What is Meaningful Use?
Meaningful Use became one of
the most frequently used terms
in the healthcare industry
in 2009. Through a series of
lawmaking, the definition of
meaningful use is being defined
and implemented
of years from 2011 through 2015.
The intention of meaningful
use through the use of certified
EHR technology is to improve
the quality of care, efficiencies
and safety in treating patients. Meaningful use is just one of the necessary
steps in improving our healthcare infrastructure.
eClinicalWorks guarantees to not only provide
products that meet the EHR certifications,
but to also work alongside
practices to ensure that they receive
the proper education and guidance
to become meaningful users.
This site provides
general information and resources about meaningful
use, including:
- Information on the many
terms buzzing around the healthcare industry
- Overview of the rule-making process taking place for meaningful use
- Review of the Stage 1 criteria
along with the functionality
in eClinicalWorks that corresponds
to the objectives
- Opportunity to register
for a Meaningful Use Webcast conducted by eClinicalWorks
- Download center including
some of the most important
websites and documents providing
detailed information on meaningful
use
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(1)Notice of Proposed Rule Making (NPRM) & Interim Final Rules (IFR)
An NPRM is a proposed rule that must be put forth before a final rule can be published. It represents the plan or intention for the rule and solicits public comment. After the public comments are reviewed, and any modifications to the proposed rule are made, a final rule is then published. The final rule is then entered in the Code of Federal Regulations.
An interim final rule adds, changes or deletes regulatory text and contains a request for comments. The subsequent final rule may make changes to the text of the interim final rule.
There are currently two major documents defining meaningful use published in the Federal Register that impact eClinicalWorks and many of our customers:
- The definition of meaningful use of an EHR by eligible professionals and hospitals issued by CMS as a NPRM. Click here to view this document.
- The functional requirements for EHR systems to provide to eligible professionals and hospitals issued by Office of the National Coordinator for Health Information Technology (ONC) as an IFR. Click here to view this document.
(2)Anticipated Certification NPRM **Released March 2nd, 2010**:
The Certification NPRM proposes the process for certification bodies to conduct testing and certification of health information technology. The NPRM will be open for public comment period once it is published in the Federal Register.
Click here to view more information.
(3)Public Comment Period
- The public comment period opened on January 13, 2010 and closes on March 15, 2010. Comments can be provided electronically at www.regulations.gov, or in written form as directed in the NPRM or IFR. It is recommended that impacted entities and individuals provide comment for consideration in the rule making.
- Comments can be viewed from www.regulations.gov. Searching by the IFR Docket IDs (CMS-2009-0117 and HHS-OS-2010-0001) allows for easier identification of the comments.
(4)Final Rule Issued
- The final rules will be issued at some point in 2010.
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Proposed Medicare Eligibility Criteria and Incentives Program
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Specific incentive payment details can be found in the NPRM or in the CMS fact sheet for the incentive program.
Medicare Eligible Professionals (EPs)An eligible professional (EP) for Medicare is defined in the NPRM as:
- Doctor of medicine or osteopathy
- Doctor of dental surgery or dental medicine
- Doctor of podiatric medicine
- Doctor of optometry
- Chiropractors that are legally authorized to practice under state law
A hospital-based EP who furnishes 90% or more of their services in the hospital setting is not qualified as an EP to receive meaningful use incentives.
According to the NPRM, a qualified EP that demonstrates meaningful use of a certified EHR can receive incentive payments starting as early as 2011. Incentive payments are available for meaningful users for up to five years (ending in 2016). The maximum total incentive payment is $44,000.00 for the Medicare program.
Beginning in 2015, EPs that are not meaningful users will incur negative payment adjustments for their covered services.
Medicare Eligible Hospitals
An eligible hospital for Medicare is defined in the NPRM as:
- Subsection (d) hospital
- Paid according to the hospital inpatient prospective payment system
- Located in one of the 50 states or the District of Columbia
Medicare Advantage organizations demonstrating meaningful use are eligible for incentive payments by their affiliated eligible hospitals.
Incentive payments are available to qualified eligible hospitals demonstrating meaningful use for up to four years starting in the 2011 fiscal year. Payment is made according to the Federal Fiscal Year.
Payment reductions to eligible hospitals that do not demonstrate meaningful use will begin in 2015.
Critical Access Hospitals (CAHs)
An eligible critical access hospital is defined in the NPRM as:
The CAH must demonstrate meaningful use according to the definitions for an eligible subsection (d) hospital.
Incentive payments are available to qualified CAHs for up to four years beginning with cost reporting periods that begin in fiscal year 2011.
Payment reductions to CAHs that do not demonstrate meaningful use will begin in 2015.
Proposed Medicaid Eligibility Criteria and Incentives Program
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Specific criteria and incentive payment details can be found in the NPRM or in the CMS fact sheet for the incentive program.
Medicaid Eligible Professionals (EPs)
An eligible professional (EP) for Medicaid is defined in the NPRM as:
- Physicians
- Dentists
- Nurse practitioners
- Certified nurse midwives
- Physician assistants who practice predominantly at a FQHC/RHC that is lead by a physician assistant
A hospital-based EP who furnishes 90% or more of their services in the hospital setting is not qualified as an EP to receive meaningful use incentives.
According to the NPRM, a qualified EP that makes effort to adopt, implement, upgrade, or meaningful use of a certified EHR can receive incentive payments in their first year of participation. In subsequent years the EP must demonstrate meaningful use of a certified EHR to receive incentive payments. To receive payments for the Medicaid incentive, the EP may not also receive payments from Medicare for meaningful use.
Medicaid Eligible Hospitals
- Acute care hospital
- Children’s hospital
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Stage 1 Criteria
The Stage 1 criterion is the first set of requirements proposed for defining and meeting meaningful use in 2011 (and 2012). It is the plan of CMS to continue to advance the definition of meaningful use based on capabilities in the marketplace, and to make the electronic management of healthcare more robust. The Stage 1 criteria consists of:
- 25 objectives and measures for eligible professionals (EPs)
- 23 objectives and measures for eligible hospitals
2011
Medicare requires all objectives and measures to be reported to CMS in the first year by the EPs and hospitals. Medicaid requires attestations to the state by the EPs and hospitals.
2012
CMS proposes direct submission of clinical quality measures to CMS for Medicare and/or to the states for Medicaid directly by the EHR.
eClinicalWorks provides an overview of the Stage 1 criteria along with corresponding capabilities in our product line to meet the proposed requirements. Click here to read more.
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Buzzwords
There is a lot of buzz in the healthcare industry surrounding the term “meaningful use.” It is a term that has become one of the most frequently used buzzwords in the industry. Along with it there are many more acronyms and jargon terms that may be difficult to decipher.
Be sure to check out our Industry Buzzwords page to brush up on meaningful use lingo.
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eClinicalWorks would like to get a better sense of your views on Meaningful Use. We are in the process of building education programs, tools, and outreach mechanisms to support our clients, and answering these questions will aide our thought process. This survey can be completed by multiple providers (or staff member on the behalf of their provider) in a practice or organization. Click here to fill out the survey. Please keep in mind, this survey is completely anonymous.
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