Meaningful Use Summary Guide
1. Who is eligible to apply?
For Medicaid, there are also patient volume requirements to qualify:
2. What is “meaningful use” exactly?
Meaningful use is defined as:
A. Use of a certified EHR in a meaningful manner (ex: clinical documentation, e-prescribing, etc.)
B. Use of certified EHR technology for electronic exchange of health information
C. Use of certified EHR technology to submit clinical quality and other measures.
3. How do I qualify for incentive payments?
Requirements vary based on whether the applicant is an “eligible professional” or eligible hospital.” Tables summarizing the requirements are provided at the end of this document.
Eligible Professionals (EPs)
• Must meet 15 core requirements + 5 menu requirements
• Quality measures required for reporting for EPs – 3 core + 3 menu
• If EP unable to report on normal core measures, three (3) alternative core measures are specified as well as a process for determining reporting requirements for the EP.
Eligible Hospitals and Critical Access Hospitals
• Must meet 14 core requirements + 5 menu requirements
• Quality measures required for reporting - 15 measures for hospitals
Reporting Requirements:
• Reporting Period –for any consecutive 90 days for first year; one year subsequently
• For 2011 –Providers required to submit summary quality measure data to CMS or States by attestation
• For 2012 –Providers required to electronically submit quality measure data to CMS or States
4. Where do I begin?
Step 1: Sign up to work with the CHITREC expert staff.
Step 2: Work with CHITREC staff to determine which category of incentives best meets your profile:
• Medicare Incentives (Either Fee-For-Service or Medicare Advantage)
• Medicaid Incentives
Step 3: CHITREC staff will assess your practice and help you develop a meaningful use action plan.
5. How much money can I receive in incentives?
Eligible professionals (EPs) Timeline
• 2011-2016 (Medicare) –Up to $44,000 over 5 years if “meaningful user”
• 2011-2021 (Medicaid) –Up to $63,750 over 6 years –Adopt/Implement/Upgrade systems or meaningful use in Year 1, meet MU requirements in Years 2-6
• 2015 and later –If not “meaningful user” up to 3% payment adjustment in Medicare reimbursement
• After the initial designation, EPs will be allowed to change their program selection only once during payment years 2012 through 2014.
6. When can I apply?
7. Which incentive program is best for me – Medicare or Medicaid?
This decision will be based on a number of factors, especially patient mix. Medicaid incentives are more generous but also come with different requirements. Some key differences are provided below.
Key Differences in the Two Incentive Programs
8. What if I don’t see a lot of Medicare patients? What kind of incentive payment should I expect?
9. I am a health care professional who… What do I need to know?
• Is an eligible provider under Medicare Advantage?
• Practices primarily in a hospital inpatient setting. Am I eligible for incentives?
· Hospital-based EPs do NOT qualify for Medicare EHR incentive payments
· Most hospital-based EPs will NOT qualify for Medicaid EHR incentive payments
· Defined as an EP who furnishes 90% or more of their services in a hospital setting (inpatient, outpatient, or emergency room)
• Practices predominantly in FQHC/RHC or provides care for “Needy Individuals”
· EP is also eligible when practicing predominantly in federally qualified health clinic (FQHC) or rural health clinic(RHC) providing care to needy individuals
· Proposes practicing predominantly is when FQHC/RHC is the clinical location for over 50% of total encounters over a period of 6 months in the most recent calendar year
· Needy individuals (specified in statute) include:
o Medicaid or CHIP enrollees;
o Patients furnished uncompensated care by the provider; or
o furnished services at either no cost or on a sliding scale.
• Practices in a Health Professional Shortage Area (HPSAs) - Medicare meaningful use incentive payments are increased by 10% for providers located in a “health professional shortage area” who accrue the maximum allowable charges ($24,000). For more information on HPSAs, see http://bhpr.hrsa.gov/shortage/.
10. Aren’t there OTHER incentive programs – do they overlap?
Meaningful Use Detail Tables
Additional Meaningful Use Resources:
Chicago Health IT Regional Extension Center
CMS EHR Incentive Program Home Page
Office of National Coordinator for Health IT