Financial Incentives, Meaningful Use and HIE's

In order to qualify for the American Recovery and Reinvestment Act of 2009 (ARRA), Health Information Technology for Economic and Clinical Health (HITECH) Financial Incentives; the healthcare provider must utilize an electronic health record (EHR) system that engages the patient, share data and improve quality of care. Unfortunately, most healthcare providers do not meet the new federal mandates to qualify for financial incentives.  Purchasing an Electronic Medical Record (EMR) system is not enough. Connecting to a Health Information Exchange (HIE) is not enough. You must use your EMR in a meaningful way, share with other providers, public health agencies for bio-surviellance and population health, engage your patients and provide them with access to their personal health record (PHR).

What is Meaningful Use?

Meaningful use of health information technology is an umbrella term for rules and regulations that hospitals and physicians must meet to qualify for federal incentive funding under the ARRA, HITECH Act. ARRA authorizes the Centers for Medicare & Medicaid Services (CMS) to provide reimbursement incentives for eligible professionals and hospitals that meet meaningful use criteria along the road to becoming "meaningful users" of certified EHR technology. This includes using an EHR for functions that both improve and demonstrate the quality of care, such as e-prescribing, electronic exchange of health information, and submission of quality measures to CMS.

The purpose of the ARRA/HITECH is to:

• improve quality, safety, efficiency, and reduce health disparities
• engage patients and families
• improve care coordination
• ensure adequate privacy & security protections for personal health information
• improve population and public health

How Does Health Information Exchanges Help Meet Meaningful Use Requirements?

There are 5 key requirements that most ONC Certified Electronic Medical Records (EMR) and Hospital Information Systems (HIS) are not able to do alone. You need to connect to an HIE to demonstrate the following;

• Exchange Key Clinical Information
• Syndromic Surviellance to Public Health Agencies
• Submit Lab Results to Public Health Agencies
• Submit Immunization Data to Immunization Registries
• Calculate and Transmit CMS Requirements to Public Health Agencies

If you have an ONC Certified EMR/HIS, use CPOE and ePrescribe, Electronic Health Network will help you meet those final 5 requirements for your Incentive Payment. Stage One under Meaningful Use, requires the following;

Eligible Providers	Hospitals / CAH
15 Core Objectives 5 Objectives from Menu Set 6 Clinical Quality Measures (CQM) Learn More (PDF)	14 Core Objectives 5 Core Objectives from Menu Set 15 Clinical Quality Measures (CQM) Learn More (PDF)

You have to share information with different EHR systems.

Financial Incentives

Eligible Hospitals (EH)

Eligible hospitals can receive up to four years of financial incentive payments under Medicare beginning in 2011 and up to six years of incentive payments under Medicaid. Hospitals must increase use of comprehensive EHR systems from 10% in 2009 to 55% by 2014. Doing so yields substantial incentive payments – a typical 275-bed hospital would be eligible for approximately $5 million.

Eligible Professionals (EP)

Eligible healthcare providers are encouraged to register as soon as possible to receive incentive payments for meeting meaningful use criteria. The EP incentive payments range from up to $44,000 over five years under Medicare or $63,750 over six years under Medicaid. Physicians can apply for either/or – not both. Hospital-based physicians and those in practices owned by a hospital are not eligible. Waiting to adopt an EHR has a price – incentive payments are gradually reduced each year, stopping entirely in 2016. Learn More (PDF)

Medicare Incentives Payment

Year 1st File	2011	2012	2013	2014
2011	$18,000
2012	$12,000	$18,000
2013	$8,000	$12,000	$15,000
2014	$4,000	$8,000	$12,000	$12,000
2015	$2,000	$4,000	$8,000	$8,000
2016	$0	$2,000	$4,000	$4,000
Total	$44,000	$44,000	$39,000	$24,000

Medicaid Incentive Payment

Year 1st File->	2011	2012	2013	2014	2015	2016
2011	$21,250
2012	$8,500	$21,250
2013	$8,500	$8,500	$21,250
2014	$8,500	$8,500	$8,500	$21,250
2015	$8,500	$8,500	$8,500	$8,500	$21,250
2016	$8,500	$8,500	$8,500	$8,500	$8,500	$21,250
2017		$8,500	$8,500	$8,500	$8,500	$8,500
2018			$8,500	$8,500	$8,500	$8,500
2019				$8,500	$8,500	$8,500
2020					$8,500	$8,500
2021						$8,500
Total	$63,750	$63,750	$63,750	$63,750	$63,750	$63,750

Fee Reductions and Penalties

Healthcare Providers who do not demonstrate meaningful use by 2014 will have their 2015 fee schedules from Medicare decrease by 1%. An additional decrease of 1% will be affected in 2016 and 2017 down to a total of 97% of the regular fee schedule. Healthcare Providers can lose an additional 5% if the Secretary determines that total adoption is below 75% in 2018.

Additional Incentives

• ePrescribe Incentives - The Medicare Improvement for Patients and Providers Act of 2008 and the PQRI incentives; offers a qualified provider up to $8,000 to fully adopt to electronic prescriptions aka ePrescribe. Most Certified EHR offer a ePrescribe Solution. EHN has a Complete ePrescribe solution if you don't have one. Learn More
• Patient-Centered-Medical Homes (PCMH) - The Patient-centered medical home (PCMH) is a model of care where patients have a direct relationship with a provider who coordinates a cooperative team of healthcare professionals, takes collective responsibility for the care provided to the patient and arranges for appropriate care with other qualified providers as needed. The National Committee for Quality Assurance (NCQA) has established standards to improve care, gain recognition and receive incentives. Many of the Meaningful Use requirements are based on PCMH principles. EHN Health Information Exchange and your Electronic Medical Record along with changes in policy and procedures can put you on the fast track for level three status for high quality patient care. Learn More

Do You Qualify for Financial Incentives?

Take this simple test from CMS to see if you qualify? Download EHR-Decision Tool from CMS. This tool is in PowerPoint. [File is safe and virus free] Contact EHN for a Free Assessment.

How to sign up?

You can register online on the CMS website. Note: you can register before you have a certified EHR. Contact EHN for a Free Assessment.