Meaningful Use of EHRs for the Eligible Professional

Meaningful Use of EHRs for the Eligible Professional
Solutions for Independent Practices

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To Qualify for the Incentive Funds, Eligible Professionals
Must Prove Meaningful Use of a Certified EHR System
Eligible Professional
setting. CMS will use the place-of-service
bodies according to the meaningful
Under the Medicare provision, an EP
codes on physician claims - 21 (inpatient
use guidelines of the HHS Certification
is a physician as defined in the Social
hospital) and 23 (emergency room;
program. McKesson's Practice Partner(R)
Security Act section 1861 to include:
hospital) - to make this determination.
v9.5, Medisoft(R) Clinical v17 sp1 and
Lytec(R) MD 2011 are 2011/2012 compliant
- a doctor of medicine or osteopathy
Meaningful Use
and were ONC-ATCB certified* as a
- a doctor of dental surgery or of dental
EPs wil be eligible for the incentive
Complete EHR by CCHIT.
medicine
payments if:
Registration and Reporting
-
-
a doctor of podiatric medicine
they use a certified EHR technology
Registration by providers for the EHR
in a meaningful manner
incentive program opened in January
- a doctor of optometry
- the certified EHR is connected in a
2011. Registration for both Medicare and
- a chiropractor
manner that provides for the electronic
Medicaid programs are managed by CMS
exchange of health information to
and accessible online at
The Medicaid HIT Incentive program
improve the quality of care
www.cms.gov/EHRIncentivePrograms/20_
expands the definition of "eligible
RegistrationandAttestation.asp.
professional" to also include:
- and in using the EHR, the provider submits
information on clinical quality measures
In the first reporting year, providers
- a certified nurse mid-wife
wil need to prove meaningful use of
The Stage 1 Meaningful Use criteria
required measures over any continuous
- a nurse practitioner
focused on the electronic capture of
90-day period. In the subsequent years,
- a physician assistant practicing in
patient data were published in the
the reporting period wil be based on the
an FQHC or RHC that is led by a
Final Rule issued on July 28, 2010.
full calendar year. For 2011, providers
physician assistant
Physicians must meet 15 Core and five
wil report al measures through an
of 10 Menu objectives (see Tables 3
attestation method through a web-based
Providers participating in Medicare
and 4, respectively). Over time, EPs will
portal and will begin electronic reporting
Advantage (MA) programs wil qualify
be required to meet Stage 2 and Stage
to CMS in 2012.
as an EP if they match one of two
3 criteria that will be released in future
descriptions below:
rule making and wil focus on improved
States can determine when their
Medicaid programs wil begin and are
1. Furnish, on average, at least 20
clinical processes and the decision
allowed to propose additional core
hours/week of patient-care services
support and quality measurement
meaningful use criteria that would be
and are employed by the qualifying
reporting and outcomes respectively.
required of physicians to successful y
MA organization
Certified EHR system
participate in their Medicaid incentive
2. Are employed by, or a partner of, an
Certification standards are aligned with
program. Under the Medicaid program,
entity that through contract with the
the meaningful use criteria. Authorized
providers are not required to prove
qualifying MA organization furnishes
Testing and Certification Bodies (ATCBs)
meaningful use in the first year; instead
at least 80% of the entity's Medicare
have been named by the Office of the
they need to prove that they are in the
patient care services to enrol ees of the
National Coordinator of Health IT. The
process of adopting, implementing or
qualifying MA organization
first to be named were the Certification
upgrading certified EHR technology.
Commission of Health Information
Hospital-based physicians who furnish
Technology (CCHIT(R)), The Drummond
Incentives will be paid to providers in
"substantial y al " of their services in
Group and InfoGard Laboratories, Inc.
single, consolidated annual payments.
a hospital are not eligible for the EP
*Certification ID: CC-1112-589589-1. This
incentive, defined as providing at least
Providers must use an EHR solution that
certification does not represent an endorsement by
90% of their services in a hospital
has been certified by one of these bodies
the U.S. Department of Health and Human Services or
guarantee the receipt of incentive payments.

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Government Incentives for Providers to Drive
EHR Adoption
The passage of the American Recovery
Incentives are based on the lesser of
and Reinvestment Act (ARRA) provides
either 75% of the provider's Medicare
incentives for office-based physicians
Part B allowed charges (the lesser of
and other providers to tap into the
the actual charge or the Medicare
power of electronic health records (EHRs).
physician fee schedule amount) based
Providers may be eligible to benefit from
on claims submitted to Medicare
the incentives, whether through first-time
during the incentive payment year.
deployment of EHRs or completion of
And, physicians practicing in CMS-
existing healthcare IT projects.
designated Physician Shortage Areas
will earn an additional 10% bonus.
Incentive Overview
This program wil be administered by
Eligible Professionals (EPs) can qualify
Practice Partner v9.5,
CMS under the direction of the Secretary
under either the Medicare or Medicaid
Medisoft Clinical v17 sp1
of the Department of Health and Human
provision. EPs must be office-based to be
and Lytec MD 2011
Services (HHS).
eligible, and they cannot col ect incentive
CC-1112-589589-1
payments from both provisions.
Medicaid Provision
Learn more at: mckesson.com
Medicare Provision
Beginning in 2011, office-based physicians
encounters wil be determined by the
who qualify under the Medicaid provision
Beginning in 2011, EPs who are
encounters attributable to Medicaid (or
could collect a sum total of $63,750 --
"meaningful users" of certified EHRs
"needy individuals" in an FQHC or RHC)
calculated as 85% of EHR net average
are entitled to receive up to $44,000
over any continuous 90-day period within
al owable cost not exceeding $25,000 in
of total Medicare incentive payments
the most recent calendar year prior to
the first year, fol owed by 85% of annual
over five years -- from 2011 to 2015.
the reporting year. Providers must begin
costs not exceeding $10,000 over the
The structure of the maximum
adopting, implementing or upgrading a
next five years as shown in Table 2.
incentives is shown in Table 1.
certified EHR system in the first year and
demonstrate "meaningful use" beginning
in the second year to receive the incentive
Table 1
Table 2
Maximum Incentive Payments - Medicaid
payments. The States wil administer the
Maximum Incentive Payments - Medicare
Adoption Year
Payment
Adoption Year
Medicaid program in their respective states.
Year
Now - 2011 2012 2013 2014
Payment
30% Provider
20% Pediatrician
Year
2011 - 2016
2011 - 2016
2011
$18K
-
-
-
Year 1
$21,250
$14,167
2012
$12K
$18K
-
-
Payment Reduction
Year 2
$8,500
$5,667
2013
$8K
$12K
$15K
-
For office-based physicians who do not
Year 3
$8,500
$5,667
2014
$4K
$8K
$12K
$12K
adopt EHR technology by 2015, Medicare
Year 4
$8,500
$5,667
2015
$2K
$4K
$8K
$8K
payments wil be reduced by:
Year 5
$8,500
$5,666
2016
-
$2K
$4K
$4K
Year 6
- 1% in 2015
Total
$44K
$44K
$39K
$24K
$8,500
$5,666
(up to 2021)
- 2% in 2016
Shortage
Area
$48.4K
$48.4K
$42.9K
$26.4K
Total
$63,750
$42,500
- 3% in 2017 and beyond
Office-based physicians can qualify
To be eligible under this provision, more
In 2018 and beyond, the HHS Secretary
for a one-time, "early adopter"
than 30% of their patient encounters
may increase one additional percent per
incentive of $3,000 if they qualify
must be attributable to Medicaid,
year (maximum of 5%) contingent upon the
for the program in 2011 or 2012.
or 20% for pediatricians. Patient
levels of overall EHR adoption in the market.

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Providers Must Meet all 15 Core Objectives
Table 3: Core Objectives
Meaningful Use Stage 1 Core Objectives
Eligible Professional (EP) Objective Measures
Use CPOE for medication orders directly entered by any licensed healthcare
More than 30% of unique patients with at least one medication in their medication
professional who can enter orders into the medical record per state, local and
list seen by the EP have at least one medication order entered using CPOE
professional guidelines
Implement drug-drug and drug-allergy interaction checks
The EP has enabled this functionality for the entire EHR reporting period
More than 40% of all permissible prescriptions written by the EP are transmitted
Generate and transmit permissible prescriptions electronically (eRx)
electronically using certified EHR technology
More than 50% of all unique patients seen by the EP have demographics recorded as
Record demographics: preferred language, gender, race, ethnicity, date of birth
structured data
More than 80% of all unique patients seen by the EP have at least one entry or an
Maintain an up-to-date problem list of current and active diagnoses
indication that no problems are known for the patient recorded as structured data
More than 80% of all unique patients seen by the EP have at least one entry (or an
Maintain active medication list
indication that the patient is not currently prescribed any medication) recorded as
structured data
More than 80% of all unique patients seen by the EP have at least one entry (or
Maintain active medication allergy list
an indication that the patient has no known medication allergies) recorded as
structured data
Record and chart changes in vital signs: Height, Weight, Blood pressure, Calculate
For more than 50% of al unique patients age 2 and over seen by the EP -- height,
and display BMI, Plot and display growth charts for children 2-20 years, including BMI
weight and blood pressure are recorded as structured data
More than 50% of all unique patients 13 years old or older seen by the EP have
Record smoking status for patients 13 years old or older
smoking status recorded as structured data
Implement one clinical decision support rule relevant to specialty or high clinical
Implement one clinical decision support rule
priority along with the ability to track compliance with that rule
For 2011, provide aggregate numerator, denominator, and exclusions through
attestation as discussed in the final rule
Report ambulatory quality measures to CMS or the States*
For 2012, electronically submit the clinical quality measures as discussed in the final rule
Provide patients with an electronic copy of their health information (including diagnostic
More than 50% of all patients of the EP requesting an electronic copy of their health
test results, problem list, medication lists, medication allergies), upon request
information are provided it within 3 business days
Clinical summaries provided to patients for more than 50% of all office visits within
Provide clinical summaries for patients for each office visit
3 business days
Capability to exchange key clinical information (for example, problem list, medication
Performed at least one test of certified EHR technology's capacity to electronically
list, medication allergies, diagnostic test results), among providers of care and patient
exchange key clinical information
authorized entities electronically
Protect electronic health information created or maintained by the certified EHR
Conduct or review a security risk analysis and implement security updates as necessary
technology through the implementation of appropriate technical capabilities
and correct identified security deficiencies as part of its risk management process
*EPs will be required to report on a total of six quality measures, three core measures plus three from a list of 38 Clinical Quality Measures (not designated by specialty)

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Providers Must Choose 5 of the 10 Menu Objectives
Table 4: Core Objectives
Meaningful Use Stage 1 Menu Objectives
Eligible Professional (EP) Objective Measures
The EP has enabled this functionality and has access to at least one internal or
Implement drug-formulary checks
external drug formulary for the entire EHR reporting period
More than 40% of all clinical lab tests results ordered by the EP or by an authorized
provider of the eligible hospital or CAH for patients admitted to its inpatient or emergency
Incorporate clinical lab-test results into certified EHR technology as structured data
department (POS 21 or 23) during the EHR reporting period whose results are either in
a positive/negative or numerical format are incorporated in certified EHR technology as
structured data
Generate lists of patients by specific conditions to use for quality improvement,
Generate at least one report listing patients of the EP with a specific condition
reduction of disparities, research or outreach
More than 20% of al unique patients 65 years or older or 5 years old or younger were
Send reminders to patients per patient preference for preventive/follow up care
sent an appropriate reminder during the EHR reporting period
More than 10% of all unique patients seen by the EP are provided timely (available
Provide patients with timely electronic access to their health information (including
to the patient within four business days of being updated in the certified EHR
lab results, problem list, medication lists, medication allergies) within four business
technology) electronic access to their health information subject to the EP's
days of the information being available to the EP
discretion to withhold certain information
Use certified EHR technology to identify patient-specific education resources and
More than 10% of all unique patients seen by the EP are provided patient-specific
provide those resources to the patient if appropriate
education resources
More than 80% of all unique patients seen by the EP have at least one entry (or
Maintain active medication allergy list
an indication that the patient has no known medication allergies) recorded as
structured data
The EP who receives a patient from another setting of care or provider of care or
The EP performs medication reconciliation for more than 50% of transitions of care in
believes an encounter is relevant should perform medication reconciliation
which the patient is transitioned into the care of the EP
The EP who transitions their patient to another setting of care or provider of care
The EP who transitions or refers their patient to another setting of care or provider of
or refers their patient to another provider of care should provide summary of care
care provides a summary of care record for more than 50% of transitions of care and
record for each transition of care or referral
referrals
Performed at least one test of certified EHR technology's capacity to submit
Capability to submit electronic data to immunization registries or immunization
electronic data to immunization registries and follow up submission if the test is
information systems and actual submission in accordance with applicable law
successful (unless none of the immunization registries to which the EP submits such
and practice
information have the capacity to receive the information electronically)
Performed at least one test of certified EHR technology's capacity to provide electronic
Capability to submit electronic syndromic surveillance data to public health agencies
syndromic surveillance data to public health agencies and follow-up submission if the
and actual submission in accordance with applicable law and practice
test is successful (unless none of the public health agencies to which an EP submits such
information have the capacity to receive the information electronically)

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Get Started Today to Receive Maximum Incentives
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including messages, incoming results
Independent Practices
and a daily patient schedule - in
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elements necessary to run a modern
documents and lab results.
enables physicians to spend less time
physician practice. Proven to work for
charting and more time doing what they
thousands of practices nationwide,
- Efficiently manages orders.
do best. The dynamic processing in Bright
Practice Partner, Medisoft Clinical and
Physicians are able to quickly see
Note Technology enables physicians to
Lytec MD have helped practices improve
overdue orders and track each order
use their preferred input style to capture
bottom line productivity and quality of
by patient, status and expected time
patient data in a single note, which is
care.
for a result to return. In addition, order
instantly synchronized across the entire
status is updated as results are entered.
patient chart.
Improve Productivity
Enhance Quality
With the incentives designed to encourage
- Easy-to-complete progress notes.
the adoption of EHRs - whether pay-for-
Our solutions feature a unique note-
- Supports care plan with built-in
performance, e-prescribing, or the Medicare
centric design that allows physicians
evidence-based content. Offers
and Medicaid incentives built into the
to complete the entire chart from the
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Economic Stimulus Plan - the decision
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transcription, digital pen, dictation
maintenance protocols based on age,
For more information about our
and web-based patient data entry.
sex, disease, medications or other
Solutions for Independent Practices, call
conditions specific to the patient.
800.770.7674 or visit www.mckesson.
- Delivers quick access to patient
Includes disease and medication
com/solutionsforindependentpractices.
information. A provider dashboard
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lets you view all critical information -
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