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Meaningful Use

Use this page on the NYeC REC page to get answers to many of the most frequently asked question about Meaninful Use.  We will continue to update this page with information that is important to the healthcare providers of the state of New York.  Then, for more detail, visit the CMS Meaningful Use Website to learn more.  Launched in June 2010, this CMS website is designed to provide complete, up-to-date, detailed information about the CMS Electronic Health Record (EHR) incentive programs.

 

What is "Meaningful Use"?

How will Meaningful Use criteria be implemented?

Who is eligible for the Meaningful Use incentive payments?

Medicare Meaningful Use Incentive Payment Schedule for Eligible Professionals

Medicaid Meaningful Use Incentive Payment Schedule for Eligible Professionals

How long do I need to use an EHR to qualify for the incentive payments?

This seems complicated. Where can I get help?

 

What is "Meaningful Use"?

 

On February 17, 2009 the American Recovery and Reinvestment Act of 2009 (ARRA) was signed into law. The Health Information Technology for Economic and Clinical Health Act, (HITECH), a provision within ARRA, gave CMS the authority to offer financial incentives to eligible physicians for the adoption and "Meaningful Use" of Health and Human Services (HSS)-certified EHR technologies.

Subsequently, the Office of the National Coordinator for Health Information Technology (ONC) and the CMS released a proposal offering additional detail on the specific requirements of "Meaningful Use." ONC also released a preliminary proposal outlining an initial set of standards, implementation specifications, and criteria for the certification of EHRs.

The CMS definition of "Meaningful Use" is intended to work within the existing framework of Medicare and Medicaid law while promoting improvement in the quality, efficiency, and safety of healthcare through the use of certified information technologies. CMS’s proposed implementation of Meaningful Use introduces increasingly stringent qualification criteria in 3 distinct stages.

CMS Meaningful Use Fact Sheets
Meaningful Use, Certification Criteria and Standards, and HHS Certification Process 

Final Regulations Define Meaningful Use and EHR Standards

Electronic Health Records at a Glance

Medicaid Incentive Program

Medicare Incentive Program

CMS Frequently Asked Questions

View the CMS press release

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How will Meaningful Use criteria be implemented?

 

Stage 1 "Meaningful Use" criteria, beginning in 2011, are focused upon the electronic capture of medical information in a fully-coded format and the use of that information to track clinical conditions and for the purpose of assisting with care coordination. Stage 1 also proposes the use of clinical decision support applications to facilitate disease and medication management and requires the reporting of clinical quality metrics and public health information.

For 2011, CMS has outlined 25 specific Meaningful Use objectives and associated performance measures for eligible physicians. In 2012, CMS will also require the direct electronic submission of clinical quality measures to CMS via certified EHR technology.

Stage 2 criteria will be based upon the findings of Stage 1 and are expected to leverage the broader use of the EHR technology implemented during 2011 and 2012. Stage 2 will bring greater emphasis on disease management, clinical decision support, medication management, patient access to personal health information, care transition of care, and bi-directional communication between physicians and public health agencies.

Stage 3 will be centered on improvements in quality, safety and efficiency; will require clinical decision support for conditions of high-priority to the general public health; and provide patient access to health self-management tools.

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Who is eligible for Meaningful Use incentive payments?

 

Medicare defines an "eligible professional" as:

  • Doctor of medicine/osteopathy
  • Doctor of dental surgery/medicine
  • Doctor of podiatric medicine
  • Doctor of optometry
  • Chiropractor.

Medicaid defines an "eligible professional" as:

  • Physicians
  • Dentists
  • Certified nurse midwives
  • Nurse practitioners
  • Physician's assistants in a FQHC or RCH (that is led by a physician assistant).

The ARRA EHR incentive program will provide incentive payments to eligible professionals (EPs) that become Meaningful Users of certified EHRs.

  • Medicare: Physicians are eligible for payments equal to 75 percent of what they bill to Medicare, up to $44,000 over five years, with payments starting in 2011
  • Medicaid: Office-based physicians whose patient mix includes at least 30 percent Medicaid beneficiaries (either managed care or fee-for-service) are eligible for up to $63,750. For pediatricians, the threshold is lowered to 20%
  • Providers may receive either Medicare or Medicaid Meaningful EHR Use payments, but not both

For more detail on eligibility for Medicare incentives, click here.

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Medicare Meaningful Use Incentive Payment Schedule for Eligible Professionals

 

 

As outlined in the table above, the Medicare incentive program is designed to promote early adoption and ongoing utilization of a qualified EHR. There are also significant penalties for delaying adoption. Missing out on the ARRA incentive payments is one thing, but physicians who have not achieved Meaningful EHR use by 2015 will see their Medicare fee schedule amount reduced by 1% in 2015, by 2% in 2016, by 3% for 2017 and by between 3-5% in subsequent years if less than75% of providers have not yet adopted EHRs.

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Medicaid Meaningful Use Incentive Payment Schedule for Eligible Professionals

 

 

As with the Medicare incentives, the Medicaid incentive program is designed to promote rapid adoption of EHRs. The payments of $21,250 are designed to cover the cost of procuring or upgrading an EHR & related hardware. Subsequent $8,500 payments are contingent on achieving and maintaining meaningful use. Federal funds may not be used for Medicaid incentive payments for the purchase of EHR technology after 2016 or for the maintenance of EMRs after 2021. Unlike Medicare, the Medicaid EHR adoption program does not have payment penalties after the incentive payment period end.

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How long do I need to use an EHR to qualify for the incentive payments?

 

The Medicare and Medicaid programs differ here.  For Medicaid, an eligible professional can receive an incentive payment for Acquiring, Implementing or Upgrading a certified EHR product in their first year.  In the first year of adoption, a physician must be use a certified EHR in a manner consistent with the Meaningful Use criteria for a minimum of 90 days in order to qualify for incentives. In subsequent years, the EHR must be used in a meaningful manner for the entire year.

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What are the specific CMS criteria for "Meaningful Use?"

The Final Rule includes 25 objectives and measures for Stage 1 Meaningful Use. 20 of the objectives must be competed to satisfy Meaningful Use and quality for the incentive payments - all 15 from the Core Set and 5 our of 10 from the Menu Set.  Click Here for a full list of the Meaningful Use measures. Some of the required Cores Set components include:

  • Document patient information electronically
  • Use evidence-based order sets
  • Implement at least one 1 clinical decision rule
  • Report key quality measures to the Center for Medicaid and Medicare Services.
  • Offer patients electronic copies of their records
  • Prescribe medications electronically  

 

This seems complicated. Where can I get help?

 

As a certified Regional Extension Center, NYeC can help you with direct, on-site assistance in the selection of a "Meaningful Use" certified EHR that will best fit your existing practice workflow; assist you the efficient implementation of the EHR and help you meet all associated HIPAA-required security and patient health information privacy requirements.

 

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