‘Meaningful Use’ completed its one year: How far has your practice reached?

Meaningful use of EHR or Electronic Health Records is one of the most discussed and debated topics in the recent heath care reforms. The main components of ‘Meaningful Use’ include the use of certified EHR technology for meaningful use such as ePrescribing, electronic exchange of health information to enhance healthcare quality, and submit clinical quality and other measures.

Adopting these health care IT reforms can assist physicians to provide quality care and increase their revenue by making the process of payment quicker and by avoiding preventable errors. However, the incentives offered for implementation of EHR can differ according to when the EHR are adopted by physicians or hospitals and by measuring other parameters in the service provided by physicians. These parameters can range from recording the status of smoking among patients to numerous others such as maintaining various lists.

The objectives laid down by the HITECH Act are divided into two parts – the core set and the menu set –which define the measures to be taken in order to qualify for the incentives provided by the Federal Government. The core set consists of recording patient demographics, recording vital signs of the patients such as height, weight & BMI (Body-mass index), maintaining lists of current and active diagnoses, record smoking status of 13 years or older population, provide patients with clinical summaries for each office visit, provide patients with a copy of their health information. They can also generate and transmit permissible prescriptions electronically among other core set of objectives.

Meaningful Use is categorized into three stages – stage 1 which began in 2011, and stages 2 and 3 which are planned for 2013 and 2015 respectively. There are 25 objectives or measures for eligible providers (EP) for stage 1 whereas stage 2 and 3 would expand upon stage 1 criterion. Meaningful use of EHR can also be categorized under Medicare and Medicaid incentive program where the former would pay $44,000 over a period of five years as an incentive and the latter $63,750 over a period of six years. To receive the maximum incentive under Medicare, EPs must begin participation by the year 2012. Medicaid incentive program is voluntarily offered by individual states and can begin as early as 2011.

Those Eligible Physicians, eligible hospitals, and CAHs that do not successfully demonstrate meaningful use after the year 2015 would face payment adjustments in their Medicare reimbursements. However, there is no payment adjustment for providers under Medicaid. Therefore it becomes important to ensure that your practice successfully starts meaningfully using EHR before 2012 in order to be eligible for incentives for Medicare. According to CMS the last day for Eligible Physicians to register and attest in order to receive incentive for calendar year 2011 is February 29, 2012.

The EHR Demonstration is a five-year project intended to support small to medium-sized primary care physician practices to implement and utilize EHRs to develop the quality of patient care. Practices participating in the EHR Demonstration that meet particular requirements are entitled to obtain two categories of incentive payments: one for the implementation and utilization of an EHR and the other for the reporting of and performance on twenty six clinical quality measures linked to the care of coronary artery disease (CAD), congestive heart failure (CHF), diabetes mellitus (DM), and preventive care services.

Many physicians may find it hard to just drop Medicare patients since the number of insured will go up drastically due to health reforms. Moreover, once EHR or EMR are adopted, physicians and Eligible physicians would find it much easier to handle patients and also save time and money. This fact coupled with the incentives provided would certainly increase the total revenue by more than 10 to 15 percent. Therefore adoption of EHR or EMR would become inevitable in the near future.

In the light of the increased use of technology, routine adoption of quality- and performance-based reimbursement models, and the constantly changing dynamics between the stakeholders are bound to redefine the healthcare business processes. The use of expert billing and coding professionals and staff which is trained on the latest EHR criteria and possesses domain expertise can optimize the revenue, speed, as well as value of healthcare clinics and hospitals.