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.

Proposed Health IT Certification Programs

Today the Department of Health and Human Services released a Notice of Proposed Rulemaking for the Establishment of Certification Programs for Health Information Technology (Health IT). The rule first proposes the creation of a temporary certification program for Electronic Health Records (EHRs) and EHR modules. This serves as a bridge to the second, permanent certification proposal, which establishes detailed guidelines to support an ongoing program of testing and certification of health...

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One in Three Small Town Residents Without Health Coverage by 2019

According to a recently released Center for Rural Affairs' report, approximately one in three rural Americans living in communities with fewer than 2,500 residents will be uninsured by 2019. Throughout the remainder of rural America, approximately one in four residents will likely go without health care coverage and the annual cost of health care for all rural households will rise from $2,705 to nearly $4,700 on average.

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HIPAA version 5010 fact sheets and checklists Released by CMS

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HIT Policy Committee Recommendation One Small (CPOE) Step From Flexibility

by Louis Wenzlow, Rural Wisconsin Health Cooperative What is the 3-1-1-1-0 Recommendation? The HIT Policy Committee today created a framework for much needed flexibility within the EHR incentive program. Rather than requiring providers to meet all of the 20-plus meaningful use objectives (as is currently required in the CMS proposed rule), the Policy Committee recommended that providers be able to defer a certain portion of meaningful use objectives without jeopardizing their incentive...

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CMS Proposed Rule: How to Stretch Without Breaking

By: Louis Wenzlow, Rural Wisconsin Health Cooperative Figure 1: Hospitals (I Believe) Likely to be Excluded from IncentivesLet's Get Meaningful One thing we can all agree on: for the EHR incentive program to be meaningful, it needs to be designed to support our national goals of reducing healthcare costs and increasing healthcare quality. We're moving to electronic health records not for the technology's sake, but because we believe the technology is a means to actually help people and...

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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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