Achieving Meaningful Use
Foremost to keep in mind is that organizations seeking the EHR adoption incentives must register with the Centers for Medicare and Medicaid Services (CMS) for either the Medicare or Medicaid pathway. Below, is a summary of the requirements by CMS and resources to help in achieving meaningful use for your practice.
The final rule speaks largely to Stage 1 requirements, and now the Stage 2 NPRM has also been released. Stage 1 requires a core set of 15 measures and a menu set of 10 which allow providers to select five for Stage 1. Stage 2 proposes a start date of 2014 with 17 core items for Eligible Professionals to achieve along with a menu set of five in which they are required to only choose three. Curious what current Stage 1 required measures are? Follow this link.
Taken as a whole, and with regards to the balance between the importance of EHR adoption and the presenting of attainable Stage 1 goals, meaningful use is poised for the realities of improved patient outcomes, healthcare provider ROI and the establishment of a national health information network.
"Electronic health records are the foundation of a high-performing healthcare system. If you want to improve the quality of care, you need to be able to accurately measure it. If you want to promote better coordination between doctors, you need to be able to quickly move health information wherever it's needed. If you want to empower consumers to charge of their healthcare, they need to be able to access their health information without calling up five different doctor's offices … Our goal has never been technology for the sake of technology."
– HHS Secretary Kathleen Sebelius
How Can I Qualify for MU through the Medicare Pathway?
The Medicare EHR Incentive Program will provide payments to eligible professionals that demonstrate meaningful use of certified EHR technology. The following providers are eligible to participate in the Medicare program: doctor of medicine or osteopathy, a doctor of dental surgery or dental medicine, a doctor of podiatric medicine, a doctor of optometry, or a chiropractor.
Those EPs participating in this program can receive a maximum incentive payment of $44,000 over a five-year period. An additional incentive is available for eligible professionals who provide services in a Health Professional Shortage Area (HSPA).
During the first year of attestation, eligible professionals must successfully meet the requirements while reporting Medicare allowables of up to $24,000. The provisions allow for just a 90-day continuous reporting period, in the first year, to reach that figure and secure the maximum first-year incentive payment of $18,000. However, each year subsequent, the EP must display meaningful use of the software for the entire calendar year. Medicare eligible professionals that do not successfully demonstrate meaningful use by 2015 will have a payment adjustment in their Medicare reimbursement.
How Can I Qualify for MU through the Medicaid Pathway?
The Medicaid EHR Incentive Program will provide payments to eligible professionals that demonstrate meaningful use of certified EHR technology. The following providers are eligible to participate in the Medicaid program: physicians, nurse practitioners, certified nurse-midwives, dentists, and physician assistants who practice in a Federally Qualified Health Center or rural health clinic that is led by a physician assistant.
EPs participating can receive a maximum incentive payment of $63,750 over a six-year period, choosing a commencement date prior to the end of 2016. There is an exception to this rule and that applies to Pediatricians. If a pediatrician has a Medicaid patient volume of at least 20%, they will qualify for 2/3 of the stimulus dollars, totaling $42,500. However, if that pediatrician is able to show a 30% Medicaid patient volume, they will qualify for the full $63,750. Final payments through the Medicaid program will be distributed in 2021 (see graph below).
During the first year of participation on the Medicaid side, EPs must report a 30% Medicaid patient volume within a continuous 90-day period. Also, in the first year, a practice simply must show adoption, upgrade or implementation (AIU) of the EHR software. Each year thereafter the EP must then display meaningful use of the software. It is important to realize that AIU in the first year does not count as being a meaningful user, and therefore the EP will be required to meet Stage 1 requirements for two subsequent years. Each state is responsible for managing its Medicaid meaningful use Program. Check with your state’s health department or the CMS website for more details and links to individual programs.
Greenway Recommended Best Practices
- Research the meaningful use program in detail before commencement; it is a large program and takes time and commitment to learn the process.
- Participating in your electronic health record (EHR) supplier’s training is essential to the success of your attestation; engage the entire staff in the process and encourage them to take it seriously. All providers in your practice must be using the EHR at the point of care.
- Appoint a meaningful use leader in your facility; someone who will act as a liaison with your EHR supplier and become a subject matter expert, helping physicians, office managers and even patients understand the purpose and benefit.
- Implementing and utilizing a visual meaningful use dashboard, such as what PrimeSUITE™ offers, helps tremendously in tracking compliance with core and menu set items.
- Ensure you properly document patient information electronically; print/save copies of all important items and keep it organized.
- The use of a patient portal is exceptionally helpful and will provide quality care and timely access of medical records to your patients.
- Explore immunization registries and public health agencies in your community when submitting electronic data for menu set requirements.
- Develop an understanding of the Clinical Quality Measures (CQMs) and their role in the EHR incentive program. Eligible Professionals (EPs) will need to report on between six and nine CQMs. Keep in mind, The Centers for Medicare and Medicaid Services (CMS) has made it clear it is not measuring performance with CQMs in Stage 1 of the program.(1)
- Be an activist throughout the entire process; all stakeholders can provide feedback during public comment periods, such as EPs and office managers.
- Use your resources. CMS should be the first place to inquire regarding questions about the meaningful use program. Many popular questions have been answered in the Frequently Asked Questions sections.(2)
 | Greenway EHR Meaningful Use Best Practices (94KB |
EHR Certification
For eligible professionals to receive meaningful use incentive funds, electronic health records (EHRs) must be certified per regulations put forth by the Office of the National Coordinator for Health Information Technology (ONC).
Currently, ONC recognizes a variety of Authorized Testing and Certification Bodies (ATCBs) eligible to test for and designate that EHRs are certified for meaningful use quality reporting. These ONC-ATCBs are the only organizations which can designate that an EHR is certified for meaningful use incentive capture.
The meaningful use final rule established a temporary certification process to transition into permanent certification status in 2012. That means that current ONC-ATCB 2011-2013 certification for meaningful use coincides with the Stage 1 meaningful use reporting criteria.
After that time period, increased reporting standards will commence as Stage 2 and then Stage 3 meaningful use criteria, still backed by ongoing incentive funding. In terms of reporting criteria, the current Stage 1 requirements are divided into core and menu items. With the commencement of Stage 2, all Stage 1 menu items are projected to become core criteria, as new criteria is also added, and another round of certification keeps pace.
The final rule emphasizes that ONC plans to continue to work closely with the National Institute of Standards and Technology (NIST) to formulate the tenets of ongoing reporting criteria and certification.
Greenway's PrimeSUITE® 2011 is an ONC-ATCB Complete EHR. The 2011-2013 criteria supports the Stage 1 meaningful use measures required to qualify eligible providers and hospitals for funding under the American Recovery and Reinvestment Act (ARRA). This Complete EHR is 2011-2013 compliant and has been certified by the Certification Commission for Health Information Technology (CCHIT®), an ONC-ATCB, in accordance with the applicable certification criteria adopted by the Secretary of Health and Human Services. This certification does not represent an endorsement by the U.S. Department of Health and Human Services or guarantee the receipt of incentive payments. PrimeSUITE 2011 was certified on October 14, 2010, certification number CC-1112-699072-1 for clinical quality measures NQF 0421, 0013, 0028, 0041, 0024, 0038, 0031, 0032 and 0034.
Complete EHR meaningful use certification covers some two dozen reporting standards based on criteria developed by NIST and the National Qualify Forum (NQF).
Review complete details of PrimeSUITE's meaningful use certification on CCHIT and ONC websites: http://www.cchit.org/product/onc-atcb and http://onc-chpl.force.com/ehrcert.
PrimeSUITE 2011 is also a CCHIT Certified® 2011 Ambulatory EHR, additionally certified for Child Health, Cardiovascular Medicine and Women’s Health,with optional Advanced Reporting.
Through the ONC-ATCB meaningful use and the CCHIT Ambulatory certification designations, PrimeSUITE 2011 adheres to the full range of certification standards needed for the capturing of incentive payments and the daily EHR needs of healthcare providers.
Back to Top
