The nation's healthcare system is undergoing a transformation in an effort to improve quality, safety and efficiency of care from the upgrade to ICD-10 to information exchanges of EHR technology. The Medicare and Medicaid EHR incentive programs are designed to support providers in this period of transition, but the impact of this historic change on both providers and patients will stretch far beyond the duration of these programs.
The Medicare and Medicaid EHR incentive programs provide a financial reward for the meaningful use of qualified, certified EHRs to achieve health and efficiency goals. By implementing and meaningfully using an EHR system, providers will reap benefits beyond financial incentives - like reduction in errors, availability of records and data, reminders and alerts, clinical decision support and e-Prescribing/refill automation.
To qualify for incentive payments, meaningful use requirements must be met in the following ways:
• Medicare EHR incentive program - Eligible professionals and hospitals must successfully demonstrate meaningful use of certified electronic health record technology every year they participate in the program.
• Medicaid EHR incentive program - Eligible professionals and hospitals may qualify for incentive payments for the adoption, implementation, upgrade or the demonstration of meaningful use in their first year of participation. They must successfully demonstrate meaningful use for the remaining years they participate in the program.
The Definition of Meaningful Use Requirements
The requirements of meaningful use to qualify for incentive payments was released on July 13, 2010. The final rule definitively outlines all the specifics of Stage 1 meaningful use and clinical quality measure reporting to receive the incentive payments in 2011 and 2012.
The Recovery Act specifies three main components of Meaningful Use:
• The use of a certified EHR in a meaningful manner (e.g.: e-Prescribing).
• The use of certified EHR technology for electronic exchange of health information to improve quality of health care.
• The use of certified EHR technology to submit clinical quality and other measures.
The definition of meaningful use harmonizes criteria across CMS programs as much as possible and coordinate with existing CMS quality initiatives. It also closely links to the certification standards criteria in development by the Office of the National Coordinator (ONC) and provides a platform for a staged implementation over time.
Specifics of Stage 1 Meaningful Use (2011 and 2012)
Meaningful use includes both a core set and a menu set of objectives that are specific for eligible professionals and hospitals. For Eligible Professionals, there are a total of 25 meaningful use objectives. 20 of the objectives must be completed to qualify for an incentive payment. 15 are core objectives that are required, and the remaining 5 objectives may be chosen from the list of 10 menu set objectives. For Hospitals, there are a total of 24 meaningful use objectives. 14 are core objectives that are required, and the remaining 5 objectives may be chosen from the list of 10 menu set objectives.
The definition of meaningful use includes reporting of clinical quality measures. See the link titled "Meaningful Use Clinical Quality Measures" in the Links Inside CMS section below to learn more about these specifications for eligible professionals and hospitals. More information on the final rule and fact sheets regarding meaningful use are available below.
To realize improved health care quality, efficiency and patient safety, the criteria for meaningful use will be staged in three steps over the course of the next five years. Stage 1 sets the baseline for electronic data capture and information sharing. Stage 2 (est. 2013) and Stage 3 (est. 2015) will continue to expand on this baseline and be developed through future rule making.
