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    MEDICARE/MEDICAID

    MEDICARE IS GOVERNMENT HEALTH INSURANCE

    Medicare is basically government health insurance for seniors over 65 years old, and younger people with various ailments, like dialysis patients.  Inpatient hospital visits are “Part A” and outpatient “Part B”, and “Part C” is caled a “network plan”, when the government pays for private insurance.  Part D deals with outpatient prescription payments.  Medicaid are state-supported health insurance programs.
    The U.S. government maintains a good website to handle most questions and problems of potential Medicare recipents.  Here below, is the visual interface, to show the options it has, at www.medicare.gov
    This website allows the patient to do many tasks online, which could save a trip to a crowded office, especially for some patients who are elderly, or ill.   When it is said these days, that patients should be more “pro-active” in their healthcare, this website is a prime example of the opportunity to do so.  Patients are encouraged, these days, of taking advantage of online tools, such as this web site, to make the government healthcare more streamlined, and efficient, for both patient and the healthcare system.

    Medicare Payments Linked to Adoption of EMRs

    The government is trying to stimulate the accumulation of Big Data, and to, hopefully, improve communication and streamline the healthcare system.  They are trying to encourage the adoption by physicians of the EMR.  The government has outlined a series of incentive payments, in the HITECH Act of 2009, which rewards both doctors and hospitals cash for adoption of the internet technology of Electronic Medical Records (EMRs).

    There are various guidelines that must be met to get the money,  called “Meaningful Use” rules.

    Meaningful Use Stages

    Stage 1:  sets the basic patient data that electronic health records must include, and patients must be provided electronic copies of health information.

    Stage 2:  by 2014:  increase health information exchange between providers and promotes patient engagement by giving patients secure online access to their health information.
    Stage 3:  will continue to expand meaningful use objectives to improve health care outcomes.
    The government has made it crystal clear that they want medical records to be digitalized, and has enacated Medicare penalties for not adopting the EMR system.
    For physicians who either have not adopted certified EMR systems by 2015, Medicare reimbursements will be reduced by 1%. The deduction rate increases in subsequent years by 2% in 2016, 3% in 2017, 4% in 2018, etc.

    Here’s a video which shows how a Physician can demonstrate the “Meaningful Use” of the EMR Systems.

    And, in addition for penalties by curbing some re-imbursements by Medicare to doctors, Medicare is also penalizing doctors if they do not E-PRESCRIBE

    What is Meaningful Use?
    Meaningful Use Definition & Objectives
    Why I decided to opt out of Medicare as a Provider: Blog Post

     

     

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