AchievingMeaningful UseStage 2

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Meaningful Use

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Achieving

Introduction

Key timelines

Meaningful Use Timeline & CMS Reporting – 2014

Requirements of Stage 2

Reporting Clinical Quality Measures

Attest for Stage 2 with CureMD

Stage 2 FAQs

Introduction

The Medicare and Medicaid EHR Incentive Programs offer financial incentives for the

“meaningful use” of certified EHR technology to improve patient care.

To receive an EHR incentive payment, providers have to show that they are “meaningfully

using” their EHRs by meeting thresholds for a number of objectives. CMS has established

the objectives for “meaningful use” that eligible professionals, eligible hospitals, and critical

access hospitals (CAHs) must meet in order to receive an incentive payment.

The Medicare and Medicaid EHR Incentive Programs are staged in three steps with

increasing requirements for participation. All providers begin participating by meeting the

Stage 1 requirements for a 90-day period in their first year of meaningful use and a full year

in their second year of meaningful use.

After meeting the Stage 1 requirements, providers will then have to meet Stage 2

requirements for two full years. Eligible professionals participate in the program on the

calendar years, while eligible hospitals and CAHs participate according to the federal fiscal

year.

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Stage 3

2015Improved Outcomes

Stage 2

2014Advanced

Clinical ProcessesStage 1

2011Data Capturing

& Sharing

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Key Timelines of Stage 2

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2010

FALL

2011

WINTER

2011

SPRING

2011

FALL

2012

WINTER

2014 2015 2016 2021

NOV/DECRFI for additional public input

1-2Q11Moniter Stage 1 submissions

late 2011Final recommen-dations to ONC

2014Last year to initiate participa-tion in the Medicare EHR Incentive Program

2016Last year to receive a Medicare EHR Incentive Payment

Last year to initiate participa-tion in Medicaid EHR Incentive Program

2Q11Draft recommen-dations to HIT Policy Committee

CMS

CDC

Certified EHR technology available & listed on ONC website

For Medicade Providers, States may lauch their programs if they so choose

JAN 2011

Registration for the EHR Incentive Program Begins

JAN 2011

Last year to receive Medicaid EHR Payment

2021

Medicare payment adjustments begin for EPs & eligible hospitals that are not meaningful users to EHR technology

2015

Last day for EPs to register and attest to receive and Incentive Payment for FY 2011

Feb 29,2012

EHR Incentive Payments begin

May 2011

Last day for eligible hospitals and CAHs to register and attest to receive an Incentive Payment for FY 2011

Nov 30,2011

New Criteria – From 2014,

providers participating in the

EHR Incentive Programs who

have met Stage 1 for two or

three years will need to meet

Meaningful Use Stage 2 criteria.

Improving Patient Care – Stage 2

includes new objectives to

improve patient care through

better clinical decision support,

care coordination and patient

engagement.

Saving Money, Time, Lives –

With this next stage, EHRs will

further save our healthcare

system money, time for doctors

and hospitals, and lives.

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Meaningful Use Timeline & CMS Reporting – 2014

CMS had previously established a timeline in the Stage 1 of the MU Program, requiring

providers to ascend to the criteria for Stage 2 after two years of the program which meant

that this timeline required Medicare providers demonstrating Meaningful Use in 2011 to

meet the 2013 criteria of Stage 2.

CMS then had the criteria for Stage 2 delayed for a year, making it effective in the year 2014.

For the year 2014, providers, regardless of their current Stage in the Meaningful Use time-

line, are required to demonstrate Meaningful Use for three months in that year. Medicare

Providers: The 3 month reporting period has been fixed to the fiscal year for hospitals and

critical access hospitals and the calendar year for eligible providers.

Medicaid Providers: For those who are only eligible to receive the Medicaid EHR Incentives,

the reporting period of 3 months is not fixed to any quarter and can be fulfilled at any time of

the year with 3 consecutive months of MU demonstration.

Requirements of Stage 2

Meaningful use includes both a core set and a menu set of objectives that are specific to

eligible professionals or eligible hospitals and CAHs. For eligible professionals, there are a

total of 24 meaningful use objectives. To qualify for an incentive payment, 19 of these 24

objectives must be met:

• 14 required core objectives

• 5 objectives chosen from a list of 10 menu set objectives

For eligible hospitals and CAHs, there are a total of 23 meaningful use objectives. To qualify

for an incentive payment, 18 of these 23 objectives must be met:

• 13 required core objectives

• 5 objectives chosen from a list of 10 menu set objectives

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Reporting Clinical Quality Measures

Clinical quality measures, or CQMs, are tools that help measure and track the quality of

health care services provided by eligible professionals, eligible hospitals and critical access

hospitals (CAHs) within our health care system. These measures use data associated with

providers’ ability to deliver high-quality care or relate to long term goals for quality health

care. CQMs measure many aspects of patient care including:

• Health outcomes

• Clinical processes

• Patient safety

• Efficient use of health care resources

• Care coordination

CMS provides Meaningful Use Specification Sheets that bring together critical information

on each objective to help you understand what you need to do to meet the program require-

ments. Each specification sheet covers a single eligible professional core or menu set objec-

tive in detail, including information on:

• Meeting the measure for each objective

• How to calculate the numerator and denominator for each objective

• How to qualify for an exclusion to an objective

• In-depth definitions of terms that clarify objective requirements

• Requirements for attesting to each measure

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Stage 1 - 2014Stage 2 - 2014

17 Core Measures

6 Menu Measures (at least 3)

90 Days Reporting Period

$8000-Incentive (MCR)

15 Core Measures

10 Menu Measures (at least 5)

90 Days Reporting Period

Depends on the year of participation

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• Patient engagements

• Population and public health

• Adherence to clinical guidelines

Measuring and reporting CQMs helps to ensure that our health care system is delivering

effective, safe, efficient, patient-centered, equitable, and timely care.

To participate in the Medicare and Medicaid Electronic Health Record (EHR) Incentive

Programs and receive an incentive payment, providers are required to submit CQM data

from certified EHR technology. Beginning in 2014, all providers must use EHR technology

that has been certified to the 2014 standards and capabilities that contains new CQM

criteria. Providers will report using the 2014 criteria regardless of whether they are in Stage

1 or Stage 2 of meaningful use.

Please visit the 2014 Clinical Quality Measure Page to learn more about 2014 CQMs and

2014 reporting options.

To access the EHR Incentive Program 2014 CQM electronic specifications please visit the

eCQM Library page.

To learn more about electronic reporting please visit the Electronic Reporting Specification

page of the EHR Incentive Program.

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Attest for Stage 2 with CureMD

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MU Registration

Initial Assessment &

Recommended Plan

A session in which CureMD will walk you through the

registration process.

We will assess your current process flow, and determine

the fastest path to achieving Meaningful Use.

MU Training

Monitor Progress

Towards MU Compliance

Training Session on MU Compliance and Progress

Tracking.

A monthly session where your progress towards

Meaningful Use will be reviewed.

MU Attestation A session in which CureMD will walk you through the

Meaningful Use attestation process.

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Stage 2 FAQs

How will the Physician Payment be calculated under Medicare?

The Medicare payments will be calculated by multiplying the submitted allowable charges to

Medicare by 75%, up to the capped amount for the year. So a physician aiming to collect the

full incentive payment of $18,000 in 2011 will need to submit allowable charges of at least

$24,000. Conversely, a physician submitting only $16,000 in allowables would collect

$12,000 in 2011, even though the cap is higher.

Do providers register only once for the Medicare and Medicaid Electronic Health

Record (EHR) Incentive Programs, or must they register every year?

Providers are only required to register once for the Medicare and Medicaid EHR Incentive

Programs. However, they must successfully demonstrate that they have either adopted,

implemented or upgraded (first participation year for Medicaid) or meaningfully used

certified EHR technology each year in order to receive an incentive payment for that year.

Additionally, providers seeking the Medicaid incentive must annually re-attest to other

program requirements, such as meeting the required patient volume thresholds. Providers

will register using the Medicare and Medicaid EHR Incentive Program Registration &

Attestation System, a web-based system. Providers who have elected to participate in the

Medicare EHR Incentive Program will also use this system to attest to their program

eligibility and meaningful use.

Providers who select the Medicaid EHR Incentive Program will demonstrate their eligibility

and attest via their State Medicaid Agency's system. If any basic registration information

changes, the provider will need to update their information in the Medicare and Medicaid

EHR Incentive Program Registration & Attestation System.

When can I register and where do I register for the Medicare and Medicaid Electronic

Health Record (EHR) Incentive Programs?

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Registration for the Medicare EHR Incentive Program began on January 3, 2011 and is

available for eligible professionals (EPs), eligible hospitals and critical access hospitals

(CAHs) online at CMS.

Please note that although the Medicaid EHR Incentive Programs will begin January 3, 2011,

not all states will be ready to participate on this date. Information on when registration will

be available for Medicaid EHR Incentive Programs in specific States is posted at CMS Incen-

tive Program.

Can eligible professionals (EPs) receive electronic health record (EHR) incentive

payments from both the Medicare and Medicaid programs?

Not for the same year. If an EP meets the requirements of both programs, they must choose

to receive an EHR incentive payment under either the Medicare program or the Medicaid

program. After a payment has been made, the EP may only switch programs once before

2015.

How much are the Medicare and Medicaid Electronic Health Record (EHR) incentive

payments to eligible professionals (EPs)?

Under the Medicare EHR Incentive Program, EPs who demonstrate meaningful use of

certified EHR technology can receive up to a total of $44,000 over 5 consecutive years.

Additional incentives are available for Medicare EPs who practice in a Health Provider

Shortage Area (HPSA) and meet the maximum allowed charge threshold. Under the

Medicaid EHR Incentive Program, EPs can receive up to a total $63,750 over the 6 years

that they choose to participate in program. EPs may switch once between programs after a

payment has been made and only before 2015.

Are there any special incentives for rural providers in the Medicare and Medicare

Electronic Health Record (EHR) Incentive Programs?

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We note that nothing in the Act excludes such payments from taxation or as tax-free income.

Therefore, it is our belief that incentive payments would be treated like any other income.

Providers should consult with a tax advisor or the Internal Revenue Service regarding how to

properly report this income on their filings.

In order to receive payments under the Medicare and Medicaid Electronic Health

Record (EHR) Incentive Programs, does a provider have to be enrolled in the Provider

Enrollment, Chain, and Ownership System (PECOS)?

In order to receive Medicare EHR incentive payments, EPs, eligible hospitals, and critical

access hospitals must have an enrollment record in PECOS. Medicaid EPs do not have to be

in PECOS. There are three ways to verify that you have an enrollment record in PECOS:

This information is accurate, to the best of our knowledge. As more information becomes

available from HHS and other agencies, this page will be updated accordingly. Please check

the CMS website.

Check the Ordering Referring Report on the CMS website. If you are on that report, you

have a current enrollment record in PECOS. Go to CMS Provider, click on "Ordering

Referring Report" on the left.

Use Internet-based PECOS to look for your PECOS enrollment record. If no record is

displayed, you do not have an enrollment record in PECOS. Go to CMS Provider, click on

"Internet-based PECOS" on the left.

Contact your designated Medicare enrollment contractor and ask if you have an enrollment

record in PECOS. Go to CMS Provider, click on "Medicare Fee-For-Service Contact

Information" under "Downloads." If you are not in PECOS, the best way to submit your

application is through internet-based PECOS.

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