Meaningful Use of EHR
From than to now..
- HITECH Act allocates $30 billion for Healthcare in February 17, 2009
- 70% of the $30 billion will be spent in 3 years (2011-2013)
- $19.2B committed to Healthcare IT for Economic and Clinical Health (HITECH) Act
HITECH Act Promotes adaption of EHR
“To reduce the duplication and waste that cost billions of healthcare dollars and medical errors that cost thousands of lives each year”
– Pres. Barack Obama
What does it mean to me?
- $44,000 as incentives for Medicare Providers
- $63,750 as incentives for Medicaid Providers (run at state level)
- You can take advantage of any one of the above, proving Meaningful Use of the EHR in your practice
Meaningful Use Rules… Released!
“This is truly a turning point in healthcare and will make for better, safer, smoother, and greater continuity of patient care; and less costly.”
- David Blumenthal, MD, National Coordinator - HIT
- CMS - Center for Medicare & Medicaid Services releases “Meaningful Use” rules on July 13 2010.
- Meaningful Use Rules will help providers to adapt EHR and prove Meaningful usage to qualify for Incentives
- 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
Stage 1 (2011 and 2012):
Establishing Functionality in Certified EHR technology (CPOE, eRx, Pat. edu. Clinical decision support etc.)
- 25 measure total
- 15 measures (core set) mandatory
- 10 measures (menu set)
- 5 of the 10 menu set are ala cart
- 5 measures not selected (differed to stage 2 in 2013)
Stage 2 (2013):
Quality Improvement & Health Information Exchange
Outcome Studies, Public Health, & Health Data Exchange
- Achieving “Meaningful Use” (MU) Standard through the use of a certified EHR within the defined time periods set forth by HHS.
- Stage 1: EP’s must prove MU for a period of 90 days (starting no earlier than January 1, 2011)
- EP’s that practice b/w multiple locations must collectively record 50% or more of medical encounter across all locations.
Medicare EP’s or Eligible Providers
- Doctor of Medicine, Osteopathy, Dental (surgery, medicine), Podiatry, Optometry, Chiropractor WHO ARE NOT HOSPITAL BASED
- EP’s who perform 90% or more of their services in a hospital or emergency room setting are considered hospital based.
|Medicare EP Qualifies to Receive First Payment in|
|Payment Amount for||2011||2012||2013||2014||2015|
|Total Payment Amount||$44,000||$44,000||$39,000||$24,000||$0|
Pay up to 75% of Medicare allowable annually for 5 years, up to the max amount defined on the payment schedule.
Example 1: 2011 Allowable $20k * 75% = $15k,
Example 2: 2011 Allowable $24k * 75% = $18k (max payable for 2011-12)
Important! For 2015 and later, Medicare eligible professionals who do not successfully demonstrate meaningful use will have a payment reduction in their Medicare reimbursement. The payment reduction starts at 1% and increases up to 5% for every year that a Medicare eligible professional does not demonstrate meaningful use. Hospital-based physicians and Medicaid eligible professionals are not subject to possible payment reductions. However, if you are also a Medicare Fee-for Service providers and cannot successfully demonstrate meaningful use, you will have a payment reduction in your Medicare reimbursement starting in 2015, even if you never received an incentive payment or only participate in the Medicaid EHR incentive program.
(Can participate once my state offers the program)
Medicaid EP’s or Eligible Providers
- Physicians (Pediatricians have special eligibility and payment rules), Nurse Practitioners (NPs), Certified Nurse-Midwives (CNMs), Dentists, Physician Assistants (PAs) who provide services in a Federally Qualified Health Center (FQHC) or rural health clinic (RHC) that is led by a physician assistant PA
- To qualify for an EHR incentive payment, a Medicaid EP must not be hospital-based and must meet one of the following criteria:
- Have a minimum 30% Medicaid patient volume*
- Have a minimum 20% Medicaid patient volume, and is a pediatrician*
- Practice predominantly in a Federally Qualified Health Center or Rural Health Center and have a minimum 30% patient volume attributable to needy individuals
A Medicaid EP is considered hospital-based if 90% or more of the EP's services are performed in a hospital inpatient or emergency room setting.
* Children's Health Insurance Program (CHIP) patients do not count towards the Medicaid patient volume criteria.
|Medicare EP Qualifies to Receive First Payment in|
|Payment Amount for||2011||2012||2013||2014||2015||2016|
|Total Payment Amount||$63,750||$63,750||$63,750||$63,750||$63,750||$63,750|
To qualify for Medicaid incentive payments, Medicaid eligible professionals must adopt, implement, upgrade or demonstrate meaningful use of certified EHR technology in the first year of participation. Medicaid EPs must demonstrate meaningful use in years 2-6 of participation. For calendar years 2011-2021, participants can receive up to $63,750 over 6 years under the Medicaid EHR incentive program. Incentive payments are made by the State based on the calendar year.
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