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ODs earned $2 million in e-Rx bonuses in 2011

June 26, 2013

Almost 2,000 optometrists qualified for more than $2.2 million in bonuses through the Medicare e-Prescribing (e-Rx) Incentive Program in 2011, according to the U.S. Centers for Medicare & Medicaid Services (CMS).

Total e-Rx bonus payments to optometrists have grown or remained steady each year since the incentive program began, even though the bonus percentage has been reduced over time and many optometrists have opted to participate in the more lucrative Medicare EHR incentive program, according to AOA Federal Relations Committee Chair Roger Jordan, O.D.

“That is probably because, each year, additional optometrists discover that e-prescribing is an excellent way to begin introducing state-of-the-art health information technology (HIT) in a practice,” Dr. Jordan said. “Many practitioners have found it advantageous to begin by e-prescribing and then move on to implement a full EHR system.”

Practitioners participating in the Medicare Electronic Health Records (EHR) Incentive Program are barred from also earning Medicare e-Rx incentives, as both programs effectively reward electronic prescribing.

One out of every 20 optometrists who saw Medicare patients in 2011 earned an e-Rx bonus. One-third (33 percent) of all optometrists who attempted to earn a bonus by participating in the program during 2011 were successful.

Optometrists increasingly understand that e-prescribing is becoming an essential part of health care, said Dr. Jordan.

“We are rapidly approaching the point at which optometrists must e-prescribe in order to remain a viable part of American eye care—and the health care system overall,” Dr. Jordan said.

ODs earned a total of $2,267,445.60 in bonuses, and the average Medicare e-Rx bonus paid to optometrists during 2011 was $1,166.38. Bonus payments ranged from $26,915.34 to $37.45. The median incentive payment was $881.55.

Initiated by the CMS in 2009, the Medicare e-Rx Incentive Program offers bonus payments to health care practitioners who issue pharmaceutical prescriptions electronically at least 25 times over the course of a calendar year and report their e-prescribing through certain registries or on Medicare claims using a specific billing code (G8553).

Medicare e-prescribing bonus payments are based on a percentage of the practitioner’s total Medicare allowed charges for the year. The e-Rx bonus was set at 2 percent for 2009 and 2010, dropping to 1 percent for 2011 and 2012, and 0.5 percent for 2013.

To participate in the Medicare e-Rx Incentive Program, practitioners must install an e-Rx software system certified for use in the program. The system can be freestanding or part of an electronic health records (EHR) package.

Practitioners are not required to register for the program.

The CMS in 2011 implemented a program of negative payment adjustments for certain health care practitioners who do not e-prescribe.

Optometrists are exempt from those payment adjustments.

Some 7,939 ophthalmologists earned a total of $35,315,085.82 in Medicare e-Rx bonuses during 2011. Four out of every 10 ophthalmologists who saw Medicare patients that year earned an e-Rx bonus. More than two-thirds (69.2 percent) of ophthalmologists who attempted to earn bonuses by participating in the e-Rx incentive program did so.

e-RX made easy

Virtually all e-prescribing in the United States today is accomplished through the SureScripts network, the nation’s consolidated e-prescribing system (http://surescripts.com).

The network can be accessed using any EHR certified for use in the Medicare EHR Incentive Program or many stand-alone e-prescribing software programs. Practitioners can find a list of 44 stand-alone e-prescribing software programs, certified for use with the Surescripts network, at www.surescripts.com/connect-to-surescripts.

The National e-Prescribing Patient Safety Initiative (NEPSI) – a private-sector coalition formed to reduce medical errors – makes secure, easy-to-use e-prescribing software available to all physicians and medication prescribers is free-of-charge nationwide. The organization’s Allscripts™ ePrescribe Basic software is fully certified for use in accessing the Surescripts network. Practitioners can register to obtain the free software at www.nationalerx.com.

Additional e-prescribing resources, including an interactive Electronic Prescribing Readiness Assessment and information on NEPSI software, can be found under the “e-Prescribing” tab on the AOA EHR page (www.aoa.org/EHR).

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