EHR and practice management for mental / behavioral health

What You Should Know About the EHR Mandate

by Donna Koger, 5.29.13

Can the federal government force practitioners to adopt Electronic Health or Medical records (EHR or EMR) software? The simple truth is NO – it’s not a mandate. A mandate implies you are required to do something or there are some grave consequences. 

What is an EHR?

According to the Centers for Medicare and Medicaid Services (CMS), an Electronic Health Record (EHR) is an electronic version of a client‘s medical history that is maintained by the provider over time, and may include all of the key administrative data relevant to that person’s care under a particular provider, including demographics, progress notes, problems, medications, vital signs, past medical history, treatment notes and reports.

The EHR automates access to information and has the potential to streamline the practitioner’s workflow. The EHR also has the ability to support other care-related activities directly or indirectly through various interfaces, including evidence-based decision support, quality management, and outcomes reporting.

What is the EHR mandate? Does it apply to mental health EHR / EMR?

The EHR “mandate” as concerning President Obama’s vision to transform all medical records to electronic based, is only about one year from now (May 2013).  Originally an initiative led by the medical record industry, electronic records systems have received a push from President Obama’s Economic Stimulus Plan. The legislation known as ARRA or The American Recovery and Reinvestment Act contains healthcare components that assist with the adoption, development, and Meaningful Use of electronic medical record systems for all practitioners by 2014.

Starting in early January 2015, the HITECH (Health Information Technology for Economic and Clinical Health) Act has provided some penalties that could be considered a serious consequence for those not adopting an EHR. To get the applicable funding, health practitioners must understand and prove Meaningful Use of client medical records and the use of certified EHR technologies.  This means that the EHR vendor selected by medical practitioners must comply strictly with the rule set.  PIMSY Platinum Mental Health EHR is 2014 Edition ONC-ACB certified for Meaningful Use. 

(CMS is retiring 2011 Edition).

What are the penalties for mental health EHR, and how do you avoid them?

For eligible EHR users (Psychiatrist/NP/Prescriber) who do not pass Meaningful Healthcare Use by 2015, their Medicare payments will be reduced by 1% and reduction increases to 2% if in 2016 they are still not able to demonstrate Meaningful Use. This will be increased to 3% in subsequent years.  If the HHS (Health and Human Services) Department found that, by the end of 2017, a Meaningful User is still less than 75%, proportion of the payment reduction will resume again at 1% per year.  But in some cases, such as providers who practice in places that do not reach the internet, there are exceptions.

The best way to avoid the 2015 penalty of electronic medical records mandate is to demonstrate Meaningful Use in 2013. If you decide to wait until 2014 as your first year to participate, the last reporting period is July-September 2014. Electronic practitioners will not be given the October-December 90-day period in 2014 since the attestation deadline will extend to February 2015. The same rule applies for 2015 and later. What this means is that you should not wait to implement an EHR and be a meaningful user until 2015. You must begin your first 90-day reporting period no later than July 1, 2014.

Even though you may not be officially mandated to adopt an EHR, there are several compelling reasons to go electronic now or in the near future:

       1. Ability to Sell Your Practice – Many younger providers will want to purchase a practice that has an EHR. The common thinking is that a practice will be more valuable if it is electronic.

       2. Government Mandated Reporting – While the government can’t really mandate the use of an EHR, it seems reasonable that the government could require certain reporting be done. Of course, you could manually do this reporting, but at some point the manual way will be much harder than using an EHR where the reporting can be automated.

       3. Reimbursement Requirements – At some point the insurance companies are going to require their data electronically. So, if you’re going to want to keep accepting insurance, then you’re going to need to be electronic. The insurance companies are still watching and waiting to see what happens with Meaningful Use before they decide how they’ll approach it. However, you can be sure the insurance companies and the government want more data; and electronic is the way to make that happen.

       4. Clients – It hasn’t happened quite yet, but get ready for a new client base that wants their provider to be electronic. No, you won’t have a “Got EHR?” sign outside your office to market to clients; it will come in more subtle ways, like the ability to schedule an appointment online. The ability to request refills electronically. Not having to carry (and possibly lose) their prescription to the pharmacy and then wait for it to be filled. Not having to fill out the same paperwork over and over and over again. Once clients get a real taste for these features, they’re going to be more selective in the providers they choose to use.

       5. ROI for Your Practice – There are plenty of arguments for and against the use of an EHR from an ROI (return on investment) perspective. Certainly it takes a smart EHR selection process and a well-done EHR implementation to achieve the ROI, but a lot of people have saved a lot of money thanks to their EHR. Add in things to come like practitioner liability insurance discounts, and the ROI will get even better over time. For some practices having tough times financially, their implementation of an EHR helped to solve some of those financial issues.

Stimulus Incentive Programs for Mental / Behavioral Health and Psychiatry EHRs

Then there are the stimulus plans offered by the federal government. Anyone who adopts an EHR that is ONC-ATCB Meaningful Use certified can apply for monies available through the provision of $40,000 in incentives for practitioners to use an EHR.

According to CMS, The Medicare and Medicaid EMR Incentive Programs provide incentive payments to eligible professionals as they adopt, implement, upgrade or demonstrate meaningful use of certified EMR technology. Eligible professionals can receive up to $44,000 through the Medicare EMR Incentive Program and up to $63,750 through the Medicaid EMR Incentive Program.

Other EMR incentive programs and benefits provided by the federal government include:

  • Creation of Healthcare Information Technology (HIT) Extension Programs that would facilitate regional adoption efforts
  • Development of education programs to train clinicians in EMR use and increase the number of healthcare IT professionals
  • Creation of HIT grant and loan programs
  • Acceleration of the construction of the National Health Information Network (NHIN)
  • Provision of funds to states to coordinate and promote interoperable EMRs

Whether you are a large or small practice, the reasons are obvious for adopting an EMR today. Don’t be left behind, contact PIMSY EHR for more information.

Donna Koger is Compliance Officer of PIMSY EHR.


Donna Koger is Compliance Officer of PIMSY EHR. For more information about electronic solutions for your practice, check out Mental Health EHR.


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