Meaningful Use Overview for Eligible Professionals

 

The Medicare and Medicaid EHR Incentive Programs provide financial incentives for the “meaningful use” of certified EHR technology to improve patient care. To receive an EHR incentive payment, providers have to show that they are “meaningfully using” their EHRs by meeting thresholds for a number of objectives. CMS has established the objectives for “meaningful use” that eligible professionals must meet in order to receive an incentive payment.  

The Medicare and Medicaid EHR Incentive Programs are staged in three steps with increasing requirements for participation. All providers begin participating by meeting the Stage 1 requirements for a 90-day period in their first year of meaningful use and a full year in their second year of meaningful use. After meeting the Stage 1 requirements, providers will then have to meet Stage 2 requirements for two full years. Eligible professionals participate in the program on the calendar years.

What are the requirements for Stage 1 of Meaningful Use?

Meaningful use includes both a core set and a menu set of objectives that are specific to eligible professionals.For eligible professionals, there are a total of 24 meaningful use objectives.  To qualify for an incentive payment, 19 of these 24 objectives must be met:

  • 15 required core objectives
  • 5 objectives chosen from a list of 10 menu set objectives.

CMS provides Meaningful Use Specification Sheets that bring together critical information on each objective to help you understand what you need to do to meet the program requirements. Each specification sheet covers a single eligible professional core or menu set objective in detail, including information on:

  • Meeting the measure for each objective
  • How to calculate the numerator and denominator for each objective
  • How to qualify for an exclusion to an objective
  • In-depth definitions of terms that clarify objective requirements
  • Requirements for attesting to each measure

 

How Much Will You Get Paid (Medicare)

The amount of your incentive payment depends on when you begin participating in the program. The incentive payment is 75% of your Medicare allowed charges up to a maximum annual cap. The table below shows the maximum incentive amounts broken  own by the year you start participating in the program.

 

 

How Much Will You Get Paid (Medicaid)


Your incentive payment is a fixed amount each year and will remain constant as long as you meet all eligibility requirements for program participation. These requirements include adopting, implementing, upgrading to, or demonstrating meaningful use of certiied EHR technology in your first year of program participation, and achieving the meaningful use requirements for the remaining years you partcipate. There is no payment threshold for participants in the Medicaid EHR Incentive Program. The table shows the incentive amounts broken down by the year you start participating in the program.

 Medicaid Incentives

 

Are There Penalties?

Medicare eligible professionals who do not meet the requirements for meaningful use by 2015 and in each subsequent year are subject to payment adjustments to their Medicare reimbursements that start at 1% per year, up to a maximum 5% annual adjustment.

What are the requirements for Stage 2 of Meaningful Use?

For detailed information about the Stage 2 requirements of meaningful use for eligible professionals, visit CMS.GOV website. Please note, however, that you would not meet these Stage 2 requirements until you have met the Stage 1 requirements of the EHR Incentive Programs for a 90-day period in your first year of participation and a full year in your second year of participation.

 

Reporting on Clinical Quality Measures?

 In addition to meeting the core and menu objectives, eligible professionals are also required to report clinical quality measures.

  • Eligible professionals must report on 6 total clinical quality measures: 3 required core measures (or 3 alternate core measures) and 3 additional measures (selected from a set of 38 clinical quality measures).
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