Knowledge Center

Stimulus Overview

What is the American Recovery and Reinvestment Act of 2009?

ARRA, the American Recovery and Reinvestment Act of 2009, also referred to as the 2009 Stimulus Plan was signed into law by President Barack Obama in February 2009. The Act was designed to positively impact the national economy directed towards investments in infrastructures, unemployment benefits, transportation systems, educational activities, and healthcare.

How do you benefit?

Healthcare professionals are directly impacted by ARRA through the Health Information Technology for Economic and Clinical Health Act, or Hi-Tech Act. The Hi-Tech Act promotes the integration of healthcare technology through incentive opportunities. One of the incentive programs has been designed to accelerate the adoption of Electronic Health Record (EHR) technology. Eligible providers may qualify to receive $63,000+ in EHR incentives alone.

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Meaningful Use

What is "Meaningful Use"?

The American Recovery and Reinvestment Act of 2009 specifies three main components of Meaningful Use:

  1. The use of a certified EHR in a meaningful manner, such as e-prescribing.
  2. The use of certified EHR technology for electronic exchange of health information to improve quality of health care.
  3. The use of certified EHR technology to submit clinical quality and other measures.

"Meaningful use" means providers need to show they're using certified EHR technology in ways that can be measured significantly in quality and in quantity. (Information provided by CMS)

To qualify as a valid and certifiable EHR vender, Arete Healthcare Services product, enCompass, passed a test series administered by Drummond Group and became ONC Certifiable for 2011-2012. Arete Healthcare Services certified enCompass 2.0 in January 2011.

As we host a certified product, upon meeting all attestation requirements and being and eligible provider, you may qualify to receive the maximum allotted incentives payments as listed below.

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Meaningful Use Medicare Incentive Payment Schedule

Payment Amount 1st Payment in 2011 1st Payment in 2012 1st Payment in 2013 1st Payment in 2014 1st Payment in 2015
2011 $18,000.00
2012 $12,000.00 $18,000.00
2013 $8,000.00 $12,000.00 $15,000.00
2014 $4,000.00 $8,000.00 $12,000.00 $12,000.00
2015 $2,000.00 $4,000.00 $8,000.00 $8,000.00
2016 $2,000.00 $4,000.00 $4,000.00
Total $44,000.00 $44,000.00 $39,000.00 $24,000.00
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Meaningful Use Medicaid Incentive Payment Schedule

Payment Amount 1st Payment in 2011 1st Payment in 2012 1st Payment in 2013 1st Payment in 2014 1st Payment in 2015 1st Payment in 2016
2011 $21,250.00
2012 $8,500.00 $21,250.00
2013 $8,500.00 $8,500.00 $21,250.00
2014 $8,500.00 $8,500.00 $8,500.00 $21,250.00
2015 $8,500.00 $8,500.00 $8,500.00 $8,500.00 $21,250.00
2016 $8,500.00 $8,500.00 $8,500.00 $8,500.00 $8,500.00 $21,250.00
2017 $8,500.00 $8,500.00 $8,500.00 $8,500.00 $8,500.00
2018 $8,500.00 $8,500.00 $8,500.00 $8,500.00
2019 $8,500.00 $8,500.00 $8,500.00
2020 $8,500.00 $8,500.00
2021 $8,500.00
Total $63,750.00 $63,750.00 $63,750.00 $63,750.00 $63,750.00 $63,750.00

For a complete Medicare and Medicaid Incentive overview visit: CMS's EHR Incentive Overview

For Medicaid State-level program release dates visit CMS's State Contacts List

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Meaningful Use 2013, 2014 and Stage 2

Beginning in 2014, the Clinical Quality Reporting for Meaningful Use has changed. Arête Healthcare Services has commenced with the design and development of our EHR's Stage 1 Meaningful Use transition to our Stage 2 Meaningful Use compliance. Current plans are to re-certify our enCompass v2.0 EHR (i.e., ONC Certified) by late 3rd quarter or early 4th quarter 2013.

Much of the transition from Stage 1 to Stage 2 Meaningful Use compliance has to do with the transition of care to/from providers outside of your practice, security controls that help keep patient data private and secure and reporting on CQM thresholds.

Per the CMS website:

In 2014, EPs must report on 9 of the 64 approved CQMs:

Beginning in 2014, all Medicare-eligible providers beyond their first year of demonstrating meaningful use must electronically report their CQM data to CMS. Medicaid EPs and hospitals that are eligible only for the Medicaid EHR Incentive Program will electronically report their CQM data to their state.

In 2013, Eligible Professionals (EPs), will continue to report from the 44 measures finalized for Stage 1 in the same schema laid out for Stage 1:

Eligible hospitals and CAHs will continue to report the 15 measures finalized for Stage 1.

Beginning in 2012 and continuing in 2013, there are two reporting methods available for reporting the Stage 1 measures:

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Updated News

Arête Healthcare Services to be the DHIN's First Hub Aggregator

May 8, 2013 - Wilmington, DE - Arête Healthcare Services, LLC has entered into an agreement with the Delaware Health Information Network (DHIN) this week. By signing this, Arête Healthcare Services, LLC becomes Delaware's first Hub Aggregator electronic health records (EHR) and outsourced medical billing services organization to interface its physician practices and patient data to the DHIN. The DHIN is a state-wide health information network that will allow providers within the network to transmit and receive patient data to one another in a standardized format.

Through this bi-directional interface between Arête Healthcare Services and the DHIN, providers can push patient data into the DHIN allowing others to pull it from anywhere within the State of Delaware where there is another DHIN interface. Arete's customers can now choose to pull results data from the DHIN through Arête's enCompass v2.0 EHR application or through their own interface. By being the DHINs first hub aggregator, Arête Healthcare Services and its providers can push results into the DHIN such as discrete patient data, CDC reports, and immunization information pertaining to patients residing within the State of Delaware. "Our customers benefit from our hub aggregation DHIN interface and can pull results or other patient data that may reside outside of our EHR platform from other DHIN connected entities such as hospitals and other providers," says Mr. David Kim, CTO/CSO of Arête Healthcare Services, LLC.

The significance of this Hub Aggregator agreement between Arête Healthcare Services, LLC and the DHIN is that this represents a bridge between the private sector and public sector within the State of Delaware. Additional discrete data types such as CCDs, medication history, and sonograms will be able to be transmitted in the future through this bi-directional interface. Once Arête's enCompass v2.0 EHR connects to the DHIN, providers of Arête will be able to push/pull discrete data elements and patient results to the DHIN where they can retrieve it at their private practice or from the Christiana Care Hospital System where many of our physicians and providers practice medicine and perform surgeries.

Arête Healthcare Services Announces Rcopia Engine Build

March 01, 2013, Wilmington, DE and Rockville, MD - Arête Healthcare Services, LLC has announced today the company's commitment to build and incorporate Dr First's Rcopia Engine into its enCompass v2.0 EHR application as its ePrescribing module. By making this commitment, Arête Healthcare Services will no longer use the Rcopia portal for ePrescribing; rather, Arête will use its previous, highly touted, ePrescribing interface for prescribing drugs electronically and will leverage Dr First's routing capabilities to transmit the ePrescriptions and Mail Order prescriptions to Pharmacies across the country.

"This is truly a win-win for our customers who depend on user-friendly access to patient medication history and efficient ePrescribing for patients," says President & CEO, Thomas Delle Donne. "Our customers will get the best of both worlds. They get an ePrescribing interface that our clients not only love and find extremely efficient, but they also get the added benefit of using Dr First's reliable network for routing ePrescriptions and updating Formulary, Benefit and Pharmacy databases."

Arête Healthcare Services first partnered with Dr First in November 2011 leveraging Dr First's Rcopia product to provide formulary, benefit and pharmacy updates as well as end to end electronic prescribing required for providers wishing to attest for CMS' Medicare/Medicaid Meaningful Use incentives.

While the portal based solution for ePrescribing was a viable solution for Arête and our customer's ePrescribing needs, our customers soon realized the workflow, layout and efficiency of Arête's previous ePrescribing solution was much more user friendly than the Rcopia portal solution. The voice of Arête's clients was loud and strong and was heard by Arête's Senior Executive Management Team.

Arête's Senior Executive Management Team made the announcement to go back to its original ePrescribing interface and use the Rcopia Engine as its transmission mechanism to transmit the prescriptions to pharmacies. The project team has reviewed the Rcopia Engine API and plans to begin development in late May. Project completion and implementation is scheduled for the September timeframe.

Arête Healthcare Services begins MU Stage 2 Development

February 14, 2013, Wilmington, DE - Arête Healthcare Services, LLC has announced the company's plans for developing the long anticipated build out of the Stage 2 Meaningful Use certification project for its enCompass v2.0 EHR application. The project is set to begin development in May, 2013 and plans to be ONC certified by late third quarter or early fourth quarter 2013. The Office of the National Coordinator for Health Technology (ONC) is the governing body that defines the EHR certification criteria that providers use to attest for Meaningful Use incentives.

Requirements analysis has already begun for the project, and development is scheduled to begin by the end of May 2013, certification by late August 2013 and implementation to all of its clients beginning in September 2013. The project is scheduled to be built, certified and implemented in parallel with the Rcopia Engine project, a project designed to electronically prescribe prescriptions connecting the original Arête Healthcare Services ePrescribing interface to Dr First's routing network using of Dr First Application Programming Interface (API).

The build out of the Stage 2 Meaningful Use criteria will require EHR applications to create, view and record such clinical items as problem lists, medication history, and allergies as well as be able to receive, transmit and display transition of care records, immunizations, electronic notes and results. The certification criteria also include much improved security requirements such as automatic logoff, access and control lists, and encryption standards. All of these security controls are designed to protect patient privacy.

Arête Healthcare Services Transition its IT Infrastructure to the Cloud

December 22, 2012 - Wilmington, DE - Arête Healthcare Services has announced it has successfully migrated its entire IT infrastructure to a private virtual cloud, hosted by XTium in King of Prussia, PA. The Arête IT department completed the infrastructure move and implementation cutover allowing its enCompass v2.0 EHR application, the PDS Cortex Practice Management software, Referral Network, and ArêteMail applications to operate in its new private virtual cloud IT infrastructure.

The infrastructure move to a private virtual cloud positions Arête Healthcare Services for growth and expansion. "We moved our IT infrastructure to a private virtual cloud with XTium to ready ourselves for scalable growth and expansion," said Mr. David Kim, Chief Technology Officer of Arete's ASP/SaaS delivery model for the enCompass v2.0 EHR. The flexibility that a private virtual cloud provides allows us to make real-time decisions regarding CPU, RAM, and SAN Storage allocations. In addition, we plan on testing our disaster recovery plan and hot-site solution that we pursued with XTium. One of the bigger advantages of moving to the cloud is the ability for Arête Healthcare Services to offer our clients various levels of disaster recovery. In the event of a disaster in the Philadelphia region, all of Arête Healthcare Services software applications will be up and running from a remote location across the country. The only portion of Arete's disaster recovery plan that is out of our control is our laboratory interfaces. We are at the mercy of Arete's lab interface partners in regards to a defined Recovery Time Objective (RTO) for a laboratory interface. Customers will for the first time be able to choose between a "Standard" or "Enhanced" disaster recovery solution for their practice.

Arête Healthcare Services Expands into Ambulance/EMS Billing

July 15, 2012 - Wilmington, DE - Arête Healthcare Services has announced the formation of a new EMS/Ambulance and Fire Billing Services Team. The Team is led by Ms. Linda Pearce-Clark, an Industry veteran with over 25+ years of experience as a Director for a regional Ambulance Billing Services Company and as a Volunteer EMS provider with Singerly Fire Company in Elkton, MD. The Team will offer ALS/BLS Billing, customizable monthly financial reporting, NIMS Compliant Education and Training, IT Support and Consulting services to assist Customers with a myriad of compliancy requirements.

"Ambulance, Fire & Rescue Billing is a logical extension of Arête's current service offerings considering the applicable skill sets, experience and success of our Sr. Executive Management and Customer Service Teams in improving collections for over 45+ medical practice groups. The opportunity to appoint Linda Pearce-Clark as Director of this newly formed business unit, combined with Arête's market census data identifying increased Customer dissatisfaction with the trend of "outsourcing" work to off-shore entities has accelerated our plans to launch this USA-based service delivery solution now," said Mr. Thomas D. Delle Donne, President & CEO of Arête Healthcare Services, LLC.

The EMS/Ambulance and Firehouse Community is led by caring, committed and experienced emergency responders that often work other jobs and as such lack the time and resources to focus on the financial, regulatory, and compliancy requirements of running a sustainable organization. Arête's comprehensive and streamlined approach ensures front and back office operational efficiency and improved return on investment commensurate with maximizing revenue collections.

M3 Healthcare Partners with DrFirst to Deliver Comprehensive E-Prescribing Functionality to its Customers

Fully Integrated E-Prescribing Solution Will Dramatically Improve Prescribing Safety and Efficiency

November 03, 2011, Newark, DE and Rockville, MD - Arete Healthcare Services announced today its new partnership with DrFirst to provide comprehensive e-prescribing functionality to practices using the company's enCompass 2.0 Electronic Health Records (EHR) system. The fully integrated e-prescribing solution will enable customers to improve prescribing safety and medical practice efficiency.

With the integration of DrFirst's Rcopia e-prescribing technology, enCompass 2.0 users will now be able to easily and securely submit electronic prescriptions to any retail or mail-order pharmacy while accessing comprehensive clinical information for each patient. Accessible patient information includes drug and allergy interactions, complete prescribing histories and formulary information. Doctors and their staff members can easily access this SureScripts-RxHub Certified functionality from within the enCompass 2.0 online EHR application and all resulting prescribing data is instantly captured within the application.

The joint e-prescribing solution will comply with the 2009 regulatory requirements issued by CMS. Additionally, customers using the solution will eliminate illegible prescriptions, issue faster prescriptions, and experience dramatic reductions in calls and faxes between the medical office and the pharmacy.

"We are pleased to work with Arete to bring industry-leading electronic prescribing technology to its physician customers," said G. Cameron Deemer, President of DrFirst. "Through this integration, Arete users will participate in the benefits of e-prescribing while being fully compliant with the growing body of state and federal regulations."

"In partnering with an established e-prescribing leader such as DrFirst, Arete continues its dedication to expand enCompass 2.0 and its functionality," said Justin Mann, president and CEO of Arete Healthcare Services. "We keep pushing the technology envelope further to stay ahead of customer demand and offer the best and most affordable EHR system possible."

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