- Provider for Medicare or Medicaid;
- Be a meaningful EHR user
- Physicians must qualify
- Proves to have implemented a qualified EHR software and be interoperable
Physicians with a qualified EHR, qualified EMR in place before 2011 or 2012 will be eligible for the maximum Medicare incentive payments allowed by the stimulus package. Doctors who have not adopted an EHR before 2015 and who fail to obtain a hardship exemption will see a 1% cut to Medicare pay, a reduction that phases up to 3% for 2017 and remains each year after that.
In 2011, however, the reward for e-prescribing will begin to decrease, a fee for not using e-prescribing will begin in 2012. The e-prescribing incentive payment will be 1 percent in 2011 and 2012, and 0.5 percent in 2013. The fee for not using e-prescribing will be a reduction in Medicare reimbursement by 1 percent in 2012, 1.5 percent in 2013, and 2 percent in 2014.
Depreciation and Expenses 2010
Section 179 limits. The maximum expense deduction you can elect for qualified property you placed in service in tax years that begin in 2009 remains at $250,000 ($285,000 for qualified enterprise zone property and qualified renewal community property). This limit is reduced by the amount by which the cost of property placed in service in the tax year exceeds $800,000
Under the 2008 Economic Stimulus Act (ESA), you can take further advantage of the Section 179 expense allowance to write off the entire cost of your new and used Healthcare equipment purchases in 2010.
Specifically, the expense allowance has been temporarily increased from $128,000 to $250,000 for taxpayers with total capital investments of $800,000 or less. Equipment acquired with a capital lease ($1 purchase option) and placed into service by December 31, 2008 is eligible for the increased allowance.
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| EMR Options |
DO I NEED A SERVER FOR MY EMR / EHR?
Most EMR companies will "force" you to buy a server due to the reliability and security of having a Server. But, technically, it is possible to waive that investment for a period of time. Some EMR / EHR companies will bundle the server as part of their solution. If you are a technical person, you already know that you can save that money for now. But let us look at the facts, not every practice has the same access to investment funds. The options presented below are based on what we think is possible, but the options may not apply to your circumstances depending on the hardware requirements of the EMR Software / EHR Software you select. If you have the freedom to select your own hardware, use these guidelines to save money, but never use them to replace the benefits of having a server.
Where the hardware requirements come from?
- The database used (how much resources it uses)
- Number of users connecting to the database (server)
- Amount of data expected to be stored (Hard Disk requirements)
- How much resources the application need (mostly memory and processor)
- Recommendation for the client computer (the computers connecting to the server)
Warning signs
- If the EMR / EHR you have selected uses a very powerful server just for very few users, it may be a sign that the application has a bad design and the application uses a lot of resources to compensate the bad design.
- If the application runs well in a standard computer or server, it may be a sign that the application has a good design and the performance will be good.
- Another reason the EMR / EHR companies propose a very powerful server is because they use a standard configuration, for which you will pay, when you actually may not need it. - Another consideration is how long you expect to use that server.
Follow these recommendations, but don't commit yourself to this. Follow the recommendations of your trusted IT person. IT people will usually stick to the EMR/ EHR company’s recommended hardware, and will not take risks associated with his / her judgement regarding hardware.
If you are opening a new practice with an EMR / EHR Software:
(Maximum 4-5 client computers, This technology is called peer-to-peer network)
The short answer is no, you do not need a server. You are looking for the basics with room to expand in the short or long term. You need to have access to the EMR / EHR from all of your computers. In this environment, one computer will act as a server (master computer), and the rest will be connecting to the master computer. Some strong databases in the market such as Sybase are very user friendly with the database and in the peer-to-peer environment. This friendly access is behind the scenes and you will not notice it. What you will see is the application itself, and how friendly the application is. The design of the application is what makes the big impact in performance and reliability not the brand of database used.
If you are a solo practitioner with or without a partner, or a visionary solo practitioner
(Maximum 8 computers, still under the peer-to-peer environment)
The short answer is maybe. If you are a visionary physician and have ideas for your new practice, i.e EMR / EHR, marketing your practice with a Web site, and also want to connect to your medical office from home, then we recommend you consider a small server.
If your computer network is growing to more than 8 computers, then you should start considering a small server with enough memory. You can grow to a maximum of 8 computers without a server, but if you reach the limit, expect performance problems. If you envision 8 computers and printers in your medical office, then do not wait more time to buy a small server with enough memory.
Practice with 10 computers and printers
Get a server immediately, you data is at high risk. If you want to have your practice management software and electronic medical records in the same place, this configuration will work very well for you. Your electronic medical records can be accessed from a stationary computer in the room, or using a portable computer. Your medical records can also be accessed anywhere from home, hospital, from abroad, and other places.
Practice with more than 10 computers and printers
If you have a practice that has grown to more than 10 computers, you probably already have the server you need, but it may not be suitable for the EMR / EHR you have selected.
If you have two or more practices
You need a centralized server for your Practice Management Software and Electronic Medical records with a DSL or T1 connection. Terminal services software would probably be better for you.
