Executive Summary
What does Stage 2 Meaningful Use mean for providers? The simple answer is that it raises the bar: there are
more core measures, new menu measures, and higher reporting thresholds. In addition, the focus of Stage 2
Meaningful Use shifts away from recording and reporting towards care coordination and patient engagement.
In 2014, medical practices will face a “perfect storm” of regulatory and compliance issues with both
Meaningful Use and the ICD-10 conversion happening at virtually the same time. Achieving both in the same
year can seem daunting and complex. However, with the right planning and the right health information
technology in place, it is possible to achieve Stage 2 Meaningful Use while successfully navigating the
transition to ICD-10.
Reap the rewards—and avoid significant penalties—by following these five steps to successfully bring your
practice through the Meaningful Use program and beyond:
1) Assess Your Starting Point
• See how Stage 1 compares to Stage 2, and where you need to focus to attain Meaningful Use objectives.
2) Plot Your Timeline
• Understand your incentive payment schedule, your Meaningful Use reporting period, and how to ramp
up to Stage 2 while also undergoing the 2014 ICD-10 conversion.
3) Upgrade Your EHR
• Assess your EHR’s ability to handle the Stage 2 requirements, including the required transition to the
2014 certified version, and determine the right criteria for evaluating EHRs if you need to switch.
4) Integrate Meaningful Use Measures into Your Workflow
• Evaluate your current workflow to maximize performance and increase your Stage 1 performance to
meet the Stage 2 thresholds.
5) Create A Patient Engagement Strategy
• Create a patient engagement strategy that leverages technology and marketing to launch and promote
a patient portal and actively engage patients in their care.
Are You On Board with Meaningful Use?
The Medicare and Medicaid Electronic Health Record (EHR) Incentive Programs, or “Meaningful Use”
programs, create infrastructure to support higher quality care, better health outcomes, and lower costs.
To receive an EHR incentive payment—and avoid upcoming penalties—providers must show that they are
“meaningfully using” their EHRs by meeting thresholds for a number of objectives.
However, only a small percentage of eligible providers are participating in the Meaningful Use programs.
According to the U.S. Department of Health & Human Services, as of April 2013 more than 291,000 eligible
professionals and over 3,800 eligible hospitals have received incentive payments from the Medicare and
Medicaid EHR Incentive Programs. That includes approximately 80 percent of all eligible hospitals and critical
access hospitals in the U.S. But only about half of physicians and other eligible professionals in the U.S.
have received an incentive payment for adopting, implementing, upgrading, or meaningfully using an EHR.
In addition, a survey of 1,820 primary care physicians and specialists in office-based practices showed that
43.5% reported having a basic EHR but only 9.8% met Meaningful Use criteria.
The actions you take (or fail to take) in the next year will determine how you benefit from available incentives or get penalized for noncompliance.
Does this sound familiar? For many health care organizations, EHR adoption and Meaningful Use are difficult to achieve because of cost, lack of knowledge,workflow challenges, and lack of interoperability. These are real issues. But they can be successfully addressed and should not prevent your organization from participating in Meaningful Use.
Regardless of where you are in EHR adoption and the Meaningful Use program, the actions you take (oil to take) in the next year will determine how you benefit from available incentives or get penalized for noncompliance.
These five steps will help you prepare for success with Meaningful Use Stage 2:
1) Assess Your Starting Point
• See how Stage 1 compares to Stage 2, and where you need to focus to attain Meaningful Use objectives.
2) Plot Your Timeline
• Understand your incentive payment schedule, your Meaningful Use reporting period, and how to ramp
up to Stage 2 while also undergoing the 2014 ICD-10 conversion.
3) Upgrade Your EHR
• Assess your EHR’s ability to handle the Stage 2 requirements, including the required transition to the
2014 certified version, and determine the right criteria for evaluating EHRs if you need to switch.
4) Integrate Meaningful Use Measures into Your Workflow
• Evaluate your current workflow to maximize performance and increase your Stage 1 performance to
meet the Stage 2 thresholds.
5) Create a Patient Engagement Strategy
• Create a patient engagement strategy that leverages technology and marketing to launch and promote a patient portal and actively engage patients in their care.
What is Meaningful Use and How Does It Impact My Practice?
The Medicare and Medicaid EHR Incentive Programs are unfolding in three steps:
• Stage 1 (launched in 2011): Encourages adoption of electronic health records (EHRs), focusing on data
capture and sharing. All providers begin Meaningful Use participation by meeting the Stage 1 requirements.
• Stage 2 (2014): Addresses advanced clinical processes and the ability to exchange information privately and securely. CMS recently finalized the rule that specifies the Stage 2 criteria.
• Stage 3 (date to be announced): Expected to address the ability to use that information to improve quality of care, achieve better quality outcomes, simplify administrative systems, control costs and manage public health and population.
The incentives for participating in Meaningful Use are considerable: under the Medicare EHR Incentive Program, eligible professionals (EPs) can receive up to $44,000 over five years. In the Medicaid EHR Incentive Program, EPs can receive up to $63,750 over six years.
Penalties are looming
However, if Medicare eligible professionals do not adopt and successfully demonstrate Meaningful Use of a
certified EHR technology (CEHRT) by October 1st, 2014, the EP’s Medicare physician fee schedule amount for covered professional services will be adjusted down by 1% each year.
The adjustment schedule is as follows:
• 2015: 99% of Medicare physician fee schedule covered amount
• 2016: 98 % of Medicare physician fee schedule covered amount
• 2017 and each subsequent year: 97% of Medicare physician fee schedule covered amount
These penalties will add up to significant, ongoing costs—and could put some practices at risk.
Currently, the only potential relief from these adjustments is if less than 75% of EPs have become meaningful users of EHRs by 2018, the adjustment will change by 1% point each year to a maximum of 5% (95% of the Medicare covered amount).
In addition, the Recovery Act allows for hardship exception from the payment adjustment in certain instances.
The exemption must be renewed each year and will not be given for more than 5 years. CMS is developing more information on payment adjustments and the requirements to qualify for a hardship exemption.
Using the right EHR can help providers make better care decisions by using comprehensive patient
information, reduce and prevent medical errors, and improve patient outcomes. If you haven’t yet adopted an EHR, or are dissatisfied with your current product, it is not too late to implement the right system and plan for success with Meaningful Use and beyond.
No matter where you are in EHR and Meaningful Use adoption, here’s where to begin.
Step 1. Assess Your Starting Point
Step 2. Plot Your Timeline
Step 3. Upgrade Your EHR
Step 4. Integrate Meaningful Use Measures into Workflow
Step 5. Create a Patient Engagement Strategy
