Medicaid and Medicare physicians, hospitals and health care providers are required to implement electronic medical records

But what happens if 2015 comes and you don’t have Electronic Medical Records?

The government has penalties starting in 2015 for Medicare health care providers who fail to implement electronic medical record (EMR) / electronic health record (EHR) technology. Medicare reimbursements will be cut by 1% in 2015. But it doesn’t stop there. Physicians without a certified electronic health record system, face a 2% penalty in 2016, 3% in 2017 and so on up to 2019.

The Medicaid electronic medical records initiatives are administered by the states. There are actually some states which choose NOT to participate in the HITECH Act. So, although CMS Medicaid reimbursements are generally less than Medicare, Medicaid physicians do not have to worry about the Centers for Medicare & Medicaid Services (CMS) penalties for failure to adopt electronic health records.

electronic medical recordsWhy are some private physician practices avoiding
Electronic Medical Records

It cost MONEY!


Yes, if you adopt electronic health record technology and use your EMR software solution to demonstrate the CMS meaningful use criteria, you can get paid. Physicians who participate in Medicare can get up to $44,000 from the HITECH Act EHR incentive program.

But doctors are going broke, especially the Medicare physicians.

Doctors list shrinking insurance reimbursements, changing regulations, rising business and drug costs among the factors preventing them from keeping their practices afloat. But some experts counter that doctors’ lack of business acumen is also to blame.

Loans to make payroll: Dr. William Pentz, 47, a cardiologist with a Philadelphia private practice, and his partners had to tap into their personal assets to make payroll for employees last year. “And we still barely made payroll last paycheck,” he said. “Many of us are also skimping on our own pay.”

Pentz said recent steep 35% to 40% cuts in Medicare reimbursements for key cardiovascular services, such as stress tests and echocardiograms, have taken a substantial toll on revenue. “Our total revenue was down about 9% last year compared to 2010,” he said.
“These cuts have destabilized private cardiology practices,” he said. “A third of our patients are on Medicare. So these Medicare cuts are by far the biggest factor. Private insurers follow Medicare rates. So those reimbursements are going down as well.”
Pentz is thinking about an out. “If this continues, I might seriously consider leaving medicine,” he said. “I can’t keep working this way.”

Also on his mind, the impending 27.4% Medicare pay cut for doctors. “If that goes through, it will put us under,” he said.
Federal law requires that Medicare reimbursement rates be adjusted annually based on a formula tied to the health of the economy. That law says rates should be cut every year to keep Medicare financially sound.

Although Congress has blocked those cuts from happening 13 times over the past decade, most recently on Dec. 23 with a two-month temporary “patch,” this dilemma continues to haunt doctors every year.

Beau Donegan, senior executive with a hospital cancer center in Newport Beach, Calif., is well aware of physicians’ financial woes.
“Many are too proud to admit that they are on the verge of bankruptcy,” she said. “These physicians see no way out of the downward spiral of reimbursement, escalating costs of treating patients and insurance companies deciding when and how much they will pay them.”

Donegan knows an oncologist “with a stellar reputation in the community” who hasn’t taken a salary from his private practice in over a year. He owes drug companies $1.6 million, which he wasn’t reimbursed for.

Dr. Neil Barth is that oncologist. He has been in the top 10% of oncologists in his region, according to U.S. News Top Doctors’ ranking. Still, he is contemplating personal bankruptcy.
That move could shutter his 31-year-old clinical practice and force 6,000 cancer patients to look for a new doctor.

Changes in drug reimbursements have hurt him badly. Until the mid-2000’s, drugs sales were big profit generators for oncologists.
In oncology, doctors were allowed to profit from drug sales. So doctors would buy expensive cancer drugs at bulk prices from drugmakers and then sell them at much higher prices to their patients.

“I grew up in that system. I was spending $1.5 million a month on buying treatment drugs,” he said. In 2005, Medicare revised the reimbursement guidelines for cancer drugs, which effectively made reimbursements for many expensive cancer drugs fall to less than the actual cost of the drugs.

“Our reimbursements plummeted,” Barth said.

Source: Doctors going broke

Are Electronic Medical Records detrimental to the health of physician practices?

The prior article “Can Electronic Medical Records Reduce The Post-Holiday Cash Crisis?”  claims that once implemented, an electronic health record system can save the practice money. One of the goals of the HITECH Act is to cut or at least reduce the increase in healthcare costs in the United States.

But to get to the point where they can save money, medical practices must make the initial financial investment in electronic medical records software and hardware.

If you’re a physician struggling to stay afloat financially, any additional outlay of cash can be deadly to your practice. The upcoming 1% to 5% CMS penalties for failing to implement electronic medical records, is small compared to the potential Medicare cuts you may be facing.

Got questions?
about the HITECH Act, Electronic Health Records or the
Centers for Medicare Medicaid Services (CMS)
EHR incentive program

I invite you to claim free access to an informative interview audio titled

How To Convert To Electronic Health Records,
When I’m Completely Technology Adverse,
And Don’t Know Where To Start!



Is electronic health record adoption a mystery to you?

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Want to take advantage of EHR incentive money?


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MUSICMeaningful Use System Implementation Consulting MUSIC
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