Background on Meaningful Use
Provider EHR Incentives
Under the provisions of the American Recovery and Reinvestment Act of 2009 (ARRA, or the “Stimulus Act”), physicians and certain other
mid-level providers are eligible for financial incentives for demonstrating “meaningful use” of an electronic health record (EHR) system.
Generally, almost all Medicare providers will be eligible for up to $44,000 in incentives paid out over 5 years beginning in 2011. Select
providers working in Federally Qualified Health Centers (FQHCs) are eligible for incentives through the Medicaid program of up to $63,750
per provider. Providers included as “eligible professional” under the final rule include physicians, certified mid-wives, advanced practice
registered nurses, and in very limited circumstances, physician assistants.
Since ARRA was signed into law in February 2009, the federal Centers for Medicare and Medicaid Services (CMS) have been involved in a
regulatory process to determine the final rules for what “meaningful use” entails. This process culminated in a final rule which was
published on July 28, 2010. By federal rules, the final definition will take effect at the end of September 2010.
At its core, meaningful use is a set of criteria, known as “objectives and measures,” on which physicians will have to report.
Physicians accessing the Medicare incentives will report to CMS, while FQHC providers will receive incentives (after being “certified”
by a state level Regional Extension Center) through the state Medicaid program.
Reporting of Objectives and Measures
The main set of items providers and hospitals will report are known as “Objectives and Measures.” The objectives are broad policy goals
that CMS hopes to achieve through meaningful use – such as encouraging electronic prescribing. The measures are the actual criteria that
providers and hospitals will have to meet to realize that objective.
The objectives and measures are broken into two parts, known as “core” objectives and “menu” objectives. The Core Objectives and
measures are a list of fifteen items on which all providers will have to report. In addition to the 15 core items, physicians will select
5 additional “menu” objectives from a list of ten options.
Reporting of Clinical Quality Measures
One of the Objectives is that providers will report on is Clinical Quality Measures. Providers must report clinical quality measures
to CMS or to the state, depending on whether they are receiving incentive payments via Medicare or the state Medicaid program.
Within the Clinical Quality Measure Objective, three of the quality measures will be “core” measures on which all providers will have
to report – Adult Weight Screening and Follow-up, Hypertension: Blood Pressure Management, and Tobacco Screening and Cessation. If a
provider feels that one of these core measures do not apply to his or her specialty, then that provider may report on one of three
“alternate core” quality measures – Influenza Screening for Patients over the Age of 50, Weight Assessment and Counseling for Children
and Adolescents, and Childhood Immunization Status.
In addition, providers will select three clinical quality measures from a list of 41 options. For example, physicians may choose to
report on the percentage of their female patients who receive breast cancer screening, or the percentage of their patients who receive
proper asthma treatments. This will give providers the flexibility to select measures that are most applicable to their practice specialty.
Important Dates
- October 1, 2010 – Reporting year begins for eligible hospitals and CAHs.
- January 1, 2011 – Reporting year begins for eligible professionals.
- January 3, 2011 – Registration for the Medicare EHR Incentive Program begins.
- January 3, 2011 – For Medicaid providers, states may launch their programs if they so choose.
- April 18, 2011 – Attestation for the Medicare EHR Incentive Program begins.
- May 2011 – EHR Incentive Payments expected to begin.
- July 3, 2011 – Last day for eligible hospitals to begin their 90-day reporting period to demonstrate meaningful use for the Medicare EHR Incentive Program.
- September 30, 2011 – Last day of the federal fiscal year. Reporting year ends for eligible hospitals and CAHs.
- October 3, 2011 – Last day for eligible professionals to begin their 90-day reporting period for calendar year 2011 for the Medicare EHR Incentive Program.
- November 30, 2011 – Last day for eligible hospitals and critical access hospitals to register and attest to receive an Incentive Payment for Federal fiscal year (FY) 2011.
- December 31, 2011 – Reporting year ends for eligible professionals.
- February 29, 2012 – Last day for eligible professionals to register and attest to receive an Incentive Payment for calendar year (CY) 2011.