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Anthem Indiana and Stage 2 Meaningful Use

Anthem Indiana administers Medicare to clients who participate in the program. One of the areas in which we are getting a lot of feedback from physicians is the use of electronic health records.

The practice is being implemented across the country, in all 50 states, and has received mixed reviews. Family practice doctors and emergency room staff are the biggest proponents of electronic health records. Family practice physicians state that they spend far less time on paperwork, and are more diligent in notating all of the information concerning their patients’ conditions, as a result of this method of notating health records. Emergency room staff also advocates the electronic records, because they can immediately get a full picture of a patient’s entire medical history, whereas before they had only a very myopic picture delivered under the stressful conditions that inevitably accompany an emergency situation.

However, there are some problems being reported to Anthem Indiana from doctors who take care of Medicare and Medicaid patients. The process of electronically recording patient health information is open to all specialists, therapists, physicians, clinics, and hospitals that treat patients. While this should be an excellent way to keep track of all treatments the patient is receiving, it can create a serious problem of accountability for the primary care physician. Stage 1 Meaningful Use rules are currently in effect, and there are a host of problems with them. Stage 2 Meaningful Use rules are about to go into effect, creating an even greater potential threat to these physicians.

The American Medical Association (AMA) is teaming up with state organizations and specialties to get the Centers for Medicare & Medicaid to review Stage 1 rules and reconsider Stage 2 rules. Currently, there are no exclusions that will allow a physician to opt out on requirements that don’t apply to his or her practice. The physician is forced to come up with some way to answer to the requirements, which creates its own brand of complications. In addition, doctors are held accountable for entries made into the patients’ records by the patients themselves and for other doctors.

Medicare and Medicaid offer incentives for physicians who enroll in EHR, and so far about 62,000 doctors have received the incentives, out of about 185,000 who have registered. However, there are still hundreds of thousands of physicians and other health care providers who have not registered for the program, despite the $44,000 being offered over 5 years for physicians who sign up.

Anthem Indiana has been informed that Stage 1 rules require each physician to meet 15 core measures, while Stage 2 rules will require 17 core measures. Under Stage 1, the doctors also have to meet five optional measures, while Stage 2 requires three of five optional measures. While AMA is in favor of EHR adoption by doctor’s offices, they do not support the additional criteria being instituted by Medicare.

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