What is Meaningful Use and How Does It Impact My Practice?

The Medicare and Medicaid EHR Incentive Programs are unfolding in three steps:

• Stage 1 (launched in 2011): Encourages adoption of electronic health records (EHRs), focusing on data capture and sharing. All providers begin Meaningful Use participation by meeting the Stage 1 requirements.

• Stage 2 (2014): Addresses advanced clinical processes and the ability to exchange information privately and securely. CMS recently finalized the rule that specifies the Stage 2 criteria.

• Stage 3 (date to be announced): Expected to address the ability to use that information to improve quality of care, achieve better quality outcomes, simplify administrative systems, control costs and manage public health and population.

The incentives for participating in Meaningful Use are considerable: under the Medicare EHR Incentive Program, eligible professionals (EPs) can receive up to $44,000 over five years. In the Medicaid EHR Incentive Program, EPs can receive up to $63,750 over six years.

Penalties

However, if Medicare eligible professionals do not adopt and successfully demonstrate Meaningful Use of a certified EHR technology (CEHRT) by October 1st, 2015, the EP’s Medicare physician fee schedule amount for covered professional services will be adjusted down by 1% each year.

The adjustment schedule is as follows:

• 2015: 99% of Medicare physician fee schedule covered amount

• 2016: 98 % of Medicare physician fee schedule covered amount

• 2017 and each subsequent year: 97% of Medicare physician fee schedule covered amount

These penalties will add up to significant, ongoing costs—and could put some practices at risk.

Currently, the only potential relief from these adjustments is if less than 75% of EPs have become meaningful users of EHRs by 2018. In that case, the adjustment will change by 1% point each year to a maximum of 5% (95% of the Medicare covered amount).

In addition, the Recovery Act allows for hardship exception from the payment adjustment in certain instances. The exemption must be renewed each year and will not be given for more than 5 years. CMS is developing more information on payment adjustments and the requirements to qualify for a hardship exemption. Using the right EHR can help providers make better care decisions by using comprehensive patient information, reduce and prevent medical errors, and improve patient outcomes.  If you haven’t yet adopted an EHR, or are dissatisfied with your current product, it is not too late to implement the right system and plan for success with Meaningful Use and beyond.

If you are looking to be able to attest for the meaningful use incentive it is imperative that you begin now and get a certified EHR system in your practice.