Why should you sign up with your local REC, and who is not eligible for subsidized REC services? In my last post on this topic, we reviewed the basics about RECs (Regional Extension Centers), their role in reaching the goals of the HITECH Act, and the services they are to provide.
The goal of the REC program is ambitious: provide outreach and support services to at least 100,000 priority primary care providers (PPCPs) within two years. Support services are at no cost to the PPCPs, if they signed up with their REC or LEC. So the first task is outreach to these PPCPs, and convincing them to sign up for services.
The RECs must provide at least 10% of their own funding in the first 2 years, and 90% of their total budget after that. To generate these funds, some, if not most, RECs will be charging some kind of application or participation fee to providers, and some are inviting organizations (insurance companies, large provider networks, and professional associations) to join and pay membership 
fees based on sales or revenue. Individual providers may be charged an annual fee of $250 or more, and will probably be asked for a minimum of a two-year commitment. Some RECs will waive the fee for at least the first year for providers who sign up in 2010.
Funding to RECs is designed to be performance-based, that is, RECs will receive funding as providers achieve milestones on the way to achieving meaningful use of certified EHR technology.
RECs will receive approximately $5,000 per PPCP, distributed in three installments based on milestones of:
- Signing participation contracts with providers,
- Providers going live with certified EHR technology, and
- Providers achieving meaningful use of certified EHR technology.
It’s important to note that these payments go to the REC for the support services it provides to PPCPs, not to providers. Providers participating in Medicare or Medicaid can qualify for HITECH incentive payments from CMS or their respective state Medicaid program for achieving meaningful use.
So if you are a PPCP, why sign up? Well, the list of support services is long, and many small practices will be hard-pressed to go through the due diligence and implementation processes without some kind of help.
But the services from a REC are not comprehensive. For instance, the focus is on implementing and achieving meaningful use of EHR technology, meaning software. REC services do not include (1) infrastructure development (the hardware, networking and telecommunications services providers will need to install and utilize the software) or (2) interface development (coordinating interfaces to lab or imaging centers, or to hospitals). (3) REC services may also not address situations where the practice is also replacing its existing practice management system as well as adding an EHR system.
The amount of resources a REC can devote to individual or small practices may also be limited since a few thousand dollars in consulting assistance for EHR selection and implementation usually doesn’t go very far. For practices with 7-10 PPCPs all in one location and using similar workflows, the assistance from the REC will go farther. The challenge will be in small practices or practices with other special circumstances that make a standardized approach to assessment and assistance a problem.
And what about practices that do not include PPCPs, like specialists? Some RECs may offer their services to these providers, but will charge full fees for the assistance. And these providers may not have access to favorable purchase agreements to be negotiated with EHR vendors, by the RECs, or the systems the RECs negotiate with may be less useful to specialty practices.
Ask your Electronic Health Records consultant about the benefits of signing up with your local REC. Learn more about a how to identify the best overall EHR for your practice by signing up for a free EHR due diligence reference guide from The Fox Group. This complete booklet is a logical and sequential description of the process: The Art and Science of Evaluating, Selecting and Implementing an Electronic Health Records System.