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What exactly is “Meaningful Use”?

On February 17, 2009, the American Recovery and Reinvestment Act of 2009 or ARRA was signed into law by the federal government. Included in this law is $22 Billion of which $19.2 Billion is intended to be used to increase the use of Electronic Health Records (EHR) by physicians and hospitals; this portion of the bill is called, the Health Information Technology for Economic and Clinical Health Act, or the HITECH Act.

HITECH contains the criteria for “Meaningful Use”, which providers must meet to qualify for financial incentives under the Medicare or Medicaid programs. Here’s the logic: EHRs can potentially improve patient care, but just having an EHR in your practice is not enough to improve care. Centers for Medicare and Medicaid (CMS) wants providers to use an EHR to collect and use “meaningful” information on clinical quality.

“By focusing on ‘Meaningful Use,’ we recognize that better health care does not come solely from the adoption of technology itself, but through the exchange and use of health information to best inform clinical decisions at the point of care. Meaningful use of EHRs, we anticipate, will also enable providers to reduce the amount of time spent on duplicative paperwork and gain more time to spend with their patients throughout the day. It will lead us toward improvements and sustainability of our health care system that can only be attained with the help of a reliable and secure nationwide electronic health information system.”

Dr. David Blumenthal
National Coordinator for Health Information Technology.

How do providers prove that they have achieved Meaningful Use?

In 2011, it will be sufficient to self-attest to the achievement of Meaningful Use measures/criteria. Eventually, proof of Meaningful Use will become more rigorous, and providers will have to demonstrate Meaningful Use electronically.

Medicare Incentive Payment Detail

  • Columns = First calendar year EP receives a payment
  • Rows = Amount of payment each year if continue to meet requirements

Chart 1


Will providers need to turn their practices upside down to qualify for Meaningful Use?

Like any new program, becoming familiar with the requirements and developing methods for meeting them will take time. However, many physicians already document what is required for Meaningful Use objectives.

Here are examples from Health IT Measures, which are common practice: maintaining up-to-date problem lists, active medication lists and allergy lists; keeping records that indicate preferred language, insurance, gender, race, ethnicity and date of birth; and recording and charting changes in vital signs and smoking status. However, in other situations, meeting the requirements will require more thought and collaboration with other providers within our community.


Can we implement an EHR system and satisfy Meaningful Use requirements at any time within the calendar year?

Medicare: For the first payment year, the certified EHR reporting period is a continuous 90 day period within a calendar year. In subsequent years, the EHR reporting period for eligible professionals will be the entire calendar year.

Medicaid: For the first participation year, eligible professionals only have to demonstrate that they have adopted, implemented or upgraded certified EHR technology. There is no reporting period for this requirement; it simply has to have been accomplished before they attest to that fact to the state.

Chart 3 When does the program start?

Medicare Eligible Professionals’ (EPs) participation in the Medicare EHR Incentive Program can begin as early as 2011 or as late as 2014. However, incentives end in 2016.

Medicaid EPs’ participation in the Medicaid Incentive Program are voluntarily offered by individual states and may begin as early as 2011 or as late as 2016. However, incentives end in 2021.

Are the ARRA incentives tied to the number of Medicare or Medicaid patients for whom a physician provides care?

Eligible Professionals who apply for the Medicare incentive payment must submit a minimum amount of Medicare charges to qualify for the full incentive payment.

For example, in 2011, a provider must submit at least $24,000 in Medicare charges to collect the maximum amount of $18,000.

Eligible Professionals who apply for the Medicaid incentive must meet specific volume requirements that are tied to patient visits. The Medicaid requirement is a minimum of 30% for physicians treating adults and a minimum of 20% for pediatricians.

Is a provider who cares for both Medicare and Medicaid patients eligible for financial incentives from both programs?

No, take your choice, but do not double dip. If a provider starts out by participating in one program and decides to change to the other, they can make the change one time only.


Medicare Incentive Payment Detail Chart 2
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