthGrades vice president of clinical quality services said in a media release. "That said, we encourage patients to prepare in advance by identifying top-performing hospitals close to home. Our research shows that it's not just the care you receive the moment you arrive that makes the difference between life and death, but the hospital's ability to continue to provide you with the right care at the right time if you need to be admitted."
The top 10 cities for emergency medicine identified by the study are:
1. Cincinnati
2. Phoenix
3. Milwaukee
4. Dayton, OH
5. Cleveland
6. West Palm Beach, FL
7. Tucson
8. Baltimore
9. Houston
10. Detroit
The study also found that:
On average, for the 12 conditions studied, the percentage of cases admitted through the ED increased 2.64% from 2007 to 2009.
Providence, RI; Las Vegas; Miami-Ft. Lauderdale; and New York City had the highest percentage of admission through the ED (93.05%, 91.65%, 91.12% and 90.78%, respectively).
Lincoln, NE; Sioux Falls, SD; Wichita, KS; and Omaha, NE had the lowest percentage of admissions through the ED (48.06%, 53.72%, 54.84% and 62.32%, respectively).
Hospitals included in the study had to have a minimum threshold in terms of patient volumes, quality ratings, and the range of services provided. A copy of the study is available here.
Healthcare CIOs remain optimistic about getting federal EHR stimulus funding, but a growing number acknowledge that federal reimbursement will come later than they'd originally predicted, a quarterly survey by the College of Health Information Management Executives shows.
One-third of the 200 CHIME members who responded to the March survey said they expect to qualify for stimulus funding under the HITECH portion of the American Recovery and Reinvestment Act within the first year of the program, which began on Sept. 30, 2010.
The survey, however, shows fewer CHIME members believe they will qualify for funding within the first six months of the federal program. Only 7.5% of respondents said they expected to qualify for funding by April 1, 2011, compared with 15% of respondents to the same question in November 2010, and 28% of CIOs who responded to the first CHIME survey in August 2010.
Pamela McNutt, senior vice president/CIO of Methodist Health System and chair of CHIME's Policy Steering Committee, told reporters in a conference call on Wednesday afternoon that the road to meaningful use is proving more arduous than many had thought, as CIOs run into a number of nettlesome problems from IT staff shortages to quality measure snafus.
"It's like anything else, the devil is in the details," says McNutt, pointing to a shift in "top concerns" among CIOs. "In December and last year people were concerned about certification and CPOE (computerized physician order entry). What we have seen now is that 26% of the participants in the survey are now concerned about capturing and submitting quality measures. The quality measures are becoming the sticky wicket for everyone."
For example, McNutt says hospitals are being challenged by new quality measures that must be created directly from EHR instead of through the current practice of having them abstracted and entered into the Centers for Medicare & Medicaid Services website.
The survey found that most CIOs said they expect to achieve meaningful use and incentive funding for Stage 1, and more than 90% believe their organizations will qualify for stimulus funding in federal fiscal years 2011 to 2013, the first years of the stimulus-funding program. Twenty-five percent of CIOs in the March poll said they expect to qualify for stimulus funding by Sept. 30, 2011, which marks the first full year of the program, and 58% expect to qualify during Stage 1, but possibly not until late in federal fiscal years 2012 or 2013.
McNutt says CIOs are confronting two challenges. "One is diving into the actual regulation and also diving into what they are specifically needing to do in their organizations," she said. "They are finding there are a lot of details they need to attend to. While they may have been doing some of the things that are in the measures already, like collecting vital signs, they may not have been collecting them in the right place for them to be reported properly. As people start to find these details out their confidence in obtaining meaningful use very quickly is beginning to wane."
Compounding the angst, McNutt says, is a Catch-22 snag that requires hospitals in Stage 1 to report some quality measures using automated physicians' notes generated in their EHRs. "Automated physician notes are not required until Proposed Stage 2," McNutt says. "You don't have your physicians reporting some of the data you need in a granular fashion, so how are you going to record some of these items that are being currently captured by abstraction? That is difficult. We don't have our physicians on electronic documentation yet in most cases."
A majority of respondents said their organizations had not registered for the federal program, the first step in declaring readiness for the incentive program and demonstrating meaningful use of EHR. A total of 19.5% of CIOs at standalone hospitals have already registered for the program, while 29.5% of CIOs at multi-hospital systems have registered all their hospitals for the program.
Responses from community hospital CIOs suggest that their organizations will need more time to qualify for stimulus funding. A total of 26% of CIO respondents from community hospitals expect to qualify for stimulus funding during the first year of the program, ending on Sept. 30, with 66% seeking to qualify in late FY2012 or FY2013.
The March poll shows that more CIOs are accelerating plans to implement EHRs, with 40.5% in March versus 35.6% in November 2010. Those who believe their current IT strategy and existing applications would help them meet meaningful use slipped to 39.5% in March, compared with 41.9% in November.
Capturing and submitting data for quality measures has become the most frequently cited concern of CIOs responding to the survey.
Nearly 75% of responding CIOs say they are concerned about legislative proposals to repeal incentive funding, including the EHR Medicare and Medicaid Incentive Program.
55% of CIO respondents say they still have lingering questions about the program, nearly six months after the Oct. 1, 2010, start of the stimulus funding program.
