Medical Billing Forum

General Category => General Questions => : desheba May 15, 2014, 01:45:50 PM

: ACO info??
: desheba May 15, 2014, 01:45:50 PM
Hello, I have a question....I was talking to a potential client that is a primary care office who is still using paper records, I asked if they had any plans to use an electronic record in the near future and her response was no because they opted out when they signed up to be an ACO. 

I was wondering if anyone has heard of this before and what exactly does it mean?  I found a website but not sure if I am interpreting it correctly that the physicians are allowed to do this....

https://www.premierinc.com/about/advocacy/issues/11/10-20-11-FLASH-ACO-final-rule.jsp

Any thoughts or comments would be greatly appreciated.

Thanks!
: Re: ACO info??
: PMRNC May 15, 2014, 02:52:28 PM
Any practice billing Medicare/Medicaid will need to have EHR.   Of course like my prediction with ICD-10, despite them saying they wouldn't delay, I'm willing to bet we see another 2-3 year delay for EHR. :) 
: Re: ACO info??
: Michele May 15, 2014, 03:30:05 PM
But if I am correct in my understanding there is no "mandate" per se.  BUT Medicare will have a penalty for providers who do NOT use EHR.  So basically they can continue to treat patients but they will be paid less for not using EHR.  But like Linda said, when this will happen, nobody knows for sure!
: Re: ACO info??
: desheba May 15, 2014, 04:25:50 PM
Thanks so much for the insight, I thought it was "required" to have an EHR, so I was shocked when they said they did not have one and no plans for one in the future.  Just wanted to make sure I cover my basis and give her accurate information when I talk to her again.

Thank you! :)
: Re: ACO info??
: PMRNC May 15, 2014, 05:39:40 PM
If they are enrolled with Medicare and Medicaid and DO not have EHR when time comes, they would be quite foolish. The reductions would surely hurt them.  Are you sure they are ACO certified? According to the Centers for Medicare and Medicaid Services (CMS), an ACO is "an organization of health care providers that agrees to be accountable for the quality, cost, and overall care of Medicare beneficiaries who are enrolled in the traditional fee-for-service program who are assigned to it."
They have agreements with CMS so if they have no plans to comply with EHR or meaningful use, they certainly might have some problems.