Personal and Confidential HITECH ACT of 2009 Presented By: Mike Herbers Sales and Marketing Manager 4/6/10

Personal and Confidential Objectives for the Presentation The US Governments Role in Changing Healthcare What is the HITECH Act? What are the financial implications? How do I qualify for the incentives? What does meaningful use mean? When should I start?

Personal and Confidential In 2007, Medicare/Medicaid initiated PQRI (Physician Quality Reporting Initiative) as required by the 2006 Tax Relief and Health Care Act The 2008 Medicare Improvements For Patients and Providers Act made the PQRI program permanent ECPs offered incentives to provide quality measures data to PQRI Incentives began at a capped 1.5% of Medicare reimbursements to 2% uncapped in 2010 (incentives expire in 2010) Over 150k ECPs participated in 2009 This data base will be key to correlating quality measures to clinical outcome in the drive to value driven health care 32/15/10 Privileged and Confidential The U.S. Governments Role In Changing Healthcare

Personal and Confidential The 2009 American Recovery and Reinvestment Act (ARRA) provided $787B in stimulus funds and tax cuts The Health Information Technology For Economic and Clinical Health Act (HITECH Act) was included in the ARRA HITECH focuses on establishing and electronic health infrastructure and provides incentives for the adoption of electronic health records (EHRs) $19.2 billion in stimulus funds to accelerate the adoption of EHRs Medicare will provide incentive payments of up to $44,000 over five years for providers not based in hospitals who demonstrate "meaningful use" of certified EHR software starting in OR - Medicaid up to $60,000 for high volume offices – AND – 2% per year up to $5k for e- prescribing 42/15/10 Privileged and Confidential The U.S. Governments Role In Changing Healthcare

Personal and Confidential What are the Financial Implications? Incentives begin in 2011 and will be available to each Eligible Provider for amounts up to $44K through Medicare. Incentives are calculated on 75% of allowable Medicare fees billed each year, up to the full amount ($18,000). 70% of the incentive is available in years 2011 and Early adopters are rewarded! Starting in 2015, non adopters will be penalized.

Personal and Confidential Medicare Payout Schedule Payout Year Current Users 2011 Adoption 2012 Adoption 2013 Adoption 2014 Adoption 2011$18K 2012$12K $18K 2013$8K $12K$15K 2014$4K $8K$12K 2015$2K $4K$8K 2016$2K$4K Total$44K $39K$24K Columns represents the first year demonstrating meaningful use of a certified EMR Rows represents how much the payout will be each year. 2/15/106 Privileged and Confidential

Personal and Confidential Meaningful Use is key to reimbursement, and there are three stages to meeting meaningful use criteria Focuses on capturing health information in a coded format, using that information to track key clinical conditions, communicating the information to allow care coordination and initiating the reporting of clinical quality measures and public health information Stage 1 begins in 2011 and includes a proposed 25 objectives/measures that must be met to be deemed a meaningful EHR user Those who dont demonstrate meaningful use in 2014 will begin to have their reimbursements discounted at an accelerated yearly rate (from – 1% in 2015 up to -5% in 2019 and thereafter) 72/15/10 Privileged and Confidential Understanding Meaningful Use

Personal and Confidential How do I qualify for the incentives? Make sure you are using or purchase a certified EHR system Check with your EHR company to make sure they have the CCHIT certification Show meaningful use of certified EHR technology Heart and Soul of HITECH Act 25+ criteria with objectives and measures. Examples: Insurance eligibility electronically – 80% Electronic claims submitted – 80% eRX electronically – 75% Report on meaningful use criteria Submit compliant clinical quality measures, such as PQRI

Personal and Confidential When should I start? Benefits for early meaningful users 70% of incentive money is available in the first 2 years For the first payment year (2011), reporting period is any continuous 90 day period within the calendar year. October 1, 2011 is latest to qualify for the 90 day period For the second, third and fourth payment years, reporting is the entire calendar year On 1/1/15, penalties start for non meaningful users 1% reduction in Medicare payments in 2015, and grows from there

Personal and Confidential Sources Officemate – – Compulink – – First Insight (MaximEyes) – Allscripts Stimulus 101 –

Personal and Confidential Questions?