CMS webinar: Eligible professionals can expect EHR incentives in 2011
 |
In speaking to the program specifics for eligible practitioners, Holland explained that the American Recovery and Reinvestment Act (ARRA) states that 90 percent or more of their covered professional services in either an inpatient or emergency room hospital setting are not qualified for incentives. In addition, there are differences in the Medicare and Medicaid programs, as the Medicare incentive program is federally run by CMS and the Medicaid incentive program is voluntary and is state-run.
According to CMS, Medicare eligible professionals were defined as one of the following:
- Doctors of medicine or osteopathy;
- Doctors of dental surgery or dental medicine;
- Doctors of podiatric medicine;
- Doctors of optometry; and
- Chiropractors.
Likewise, Medicaid eligible professionals included:
- Physicians;
- Nurse practitioners;
- Certified nurse-midwives;
- Dentists; and
- Physician assistants working in a federally qualified health center (FQHC) or rural health clinic (RHC) that is also led by a physician assistant.
Meaningful Use requirements
After distinguishing who can take part in the incentive programs, meaningful use has to be reached for EHR use as mandated in ARRA law in order to receive incentives.
“Basically, meaningful use is not just having certified EHR technology, we need use it in a way that makes a difference,” said Travis Broome, health insurance specialist at CMS. In the meaningful use rule, he noted that the CMS pinpointed five areas in which to focus, including the improvement of quality, safety, efficiency and the reduction of health disparities; the engagement of patients and families in their healthcare and the improvement of care coordination, population and public health--all while maintaining privacy and security.
Meaningful use, established in three phases: 2011, 2013 and 2015, respectively, specifies three components, according to Broome. These components are:
- Use of certified EHR in a meaningful manner (e.g., e-prescribing);
- Use of certified EHR technology for electronic exchange of health information to improve quality of healthcare; and
- Use of certified EHR technology to submit clinical quality measures (CQM) and other such measures selected by the Secretary.
Specifically for the first phase of objectives and measures reporting, which should be met by 2011, eligible practitioners must complete 15 core meaningful use objectives, five objectives out of 10 from a menu set and six clinical quality measures (three core or alternate core and three out of 38 from a menu set). However, practitioners should be “focusing more on use, not reporting on that use,” stressed Broome.
How to Participate
In order to take part in the EHR incentive program, providers must register via the incentive program website, be enrolled in Medicare FFS, MA, or Medicaid (FFS or managed care) and have a National Provider Identifier (NPI), offered Michele Mills health policy analyst of the Family and Children's Health Program Group, Center for Medicaid and State Operations, CMS.
In addition to these requirements, the practitioners must use certified EHR technology and Medicaid providers may adopt, implement or upgrade technology during their first year, she said.
Mills also noted several differences between the Medicare and Medicaid Incentive Programs, citing that in the Medicare program, the federal government will implement the EHR incentive program starting in January 2011. The meaningful use definition is common across Medicare and payment reductions begin in 2015 for providers that do not demonstrate meaningful use.
For Medicaid however, the EHR incentive program is voluntary for States to implement and most are expected to start by late summer 2011. States also can adopt certain additional requirements for meaningful use and there are no Medicaid payment reductions for providers who do not demonstrate meaningful use.
As early as this fall, certified EHR technology will be available and listed on the CMS website and in January 2011, registration for the EHR Incentive Programs begins, said Mills, noting that Medicare EHR incentive payments are slated to begin in May 2011.
“Right now, we are doing a lot of outreach to get the word out on what the rules are all about and how you can become a meaningful user,” said Mills. And for Medicaid providers, states may launch their programs if they so choose and many are interested in implementing their program in January [2011], she noted. “They want to get this money into your hands as soon as possible,” she concluded.