Is your entity thinking about engaging in a Stark/AKS Compliant EHR Donation Arrangement? If so, check out this list of top 5 issues to consider as you are assessing your options and your health IT alignment strategy.
1. An EHR donation arrangement is an effective way for hospitals to align with their physicians.
In the world of health information exchange, having the technological ability to seamlessly communicate with a hospital or referring physician is crucial to effective patient care. It enables physicians and hospitals alike to efficiently obtain patient information and to exchange this information as needed to ensure quality patient care.
2. There are specific rules – and significant consequences for breaking those rules.
Be careful not to run afoul of the Stark or Anti-Kickback rules. Ensure that your contracts are compliant with both Stark and Anti-Kickback and that the arrangement is not designed at rewarding referring physicians.
3. What is the hospital taking on when it becomes an EHR vendor?
What are the consequences for a physician practice if the local hospital is also its EHR vendor? In many arrangements the hospital is the contracting party with the EHR software vendor (i.e. Epic, Cerner, etc.) and owns the relationship. Physician groups will look to the hospital to obtain necessary service, updates, modules and when the system malfunctions. The hospital should evaluate if it is able to take on this role.
4. Physicians need to know what to expect as recipients of an EHR donation.
Often times the physician group is giving up its autonomy in choosing the EHR vendor, configuration or customization and must often defer to the hospital to make appropriate purchase, upgrade and service decisions. In addition, even though the hospital may be picking up the majority of the costs (no more than 85%) the investment may still be expensive (and will likely exceed the meaningful use incentive dollars). Items such as hardware, storage, and operating system software are excluded from the donation.
5. Before you align, be clear about who will get the “record collection” if things don’t turn out.
Before entering into a donation arrangement the parties should have a clear understanding of what happens if the relationship goes awry. How will the records be divided, extracted, or migrated into a new system? Will the physician group be able to maintain a relationship with the software vendor independently? What are the ramifications of changing vendors and separating from the hospital EHR?
Special thanks to ECG’s Michelle Holmes and OMW attorney David Schoolcraft for composing this list based on their HIMSS14 presentation “Using Stark/Anti-Kickback to Support Hospital/Physician IT Alignment Strategies.
For more information on designing Stark/Anti-Kickback compliant donation arrangements please see the previous posts describing the exception requirements and the 2013 updates. For assistance in creating a donation arrangement please contact Elana Zana, Michelle Holmes or David Schoolcraft.