South Florida Hospital News
Saturday October 31, 2020
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June 2010 - Volume 6 - Issue 12
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HITECH Act Earmarks $17 Billion for “Meaningful Use” of Electronic Records to Improve Health Care Quality and Delivery

Hospitals and physicians who demonstrate meaningful use of certified electronic health records may be eligible for a portion of $17 billion in incentive payments created under the Health Information Technology for Economic and Clinical Health Act (HITECH Act). To qualify for incentive payments, providers must meet three statutory criteria:
• Use of certified technology in a meaningful manner;
• Electronic exchange of health information to improve quality of health care; and
• Submission of information on clinical quality measures to the Secretary of the U.S. Department of Health and Human Services.
 
Specific guidance regarding these three criteria can be found through both the National Coordinator for Health Information Technology (ONC) and the Centers for Medicare and Medicaid Services (CMS). CMS’s definition for meaningful use is based on a three-stage implementation process designed to enable eligible providers to incrementally improve and expand the adoption and implementation of electronic health record (EHR) technology.
 
Stage 1, which begins in 2011, concentrates on electronically recording health information in a coded format. For example, the providers will need to use the electronic information to:
• Track key clinical conditions;
• Implement clinical decision support tools to assist in medication management; and
• Report specific clinical and public health data.
 
Stages 2 and 3, which will expand on these objectives and measures starting in 2013, will focus more on the interoperability of EHR technology and improvements in public health. CMS expects to provide guidance on Stages 2 and 3 in 2013. Thus, while the near-term requirements are clearly defined, those appearing in 2013 and 2015 remain uncertain.
 
Stage 1 includes 25 objectives for professionals and 23 for hospitals. Characteristically, the levels of minimum compliance are very high. For instance, providers must record the “smoking status” of 80% of all patients 13 and older. In addition to meeting the objectives of each stage, providers seeking incentive payments must also meet basic eligibility requirements.
 
In 2015, eligibility for the incentive program will end and no new applicants will be considered. At that time, incentive-based reform will become penalty-based reform. Hospitals will face two sets of penalties: one based on failing to report against the prescribed clinical quality metrics and another based on failing to meet the objectives of the meaningful use of EHRs.
 
Professionals failing to demonstrate meaningful use will face a more direct penalty: a reduction in their Medicare fee schedule by 1% per year. Additionally, if fewer than 75% of professionals nationwide have met the meaningful use criteria by 2015, their fee schedule may be further reduced by 1% each year.
 
Although health information technology holds great promise in improving care, the proposed meaningful use regulations seem to create uncertainty and may lead to inefficiencies and confusion. The uncertain regulatory scheme to be created in Stages 2 and 3 leaves hospitals and professionals in the dark, unable to create the long-term, detailed plans necessary to meet the demands which they will soon face. At the same time, the adoption of electronic health records is an important goal and the incentives created under the HITECH Act are designed to lead hospitals, doctors, nurses, and other caregivers in getting there. Whether the proposed regulations promulgated by CMS serve as a roadmap to this admirable goal, however, remains to be seen.
Tara Ravichandran practices health law in the Fort Lauderdale office of the statewide firm Broad and Cassel. She can be reached at travichandran@broadandcassel.com or (954) 764-7060.
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