EHR Incentives Still Out of Reach of Anesthesia & Pain Providers

The EHR incentive program is targeted at office-based practices.  Indeed, the original version of the program would have excluded anesthesiologists explicitly.  The July 28, 2010 final rule however, restricted the definition of “hospital-based”  so that it only covered physicians who provide 90 percent or more of their services on an inpatient basis or in the emergency department.  Most anesthesiologists do more than 10 percent of their cases on an outpatient basis, so they are not disqualified on the grounds that they are hospital-based.  Nevertheless, they will be ineligible for the bonus because fewer than 50 percent of their Medicare allowables will be generated in facilities with certified EHR systems and/or because fewer than 80 percent of their patients will have records in a certified EHR system.

Then there are the meaningful use standards.  Stage 1 requires the eligible professional to meet or qualify for an exclusion from each of 15 core objective functionalities (e.g., drug interaction checks) plus five out of a possible ten “menu set” measures.  The EHR must allow the eligible professional  to report at least six clinical quality measures, three of which are mandatory and three of which must be selected from a group of 38 measures.  The majority of these objectives and clinical quality measures do not apply to anesthesiology or pain medicine practice.  So the chances of quailifying for the EHR incentives are slim for anesthesia and pain professional, as the law is currently written.