Stimulus Modeling and Accountability

As well all prepare for the work ahead, many in healthcare are beginning to model the potential payments and design the reporting systems needed to account for the money spent.

I've promised to share all the BIDMC work we're doing as it happens, so here's a near real time update.

Our CFO, Steve Fischer used the guidance from the American Hospital Association to compute BIDMC's share.

You'll see that we are expecting $6.3 million because we anticipate "meaningful use of EHRs" by all our clinicians in 2011.

The computation for hospitals is calculated as Medicare’s share of the sum of $2 million plus an additional discharge-related amount. A hospital receives $200 for each discharge for discharges starting with its 1,150th and continuing through its 23,000th discharge. There is no additional payment for discharges outside of this range – which means that the largest discharge-related amount available to any hospital equals $4,370,200. The largest total amount available would be $6,370,200 ($2 million plus $4,370,200). This figure is multiplied the medicare share of inpatient days, then summed over 4 years with a decreasing payment each year - 100%, 75%, 50%, 25%

In addition to direct Medicare funding, we're anticipating grants for research, education, and health information exchange. I'm often asked how we'll report our use of such funds. Pete Orszag, the Director of OMB, has offered detailed guidance based on 5 guiding principles:

• Funds are awarded and distributed in a prompt, fair, and reasonable manner;
• The recipients and uses of all funds are transparent to the public, and the public benefits of these funds are reported clearly, accurately, and in a timely manner;
• Funds are used for authorized purposes and instances of fraud, waste, error, and abuse are mitigated;
• Projects funded under this Act avoid unnecessary delays and cost overruns; and
• Program goals are achieved, including specific program outcomes and improved results on broader economic indicators.

I hope this background is helpful to you as you prepare for the Stimulus work ahead