Meaningful Use Electronic Health Record

Meaningful Use Overview

Meaningful Use (MU) of the Electronic Health Record (EHR) is a CMS initiative funded through the 2009 stimulus packages (HITECH, ARRA):

  • UNC Health Care qualifies for two incentive programs under MU: Eligible Hospitals (EH) & Eligible Professionals (EP)
  • Hospital based providers participate under Eligible Hospital (EH); other providers under Eligible Professional (EP)—at UNC Health Care there are approximately 750 EPs, primarily faculty physicians.
    (Links to: Eligible EP List, How to Determine Eligibility)
  • MU is separate from Health Care reform Acts (Affordable Care Act).

Three overall objectives of Meaningful Use

  • Use of a certified Electronic Health Record in a meaningful manner.
  • The ability to electronically exchange health information between providers.
  • The ability to automatically submit quality and other measures to government agencies.
Over the next 5 years UNC Health Care must:
  • Create a relationship-based care delivery model that provides high quality, efficient care, while achieving Meaningful Use of the Electronic Health Record (EHR), adapting to requirements of health care reform, obtaining pay for performance through the Physician Quality Reporting System (PQRS), preparing for health care consumerism (i.e., CMS’s ‘Physicians Compare’), and meeting National Patient Safety Goals/Core Measures, readmission reductions, and other targets.
  • Maximize the potential incentive from CMS by efficiently adopting and sustaining MU program components.
  • Avoid Medicare reimbursement penalties that will be imposed starting in 2015 if UNC Health Care fails to meet MU requirements. 
The combination of Meaningful Use and other national initiatives facilitates:
  • Delivering better care for patients.
  • Mending the fragmentation of our national health care system through systems that communicate with one another.
  • Transforming care delivery by leveraging evidence-based and population-based medicine.

Meaningful Use Components & Summary of Outpatient Clinical Impact

Eligible Professionals (EP)– Components and Impact on Outpatient Care

Program Components Clinical Impact
  • Medicare or Medicaid
  • Individual application
  • No partial credit (pass or fail only)
  • De-centralized, people intervention
  • Team effort to meet requirements:
    1. Identify ideal step in workflow to record data
    2. Modifications to user interfaces
    3. Added decision support
  • 15 mandatory core requirements
  • 5 of 10 menu requirements
  • 6 of 44 clinical quality measurements
  • Link to: EP MU Measures Summary

 During each encounter, UNC Health Care practices will:

  • Maintains med, allergy, and problem lists 
  • Records vital signs
  • Record smoking status
  • Respond to specialty specific prompts
  • Prescribe electronically (e-Rx) 
  • Provide patients with a summary of their visit

Things To Know About Meaningful Use

  • Meaningful Use (MU) is here to stay.
  • There are resources to help clinics, providers, and staff achieve MU.
  • UNC Health Care wants to and can be the leader among Academic Medical Centers in achieving MU.
  • Electronic Prescribing (e-Rx) is critical to success.
  • Accurate and up-to-date allergy lists are important.
  • Accurate and up-to-date problem lists are important.
  • There will be lots of MU activity now through July 2012.
  • UNC Health Care and eligible professionals have incentive to achieve MU

Meaningful Use Short Term Incentives and Long Term Penalties

Meaningful Use Incentives & Penalties
Snap Shot Of Incentive (5 Year Total)* Penalty (annual) Begining 2015*
Initially 1% Increased to 3%
Average Department $1,144,001 to $5,405,013 -$19,088 to -$85,194 -$95,440 to -$425,971
Average Eligible Professional (EP) $15,533 to $23,069 -$447 to - $6,498 -$2,236 to - $32,488

Based on revenue sharing model adopted by Physicians & Associates board on 3/28/2011, incentive and penalty ranges are average to maximum.

Eligibility Criteria

Eligible Professionals (EPs) can participate in either the Medicare or Medicaid incentive program, not both.  The Practice Quality & Innovation Team at UNC Health Care will select the optimal incentive program for EPs.

Eligibility is defined differently for each program. (Links to: Eligible EP ListHow to Determine Eligibility)  

  • Doctors of Medicine, Osteopathy, Optometry, and P odiatry
  • Provide less than 90% of Medicare services in the inpatient hospital or ED setting
  • Incentive based on a percentage of Medicare allowed charges
  • Physicians, NPs, and certified nurse midwives
  • Provide less than 90% of Medicaid services in the inpatient hospital or ED setting
  • At least 30% of patients are Medicaid patients 
  • Pediatricians are eligible for two-thirds of the incentive if 20%-30% of their patients are Medicaid patients.