Federal Government Incentives for Electronic Health Records (EHRs) and Medical Records
The federal government has established standards for electronic health records called Meaningful Use. These standards were designed to help healthcare organizations improve their ability to provide better quality care by making sure they’re using EHR technology effectively.
To help healthcare providers meet the requirements of the federal government’s Meaningful Use program, CMS has developed several incentives aimed at encouraging them to adopt, implement and update electronic health records systems.
Despite the fact that the Meaningful Use program in the U.S. was successful in bringing about electronic health records (EHRs), providers were dissatisfied because they had to meet a myriad of requirements to show meaningful use. CMS recently revamped and rebranded the Medicare and Medicaid Promotes Interoperability Program program to promote interoperability, which effectively rendered the term “meaningful use” obsolete.
Meaningful use stages
The Meaningful Use Stage 1 program was designed to measure the meaningfulness of Certified Electronic Health Records Technology (CEHRT) in three stages:
- The primary objective of stage one was to encourage the use by hospitals of certified Electronic Health Records (EHR) technology. This phase established the standards for capturing clinical data and providing patients with electronic access to their own health records.
- To further expand on the first criterion, the second stage encouraged the use of CCHRT to improve care coordination by raising the bar on compliance and adding more clinical decision-support capabilities, care coordination requirements, patient engagement rules, and more.
- The objectives of Stage III were to establish protected health information, electronic prescribing, clinical decision support, Computerized Provider Order Entry (CPOE), patient-provider access via secure messaging, coordination of care through patient engagement, Health Information Exchange (HIE) for improved quality of care, Clinical Data Registries (CDRs) for improved quality of healthcare delivery, and Case Reporting (CR).
It was easier for providers to implement the program because they could break it up into smaller steps. However, hospitals were not happy with the program.
Meaningful use was built upon five main goals, according to the Centers For Disease Control And Prevention (CDC). These were:
- Quality, safety, and efficiency to reduce health disparities
- Increase patient engagement
- Improve care coordination
- Increase the size of the population and improve public health
- Make sure that there is adequate privacy and security protection when collecting personal health information
CMS and ONC developed meaningful use criteria to help hospitals meet their goals. By doing so, they helped compel hospitals to adopt certified electronic health records technology (CEHRT). If CMS determines that a hospital has demonstrated success in meeting its meaningful use objectives, the parties will receive federal funds.
Meaningful Use was technically voluntary, but non-compliance with meaningful usage resulted in reimbursement-related fines.
History of meaningful use
The Health Information Technology For Economic And Clinical Health (HITECH) Act of 2009 promotes the adoption of Meaningful Use. According to the U S Department of Health and Human Services, subtitle D of the HITECH act addresses the privacy and security issues associated with the electronic transmission of health information by reinforcing the HHS regulations’ civil and criminal enforcement.
To meet the requirements of Stage 1 Meaningful Use, organizations had to achieve Stage 1 by December 31, 2013. However, during this time period, the Centers for Medicare and Medicaid Services (CMS) was establishing deadlines for Stages 2 and 3. At times, these deadlines were extended. As part of the creation of the Medicare and Medicaid EHR Incentive Programs, the Center for Medicare and Medicaid Innovation (CMMI) was created to encourage the adoption of certified electronic health record technology (CEHRT).
CMS has renamed its EHR incentive programs to promote interoperability, flexibility, patient access to health information, and quality improvement.
CMS has announced that beginning in 2019, hospitals participating in Medicare and Medicaid Interoperability Programs must use the 2015 CEHRT edition of CCHIT’s certification criteria for certified EMR systems. CMS has also finalized changes to measurement standards, including the elimination of some measurement standards that do not emphasize interoperability and eHealth information exchange.
EHRs used to qualify for Medicare incentive payments have been a complicated and circuitous path.
CMS created the EMR Incentive Program in 2011 (Known as “meaningful use” in 2012). It changed its name to Promoting Interoperability programs in 2018. This was significant because it shifted from the original requirement for Meaningful Use to CMS’ new phase of EMR measurement with an increased focus on interoperability and patient access.