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How does Meaningful Use fit into the EHR Incentive Program?

February 20, 2014

EHR Incentive ProgramThe renovation of the U.S. health care system is the federal government’s attempt to curtail the rising cost of medical services by implementing digital sharing. When evaluating current Medicaid and Medicare practices, researchers felt there was too little incentive to grow into the technological era of electronic health records. Meaningful use is a large part of moving that process forward and improving coordination of care standards through digital recording.

Electronic medical records are not new. In fact, this technology has existed for decades, but the hardware was expensive and the processing complex. A 2008 survey of physicians conducted by DesRoches showed that 83 percent did not use electronic records even with the improved products. Many had the hardware available, but not the time or incentive to use it.

In 2009, President Obama signed an act that would change things. The Health Information Technology for Economic and Clinical Health Act, HITECH Act, implicated meaningful use standards to push the health care industry into a new era – one the focuses on a health information exchange. The goal is to:

  • Improve quality of care
  • Enhance care coordination
  • Engage patients in their own health care
  • Advance public health

Designers of this bill wanted EHR to be more than just something practices were always on the verge of using, so they developed a system of metrics to show meaningful use of the technology. This stair step approach leads to incentive payments for Medicaid and Medicare providers.

Money Talks

The Medicare and Medicaid Electronic Incentive Programs provide payments to eligible professionals and facilities based on their adoption and implementation of EHR technology. The Medicare EHR program pays up to 44,000 dollars in incentives and Medicaid up to 63,750, according to the Centers for Medicare and Medicaid Services. At the heart of this payment system is a series of meaningful use benchmarks that prove providers are utilizing the platform properly.

Meaningful use comes in three stages. At the completion of each stage, the professional receives an incentive payment if they meet the standards. To qualify for the Stage 1 incentive payment, eligible practitioners need to meet 14 core requirements and at least five of the 10 menu-set offerings, explains CMS. Menu-set options include items like:

  • Incorporating lab-test results into EHR
  • Sending reminders to patients regarding preventive or follow-up care
  • Submitting data to immunization registries

Medical facilities must meet 13 core requirements and five objectives.

Stage 2

Stage 2 begins in 2014. Once a practice completes all the necessary requirements for Stage 1, they are eligible to advance to Stage 2 for a second incentive payment. Stage 2 shifts the focus to information exchange and patient involvement. Of the 20 core requirements, practices must show adherence to at least 17 plus three menu objectives. Medical facilities need to meet 16 core requirements and three menu-set objectives.

Stage 3 will not begin before 2016. With Stage 3, practitioners and facilities will see a new set of challenges they must meet in order to get payment. Beyond Stage 3, the incentive system will turn into one of penalties for providers that are not adhering to the EHR system.

Meaningful use is the metric system that qualifies practices and facilities for incentive payments. It is the propelling force in the switch to a digital network that allows cooperation between all the various health care silos. The primary care physician will know what tests the specialist runs, for example. The radiologist will know what medications a patient is allergic to all by utilizing this system. Meaningful use and incentive payments are just the means to that coordinated end.


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