Meaningful Use

What is meaningful use?

If you talk to anyone who was involved in the EMR industry, one of the biggest points of discussion was what was known as “Meaningful Use of EMR/EHR”. What began as a well-intentioned effort to establish universal standards for EMR/EHR software systems has moved into a political jockeying by both corporations and “consumer watchdogs”.

Meaningful use and the ARRA

A key piece of the American Recovery and Reinvestment Act of 2009 (ARRA), which was signed into law by President Barack Obama on February 10, 2010, was directly related to the medical community and further has financial repercussions for individual medical practices. Per the terms of the ARRA, physicians were incentivized for the full implementation of an electronic medical records (EMR) system. However, the stipulation that the federal government assigned to this program as it relates to financial incentives is that the EMR system has demonstrated “Meaningful Use.”

What are the benefits of meaningful use for the average physician?

• Easy to use
• Reasonably priced
• Creates a better work flow
• Allows the physician to see more patients in a workday
• Increased revenue for the practice

What are the three main components of meaningful use?

The components of meaningful use in the medical field were broken down into three stages: Adoption of EHR Technologies, Encouraging the Meaningful Use of CEHRT, and Using CEHRT to improve health outcomes.

Stage one: Adoption of EHR technologies

This first component of meaningful use is focused on establishing requirements for the electronic paperwork and clinical data to let patients have direct access to their own sensitive health information. The adoption of EHR technology has been shown to help establish these requirements in healthcare practices.

Stage two: Encouraging meaningful use of CEHRT

The next component highlighted in meaningful use was created to emphasize the importance of patient information exchanges. Encouraging CEHRT usage has helped increase accuracy for compliance regulations and helped define clinical decisions.

Stage three: Using CEHRT to improve health outcomes

The last component stage of meaningful use is the usage of CEHRT to improve overall patient health outcomes. Everything from digital provider entries and coordinated patient care engagement has been shown to improve health outcomes in meaningful use.

What is MIPS?

Merit-based incentive payment system, or MIPS, works to reduce the overall cost of medical care and create better patient outcomes through payment tracking. It was created under MACRA in an effort to increase healthcare data and information usage. With MIPS, physicians are paid fairly for caring for someone’s medicare beneficiaries. Providers are then paid based on the quality of the care they provide patients after assessment.

How can I qualify for meaningful use?

To qualify for meaningful use, providers must adhere to the following criteria:

• Provide patients with timely health data
• Excange health care team clinical information
• Remain in communication with notable public health agencies
• Use clinical decision support during care
• Create patient lists for people who need care and reach out with frequent reminders or instructions
• Computize physician order sets
• Report information to patient registries
• Apply confidential security protections
• Share data with patients

2023 Program requirements

In the fall of 2022, CMS finalized changes to the Medicare Promoting Interoperability Program for eligible hospitals and critical access hospitals (CAHs) for calendar year (CY) 2023. These changes and requirements can be found below.

For information on Hardship Exceptions and Payment Adjustments, please visit the Medicare Promoting Interoperability Program Resource Library.

EHR reporting period in CY 2023

The Electronic Health Record (EHR) reporting period for new and returning participants attesting to CMS is a minimum of any continuous, self-selected, 90-day period.

Certified EHR technology (CEHRT)

To be considered a meaningful user and avoid a downward payment adjustment, eligible hospitals and CAHs attesting to the Medicare Promoting Interoperability Program will be required to use CEHRT which has been updated to meet the 2015 Edition Cures Update criteria.

The CY 2023 CEHRT requirements for the Medicare Promoting Interoperability Program are as follows:

• 2015 Edition Cures Update functionality must be used as needed for a measure action to count in the numerator during the EHR reporting period chosen by the eligible hospital or CAH (a minimum of any continuous 90 days in 2023).
• In some situations, the product may be deployed during the EHR reporting period but pending certification. In such cases, the product must be updated to the 2015 Edition Cures Update criteria by the last day of the EHR reporting period.
• Eligible hospitals and CAHs must provide their EHR’s CMS Identification code from the Certified Health IT Product List (CHPL), available on HealthIT.gov, when submitting their data.

To learn more about the 2015 Edition Cures Update, please review ONC’s 21st Century Cures Act Final Rule and the ONC Certification Criteria webpage. To check whether a health IT product has been updated to the 2015 Edition Cures Update, visit the Certified Health IT Product List (CHPL) at https://chpl.healthit.gov/.

Objectives and measures

Participants are required to report on four scored objectives and their measures.

• Electronic Prescribing
• Health Information Exchange
• Provider to Patient Exchange
• Public Health and Clinical Data Exchange

Participants are also required to report (yes/no) on the Protect Patient Health Information objective:

• Security Risk Analysis measure
• Safety Assurance Factors for EHR Resilience (SAFER) Guides measure

Scoring methodology

CMS continues to implement a performance-based scoring methodology. Each measure will contribute to the eligible hospital or CAH’s total Medicare Promoting Interoperability Program score. A minimum of 60 points is required to satisfy the scoring requirement.

Electronic clinical quality measures (eCQMs)

Must report on the following using 4 self-selected quarters of data:

• 3 self-selected eCQMs
• The Safe Use of Opioids Concurrent Prescribing eCQM