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Meaningful Use Stage 1
Basic Concepts and Requirements
   Dr. Jose I. Delgado, Taino Consultants Inc.
What is Meaningful Use

• Established by the Health Information
  Technology for Economic and Clinical
  Health (HITECH) Act of 2009
• Defines the use of electronic health
  records (EHR)
• Requirement before an organization
  may request payments under the EHR
  incentive program
Requirements

• Eligible Professional
  – Providers eligible for incentives
• Certified EHR
• Meaningful Use
  – Three Stages
• Specific Program
  – Medicare
  – Medicaid
Eligible Providers

Medicare                           Medicaid
•   Doctor of medicine             •   Physicians
•   Doctor of osteopathy           •   Dentists
•   Doctor of dental surgery       •   Certified nurse midwives
•   Doctor of dental medicine      •   Nurse practitioners
•   Doctor of podiatric medicine   •   Physicians assistants (in rural
•   Doctor of optometry                health clinic or FQHC led by a
•   Chiropractor                       physician assistant)
Certified Electronic Health Record

• EHR that is certified specifically for the
  EHR Incentive Programs
• Must have met CMS and the Office of
  the National Coordinator for Health
  Information Technology (ONC)
  established standards
• Must be on the Certified Health IT
  Product List (CHPL)
  – http://healthit.hhs.gov/chpl
Meaningful Use Stages

          Stage 1                          Stage 2                         Stage 3
        2011-2012                           2014                             2016
   Data Capture and                  Advance Clinical              Improved Outcomes
       Sharing                         Processes
Using the information to track   Disease management, clinical    Focusing on decision support
key clinical conditions          decision support                for national high priority
                                                                 conditions


Communicating captured           Quality measurement             Achieving improvements in
information for care                                             quality, safety and efficiency
coordination purposes
Reporting of clinical quality    Support for patient access to   Access to comprehensive
measures and public health       their health information        patient data
information
Capturing health information     Bi-directional communication    Patient access to self-
in a coded format                with public health agencies     management tools



 *Not all Inclusive.
Medicare vs Medicaid

Medicare                               Medicaid
Starts in calendar year 2011           Starts in calendar year 2011
Up to $44,000 over five years          Up to $63,750 over six years
Maximum of $18,000 on the first        based on up to 85% of state-
year if EP bills Medicare $24,000 or   calculated global average costs for
more.                                  EHR
For maximum reimbursement 1st          1st yr cost no later than 2016
year cost no later than 2012
No payments made after 2015            No payments made after 2021 or
                                       more than 5 years
Penalties start in 2015 (1%) and       No Medicaid penalty for failure to
increases by 1% every year until       demonstrate Meaningful Use
2019 with a max of 5%.
Other Issues to Consider

• Core Measure number 12
  – Responsibilities for both the HIPAA
    Privacy Rule and other applicable laws
    • Read about HIPAA Privacy Rule, HITECH,
      Omnibus Rule
• Core Measure number 15
  – Security Risk Analysis
    • perform a security review and correct any
      potential vulnerabilities
Reminders

• Meaningful use requirements go
  beyond the implementation of a
  certified EHR.
• Meaningful use is not for all healthcare
  professionals.
• EPs may only choose Medicare or
  Medicaid incentives.
Recommendations

• Familiarize yourself with the
  requirements
• Select which program is more
  convenient to you
• Look for professional assistance
• Change operational practices to meet
  the requirements
Summary

• Meaningful Use defines the use on
  Electronic Health Records
• Meaningful use must be met in order to
  receive financial incentives
• Failure to meet Meaningful use
  requirements may result in Medicare
  penalties by 2015

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Meaningful use basics

  • 1. Meaningful Use Stage 1 Basic Concepts and Requirements Dr. Jose I. Delgado, Taino Consultants Inc.
  • 2. What is Meaningful Use • Established by the Health Information Technology for Economic and Clinical Health (HITECH) Act of 2009 • Defines the use of electronic health records (EHR) • Requirement before an organization may request payments under the EHR incentive program
  • 3. Requirements • Eligible Professional – Providers eligible for incentives • Certified EHR • Meaningful Use – Three Stages • Specific Program – Medicare – Medicaid
  • 4. Eligible Providers Medicare Medicaid • Doctor of medicine • Physicians • Doctor of osteopathy • Dentists • Doctor of dental surgery • Certified nurse midwives • Doctor of dental medicine • Nurse practitioners • Doctor of podiatric medicine • Physicians assistants (in rural • Doctor of optometry health clinic or FQHC led by a • Chiropractor physician assistant)
  • 5. Certified Electronic Health Record • EHR that is certified specifically for the EHR Incentive Programs • Must have met CMS and the Office of the National Coordinator for Health Information Technology (ONC) established standards • Must be on the Certified Health IT Product List (CHPL) – http://healthit.hhs.gov/chpl
  • 6. Meaningful Use Stages Stage 1 Stage 2 Stage 3 2011-2012 2014 2016 Data Capture and Advance Clinical Improved Outcomes Sharing Processes Using the information to track Disease management, clinical Focusing on decision support key clinical conditions decision support for national high priority conditions Communicating captured Quality measurement Achieving improvements in information for care quality, safety and efficiency coordination purposes Reporting of clinical quality Support for patient access to Access to comprehensive measures and public health their health information patient data information Capturing health information Bi-directional communication Patient access to self- in a coded format with public health agencies management tools *Not all Inclusive.
  • 7. Medicare vs Medicaid Medicare Medicaid Starts in calendar year 2011 Starts in calendar year 2011 Up to $44,000 over five years Up to $63,750 over six years Maximum of $18,000 on the first based on up to 85% of state- year if EP bills Medicare $24,000 or calculated global average costs for more. EHR For maximum reimbursement 1st 1st yr cost no later than 2016 year cost no later than 2012 No payments made after 2015 No payments made after 2021 or more than 5 years Penalties start in 2015 (1%) and No Medicaid penalty for failure to increases by 1% every year until demonstrate Meaningful Use 2019 with a max of 5%.
  • 8. Other Issues to Consider • Core Measure number 12 – Responsibilities for both the HIPAA Privacy Rule and other applicable laws • Read about HIPAA Privacy Rule, HITECH, Omnibus Rule • Core Measure number 15 – Security Risk Analysis • perform a security review and correct any potential vulnerabilities
  • 9. Reminders • Meaningful use requirements go beyond the implementation of a certified EHR. • Meaningful use is not for all healthcare professionals. • EPs may only choose Medicare or Medicaid incentives.
  • 10. Recommendations • Familiarize yourself with the requirements • Select which program is more convenient to you • Look for professional assistance • Change operational practices to meet the requirements
  • 11. Summary • Meaningful Use defines the use on Electronic Health Records • Meaningful use must be met in order to receive financial incentives • Failure to meet Meaningful use requirements may result in Medicare penalties by 2015