NRHA's Rural Health Voices blog offers informed commentary on the latest news in rural health care from NRHA staff and editorials from selected contributors.

How the CMS Proposed Rule Will Raise the Cost of Rural Healthcare

by Louis Wenzlow, Rural Wisconsin Health Cooperative Summary CMS' claims regarding the financial benefits of electronic health records (EHRs) for providers are not supported by their source reference material; and the benefits CMS predicts are not likely to materialize, especially for small rural providers. Due to their low volumes, small rural providers are much more likely to see a negative financial ROI on their EHR investments. So EHRs will in all likelihood increase the cost of...

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CMS Proposed Rule Excludes Most Provider-Based Clinics

by Louis Wenzlow, Rural Wisconsin Health Cooperative CMS Excludes Most "Provider-Based" Clinics from All EHR Incentives (1-29-10: revised to clearly indicate that RHCs are eligible for Medicaid incentives, whether or not they are provider-based) On December 30th, CMS released its proposed rule for the ARRA electronic health record incentive program. Among the issues that will impact rural providers is which physicians will qualify for the Medicare and Medicaid eligible professional...

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What CMS Says (And Doesn’t Say) About Small and Rural Providers

by Louis Wenzlow, Rural Wisconsin Health Network Proposed HIT Incentive Rule: What CMS Says (And Doesn't Say) About Small and Rural Providers In order to comply with the Regulatory Flexibility Act and the Social Security Act, CMS is required to examine and analyze the impacts of the proposed EHR incentive rule on "small entities" and separately on small rural hospitals. The CMS analyses are noteworthy not for what they say, but for what they don't say, since they reveal literally...

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CMS Excludes “Provider-Based” Clinics from All EHR Incentives

by Louis Wenzlow, Rural Wisconsin Health Cooperative On December 30th, CMS released its proposed rule for the ARRA electronic health record incentive program. Among the issues that will impact rural providers is which physicians will qualify for the Medicare and Medicaid eligible professional incentives. Summary My interpretation of which eligible professionals (see Key ARRA Language for definitions of eligible professional) qualify for the incentives is as follows: Eligible ...

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CMS Meaningful Use Definition Impact on Rural Providers

by Louis Wenzlow, Rural Wisconsin Health Cooperative CMS Rule: Meaningful Use Definition Impact on Rural Providers Under the American Recovery and Reinvestment Act (ARRA), eligible physicians and hospitals must reach a certain threshold of EHR adoption (called "meaningful EHR use") in order to earn CMS incentive payments. In July, the ARRA-established HIT Policy Committee recommended a wide range of meaningful use objectives for CMS to consider in the development of a proposed HIT...

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CAH “EHR Eligible Expense” Definition Still Lacks Clarity

by Louis Wenzlow, Rural Wisconsin Health Cooperative CMS Proposed Rule: What Is A Certified EHR Expense? On December 30th, CMS released its proposed rule and ONC released its interim final rule for the ARRA electronic health record incentive program. Among the issues that will impact rural providers is what qualifies as an EHR expense. This issue will specifically impact critical access hospitals (CAHs), which will receive Medicare incentives based on their “costs incurred for the...

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CMS Proposed Rule Excludes CAHs from Medicaid Incentives

by Louis Wenzlow, Rural Wisconsin Health Cooperative On December 30th, CMS released its proposed rule for the ARRA electronic health record incentive program. Among the issues in the proposed rule that will impact rural providers is that CMS has decided to exclude critical access hospitals (CAHs) from participating in the Medicaid portion of the incentive program. Numerous studies have indicated that CAHs have significantly lower EHR adoption rates than general hospitals, as well as...

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CMS and ONC Issue Regulations Proposing a Definition of ‘Meaningful Use’

The Centers for Medicare & Medicare Services (CMS) and the Office of the National Coordinator for Health Information Technology (ONC) encourage public comment on two regulations issued yesterday that lay a foundation for improving quality, efficiency and safety through meaningful use of certified electronic health record (EHR) technology. The regulations will help implement the EHR incentive programs enacted under the American Recovery and Reinvestment Act of 2009 (Recovery Act). The...

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Help Wanted: Skilled Health IT Workforce to Modernize Health Care

A Message from Dr. David Blumenthal, National Coordinator for Health Information Technology As health care providers and hospitals across the nation incorporate electronic health records into routine patient care, the demand for highly skilled health IT professionals will rapidly grow.  We will need a workforce that not only understands the technology and how it functions, but also its implications for patient care and workflow in clinical settings.  When my practice implemented...

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White House Unveils $182 Million for Broadband

[caption id="attachment_388" align="alignleft" width="150" caption="Vice President Joe Biden (Photo Credit: Whitehouse.gov)"][/caption] Vice-President Joe Biden will announce in Georgia today the the release of Stimulus broadband grants and loans for underserved communities.  The funding will be available to schools and hospitals to expand affordable access to broadband internet connections, and is the cornerstone of achieving wide-spread health information technology (HIT) adoption in...

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