Rhode Island's Office of the Health Insurance Commissioner, with the help of the Health Insurance Advisory Council, has developed a set of standards to improve healthcare system affordability in Rhode Island. One standard focuses on EHR adoption and requires an investment and promotion of EHRs by health plans with the aim of expanding and standardizing incentive programs for physicians. The standards also require that insurers support the implementation of EHRs by increasing reimbursement fees to providers with EHRs by at least three percent (3%).
The EHR incentive programs offered by local insurers are as follows:
Blue Cross and Blue Shield of RI Incentives
PCP EHR Fee Increase Program
As part of Blue Cross & Blue Shield of Rhode Island’s (BCBSRI) ongoing efforts to provide our members with access to high-quality and affordable healthcare, the existing PCP EHR Fee Increase Program is aligning with the CMS definition of Stage 1 EHR Meaningful Use in 2011 and 2012. BCBSRI’s PCP EHR Fee Increase Program rewards PCPs, specializing in internal medicine, family practice, or pediatrics, for their use of a certified EHR through reimbursement of evaluation and management codes at a higher percentage of the Rhode Island Medicare fee schedule.
For more information on the PCP EHR Fee Increase program and the alignment to Stage 1 Meaningful Use, including program applications and requirements, please visit the EHR Funding Support Programs page of https://www.bcbsri.com/BCBSRIWeb/providers/.
EHR Grant Program for Professional Physician Practices
BCBSRI provides grant funding for professional physicians who are new or existing users of an EHR. (Professional physicians are those who practice in a solo or group practice, not at a hospital or skilled nursing facility.) The funding is intended to offset acquisition, training, and upgrade costs. The program is open to PCPs and to physicians who are dually credentialed in a primary care specialty and a sub-specialty (eg, a physician who practices as an internist and cardiologist).
Each physician may receive as much as $5,000; each mid-level practitioner (nurse practitioner or physician assistant) may receive as much as $1,500 if the supervising physician is approved for funding. Applications are reviewed as they are received, and applicants receive a determination letter within 30 days. Additional funding is also available to assess a provider's/practice's readiness for EHR implementation and to define the steps needed to be ready for an EHR.
EHR Grant Program for Rhode Island Community Health Centers
In 2010, BCBSRI established an EHR Grant Program for Rhode Island CHCs. The funding is intended to offset acquisition, training, and upgrade costs for CHCs that are new or existing users of an EHR.
Each PCP may receive up to $2,500 and each mid-level practitioner (nurse practitioner or physician assistant) may receive up to $750, if the supervising physician is approved for funding. Funding is provided through a grant application process and distributed based on an application review process. Funding is also available to assess a provider's/center’s readiness for EHR implementation and to define the steps needed to be ready for an EHR.
For more information about the BCBSRI EHR Incentive programs, visit the Provider section at https://www.bcbsri.com/BCBSRIWeb/providers/, or call the BCBSRI Physician and Provider Service Center at 401.274.4848 or 800.230.9050.
Tufts Health Plan Incentives
EMR Incentive Program
Tufts Health Plan will provide incentive payment to 300 physicians in 2011. Each physician who qualifies for the incentive will receive a one-time payment of $750. To qualify for this program, contracting physicians must report that they adopted a qualified EHR system as determined by one of the organizations authorized by the ONC.
Physicians who received the 2010 Tufts Health Plan EMR incentive payment are not eligible for the 2011 incentive program.
Note: Funding for the 2011 program is still available!
For more information and questions about the Tufts Health Plan RI EMR Incentive Program, please contact Tufts at 617.972.9400 x 3240.
UnitedHealth Incentives
Ingenix CareTracker™ Interest-free Loans
To help physicians adopt EHRs, Ingenix (a UnitedHealth Group subsidiary) offered qualifying physicians an interest-free loan (underwritten by OptumHealth Bank, Member FDIC) to license and implement CareTracker EHR, with no out-of-pocket costs and no payments until 2011. (The financing covers implementation and monthly subscription costs until November 30, 2015.)
When the ARRA reimbursements for EHRs begin this year, physicians can repay the loans with annual reimbursement dollars they receive from the federal incentives.
For more information about Ingenix’s EHR financing program, please visit www.ingenix.com/ehr; write to ingenuity@ingenix.com; or call 877.347.0845.