Meaningful Use became one of the most frequently used terms in the healthcare industry in 2009.
On July 13, 2010, the Centers for Medicare and Medicaid (CMS) announced the final ruling for the EHR Incentive Program based upon Stage 1 of Meaningful Use. This phase of adoption is focused on healthcare professionals using certified EHR technology to improve health outcomes in the following areas:
- Improve the quality of care, efficiencies and safety in treating patients
- Reduce health disparities
- Engage patients and families
- Improve care coordination
- Improve population and public health
- Guarantee adequate privacy and security protection of PHI
Understanding the Rulings that Impact Meaningful Use
1. Centers for Medicare and Medicaid - EHR Incentive Program
This ruling sets the guidelines for the incentive programs made available through the American Recovery and Reinvestment Act of 2009 (ARRA). It defines who is eligible for incentive dollars through three programs:
- Medicare Fee-for-Service (FFS) Program
- Medicare Advantage Program
- Medicaid Program
Within each of these programs there are guidelines set as to how providers are to use electronic health record technology in order to qualify to receive the incentive dollars supporting their adoption of an EHR. This phase of meaningful use adoption is referred to as Stage 1. Providers will be required to report to CMS data that demonstrates their usage of an EHR system.
2. Office of the National Coordinator - Health Information Technology: Initial Set of Standards, Implementation Specifications, and Certification Criteria for Electronic Health Record Technology
To support the success of meaningful use, and the effective adoption of EHR technology, the ONC was tasked to establish requirements for Electronic Health Record vendors. This ruling was released in coordination with the CMS EHR Incentive Program to ensure that vendors comply with minimum product capabilities and standards to support Stage 1 objectives and measures. EHR vendors are expected to enhance their products, and make the required functionality available to providers.
3. Office of the National Coordinator - Temporary Certification Program for Health Information Technology
With standards in place for meaningful use, it is also necessary to qualify the EHR technologies that meet the criteria established. This builds further confidence for providers and patients that the technology being used to support their records is compliant.
The ruling established is the first phase of the certification program designed to accelerate the formation of ONC - Authorized Testing and Certification Bodies (ONC-ATCBs). The ONC-ATCBs will be responsible for testing and certifying EHR vendors.
In order for healthcare providers to achieve meaningful use they must be using a product and version that is certified according to the meaningful use criteria. It is anticipated that ONC-ATCB's will be identified by late summer, and that EHR vendors will begin certification in the fall of 2010.
Stage 1 Requirements for Eligible Providers
Stage 1 of Meaningful Use sets the foundation for healthcare providers using EHR technology, and serves as a launch point for building a healthcare network across the United States. There will be future rulings to define the requirements for Stage 2 (est. 2013) and Stage 3 (est. 2015).
For Stage 1, eligible professionals are required to meet 15 core objectives, and 5 out of 10 menu set objectives. With each objective, there is a threshold or measure that defines the minimum usage for each objective. With each stage of meaningful use, these thresholds will increase in addition to new objectives. Beginning with Stage 2 of meaningful use, the menu set objectives will all become core objectives, thus it is important to plan full adoption of these objectives as time progresses.
* In addition to the above, to qualify for the Medicaid program, the EP must meet at least one of the following:
- 30% or more Medicaid patient volume (excluding CHIP patients)
- A pediatrician with 20% or more Medicaid patient volume (excluding CHIP patients)
- An EP that practices predominately in a FQHC or RHC with a minimum of 30% of patients being needy individuals
Important Facts and Timelines |
Medicare Fee-For-Service
Incentives up to $44,000* |
Medicaid
Incentives up to $63,750 |
| Registration launches in January, 2011 |
States have the option to launch in January, 2011 |
| Must demonstrate meaningful use in the first year. The Medicare and Medicaid EHR Incentive programs are slated to begin in early 2011. Registration is not available at this time. More information will be available in the coming months. |
Can qualify for payment for the first year if adopt, implement, upgrade, or demonstrate meaningful use in the first year. Subsequent years require demonstration of meaningful use. |
| Must demonstrate meaningful use for 90 days in the first year; subsequent years require 365 days |
By the second year, must demonstrate meaningful us for 90 days; subsequent years require 365 days |
| Must begin participation by 2012 to be eligible to receive the maximum incentive dollars |
Must begin participation by 2016 to be eligible to receive the maximum incentive dollars |
| April 2011 – attestation begins |
The last year to begin participation is 2016 |
| May 2011 – incentive payments begin |
2021 is the last year that Medicaid will distribute an incentive payment |
| February 28, 2012 – last day an EP may register and attest to receive an incentive payment for CY 2011 |
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| 2016 is the last year incentive payments can be received |
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* Health Provider Shortage Areas qualify for an additional $4,400.
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