In light of the recently proposed changes in the U.S. Healthcare system, “Meaningful Use Demonstration by adopting a certified EHR under the ARRA Act” is the biggest buzz among Physicians and healthcare professionals.  This article defines  “meaningful use” and outline to obtain the government’s incentive payments.

The American Recovery and Reinvestment Act (ARRA) authorizes the centers for Medicare & Medicaid services (CMS) to provide a reimbursement incentive for physician and hospital providers who are successful in becoming “MEANINGFUL USERS” of an Electronic Health Record (EHR). 

Quick definition of Meaningful Use

Choose from Incentive Programs:

Medicare FFS HER Incentive Program  (Five Year Program - $44,000 Incentive)

Medicaid EHR Incentive  (Ten Year Program - $63,750 Incentive)

* One time change between Incentive programs will be permissible but cannot participate in both simultaneously.

Medicare-FFS Incentive Program Details

Eligible Professionals has to demonstrate meaningful use in three phases: Stage1, Stage2 and Stage3.  Stage 2 and Stage 3 regulations are yet to be finalized.  For year 2010 and 2011 focus will be on stage 1 implementation.

Earliest you can start demonstration of meaningful use is 1^st October 2010.

You have to show meaningful use for 90 days in order to earn incentive for stage 1.  Preferably demonstrate stage 1 no later than 2013.

These incentive payments begin in 2011.

Starting in 2015, providers are expected to have adopted and be actively utilizing an EHR in compliance with the “meaningful use” definition or they will be subject to financial penalties under Medicare.

EHR Certification Facts & Timeline

On March 2^nd, 2010, ONC has announced two stage certification programs for qualified EHR Software.  Temporary Certification and Permanent Certification. 

Temporary Certification has 30 day comments period and Permanent Certification has 60 day comment period

Around end of spring or early summer, certifying bodies will be finalized who can certify EHRs.

Meaningful use Demonstration Requirement for Eligible Professionals

• There are 25 objectives and measures that must be met to be deemed a meaningful EHR user.

• Must implement 5 clinical decision rules based on demographic data, diagnosis, conditions, test results and/or medication list.

• CPOE – must demonstrate the use of CPOE in 80% of all orders.

•  For 2011, must report on clinical quality metrics and measures through an attestation summary.  Going forward, from 2012, they plan to formalize the process with electronic reporting.

• Physician incentives are based on calendar year.  To collect incentives in 2011, you must demonstrate 90 consecutive days of meaningful use starting as early as Jan.1, 2011.  After 2011, you must demonstrate meaningful use for an entire year rather than 90 days before receiving the 1^st payment.

• You have to be able to exchange data with care providers, public health agencies and other entities as recommended by CMS.

• Must demonstrate meaningful use of the EHR in more than 50% of patient encounters to be considered a meaningful user.

• Report on 2 sets of clinical quality metrics: one being a core set of measures that applies to all physicians and the other measure being specialty specific.

• A hospital based physician who provides services in the “hospital setting” is not eligible for incentive payments.  This is quantified by 90% or more of his services being done in the hospital.

• 2014 is the last year to begin receiving incentive payments.

• If a physician qualifies for both Medicare and Medicaid incentive programs, you must select the one you wish to participate in and can change your program selection only once during 2012-2014.  However, you can’t collect more than the maximum Medicaid incentive which is $64,000.

• You can’t collect e-Prescribing incentives while collecting Medicare incentives.

• Failure to adopt EHR’s by 2015 will result in Medicare penalties.  Fee schedules will be reduced by 1% each year, not to go below 95%.  For instance, you’ll be reimbursed at 99% in 2015, 98% in 2016, etc.

DigiDMS exceeds Meaningful use requirements.

In the coming months there will be more updates from us to you regarding any changes in the Meaningful usage timeline or stages of implementation.  There will also be informational webinars hosted by us.  Please don’t hesitate to contact your DigiDMS representative for further details. 

Thanks again for taking the time to read this bulletin and we look forward to working with you during this exciting and challenging period of change for the American Healthcare Industry.

All the best,

Vishal Gandhi (908.834.1608)

Tushar Desai (413.822.9340)

Ash Patel (908.451.9903)

Ankur Patel (908.966.7395)