Practice Management & Allied Staff News & Materials
March 3rd, 2010
On January 13, 2010, CMS published a Proposed Rule to implement provisions of the American Recovery and Reinvestment Act of 2009 that provides incentive payments for the meaningful use of certified EHR technology. The proposed rule outlines provisions governing the EHR incentive programs, including defining the central concept of "meaningful use" of EHR technology. CMS' goal is for the definition of meaningful use to be consistent with applicable provisions of Medicare and Medicaid law while continually advancing the contributions certified EHR technology can make to improving health care quality, efficiency, and patient safety. CMS plans to phase in criteria for demonstrating meaningful use in three stages. The proposed rule identifies and outlines stage 1 criteria for meaningful use and over time, CMS will establish stricter and more extensive criteria for demonstrating meaningful use in stages 2 and 3, as anticipated developments in technology and providers' capabilities occur. To receive an EHR incentive payment, the eligible professional is responsible for demonstrating meaningful use of certified EHR technology under both the Medicare and Medicaid EHR incentive programs. This first proposed rule provides a 60-day comment period ending March 15, 2010. In a related announcement, ONC has issued an Interim Final Rule that specifies the Secretary's adoption of an initial set of standards, implementation specifications, and certification criteria for electronic health record (EHR) technology.
The proposed Stage 1 criteria for meaningful use focus on electronically capturing health information in a coded format, using that information to track key clinical conditions, communicating that information for care coordination purposes, and initiating the reporting of clinical quality measures and public health information. Stage 1 begins in 2011 and CMS proposes 25 objectives/measures for Eligible Professionals (EPs) that must be met to be deemed a meaningful EHR user. Furthermore there is proposed additional specialty measures of which oral and maxillofacial surgery may be included in the Proceduralist/Surgery category. All of the results for all objectives/measures, including clinical quality measures would be reported by EPs to CMS, or for Medicaid EPs to the states, through attestation. In 2012, CMS proposes requiring the direct submission of clinical quality measures to CMS (or to the states for Medicaid EPs) through certified EHR technology. Stage 2 would expand upon the Stage 1 criteria in the areas of disease management, clinical decision support, medication management, support for patient access to their health information, transitions in care, quality measurement and research, and bi-directional communication with public health agencies. CMS may consider applying the criteria more broadly to both the inpatient and outpatient hospital settings. Stage 3 would focus on achieving improvements in quality, safety and efficiency, focusing on decision support for national high priority conditions, patient access to self management tools, access to comprehensive patient data, and improving population health outcomes.