What is Meaningful Use

HITECH allows eligible providers to receive increased reimbursement payments from the government payers (Medicare and Medicaid) when they demonstrate meaningful use of certified EHR technology. Physicians can receive up to $44,000 over a 5 year period (front loaded) if they are an Eligible Professional (EP) with Medicare, or up to $63,750 with Medicaid. Hospitals, Critical Access Hospitals (CAHs), and Medicare Advantage organizations (MAs) also have incentives to become "meaningful".

"...Eligible Professionals must Demonstrate Meaningful Use of Certified EHR Technology..."

• The definition of Eligible Professional is based on the Social Security Act of 1932.


• The definition of Demonstrate has been finalized by the Secretary of Health and Human Services and sets forth the methods for each EP to demonstrate meaningful use.


• The definition of Meaningful Use for Stage 1 has been finalized by the Secretary of Health and Human Services, and sets forth the requirements each EP must meet.


• The definition of Certified EHR Technology for Stage 1 has been finalized by the Office of the National Coordinator for Health IT, and sets forth the requirements for the technology each EP must use.

Stages

The government determined that becoming a meaningful user of certified EHR technology would be very difficult for EPs, Hospitals, CAHs, and MAs. As such, they created a staged approach to Meaningful Use, which allows organizations to step into an entry level of technology, and eventually step up to the final government goals.

This also puts in place a mechanism to continue to modify the government's requirements for technology, allowing them to change to the healthcare industry needs.

Stage 1 has been defined, and released in a July 2010 Final Ruling.

More information on the Stages of Meaningful Use.

Stage 1 Requirements

Stage 1 for meaningful use began in early 2009. The first release of a proposal, called the Meaningful Use Matrix, came about in June 2009. The government was required by ARRA to define meaningful use by the end of the year. They did so by releasing an Interim Final Ruling (IFR) on December 30th, 2009. This was updated a couple of weeks later to correct some mistakes - January 13th, 2010.

The IFR solicited comments from all stakeholders, and much of the Final Ruling addresses these comments. The Final Ruling was published on July 13, 2010.

The ruling changed the IFR in several ways. The biggest change is that some components are deemed core, while some are a menu set. Of the 10 menu set items, EPs can choose which 5 to meet, and may ignore up to 5. Other changes included the elimination of Practice Management features such as Electronic Claims Submission and Electronic Eligibility Inquiry. The biggest change to a component that remained was the changes in CPOE.

EP S1 Final Ruling Requirements - Chart

EP S1 Final Ruling Requirements - Official (Pages 58 - 62 of Final Ruling)

Stage 1 Security

The final ruling also called for patient privacy functions and health record and patient security issues. This basically means that you've put in place security policies and procedures and you're using a certified EHR in the way it was intended - not disabling security features such as password protection (giving all users one login/password would disable security). For patient privacy, HITECH modified several elements of HIPAA, and to demonstrate meaningful use, you must comply with certified EHR software, and privacy policies, and procedures.

EP S1 Final Ruling Security Requirements - Chart

EP S1 Final Ruling Security Requirements - Official (Pages 29 - 36 of Final Ruling)