The Medicare and Medicaid EHR Incentive Programs provide financial incentives for the “meaningful use” of certified electronic health record technology (CEHRT). To receive an EHR incentive payment, providers have to show that they are “meaningfully using” CEHRT by meeting certain measurement thresholds that range from recording patient information as structured data to exchanging summary care records. The Centers for Medicare and Medicaid Services (CMS) has established these thresholds for eligible professionals, eligible hospitals, and critical access hospitals (CAHs). As they adopt, implement, upgrade, or demonstrate meaningful use of certified EHR (sometimes also called EMR – electronic medical record) technology, eligible participants can apply for incentive payments.
Meaningful use is utilizing CEHRT technology to:
Ultimately, it is hoped that the meaningful use compliance and EMR integration will result in:
Eligible professionals participate in the program on the calendar year, while eligible hospitals and CAHs participate according to the federal fiscal year. Providers must attest to demonstrating meaningful use every year to receive an incentive and avoid a Medicare payment adjustment.
In August 2014, CMS released a final rule that grants flexibility to providers who are unable to fully implement 2014 CEHRT for an EHR reporting period in 2014 due to delays in 2014 CEHRT availability.
Providers scheduled to demonstrate Stage 1 in 2014, who have successfully implemented 2014 CEHRT, would use 2014 Stage 1 core and menu objectives.
Eligible professionals must meet the following 2014 Stage 1 criteria: 13 required core objectives and five menu objectives from a list of nine, for a total of 18 objectives.
Eligible hospitals and CAHs must meet 11 required core objectives and five menu objectives from a list of 10, for a total of 16 objectives.
The CMS Stage 2 Final Rule from 2012 specifies the criteria that eligible professionals, eligible hospitals, and CAHs must meet in order to participate in Stage 2 of the Medicare and Medicaid EHR Incentive Programs. All providers must demonstrate Stage 1 of meaningful use before Stage 2.
To help providers better understand Stage 2 meaningful use requirements, CMS developed specification sheets for eligible professionals and eligible hospitals that provide detailed information on each objective, including:
• numerator and denominator thresholds
• exclusion criteria
• definitions of important terms
• requirements for achieving the objectives
• certification information that corresponds with each objective.
The earliest providers can demonstrate Stage 2 of meaningful use is 2014. Eligible hospitals and CAHs participate on the fiscal year and eligible professionals participate on the calendar year.
Providers who began participation in the EHR Incentive Programs in 2011 will meet three consecutive years of meaningful use under the Stage 1 criteria before advancing to the Stage 2 criteria in 2014. All other providers would meet two years of meaningful use under the Stage 1 criteria before advancing to the Stage 2 criteria in their third year.
The CMS final rule released in August 2014 also grants flexibility to providers scheduled to demonstrate Stage 2 of meaningful use for an EHR reporting period in 2014.
These providers that have not fully implemented 2014 Edition CEHRT can:
All providers, regardless of their stage, are only required to demonstrate meaningful use for a 3-month EHR reporting period. For Medicare providers, this 3-month reporting period is fixed to the quarter of either the fiscal (for eligible hospitals and CAHs) or calendar (for eligible professionals) year. The 3-month reporting period is not fixed for Medicaid eligible professionals and hospitals that are only eligible to receive Medicaid EHR incentives.
To demonstrate meaningful use under Stage 2 criteria, eligible professionals must meet 17 core objectives and three menu objectives from a list of six for a total of 20 objectives. Eligible hospitals and CAHs must meet 16 core objectives and three menu objectives from a list of six, for a total of 19 objectives.
How far along is your hospital in establishing Stage 1 or Stage 2 Meaningful Use EHR integration?