Centers for medicare and medicaid services and meaningful use

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Learn more about navigating our updated article layout. The PMC legacy view will also be available for a limited time. Federal government websites often end in. The site is secure. A brief review of the Meaningful Use incentive program for eligible professionals is presented, highlighting the legislative history, criteria, and incentive payment plan of the program.

Clinical measures applicable to radiology practice and the barriers to implementation are discussed. Resources are also provided for further information on the requirements and enrollment of the program. To fulfill the requirements for Meaningful Use, eligible professionals must successfully complete the 3 main components of the program: 1 use certified EHR, 2 meet core and menu set objectives, and 3 report clinical quality measures.

These are described in detail in the following sections. Meaningful Use includes both a core set and a menu set of objectives that are specific to eligible professionals: 4. Each specification sheet includes detailed information for each objective, such as the following:.

Stage 2 expands on stage 1 criteria with a focus on ensuring that the Meaningful Use of EHR supports the aims and priorities of the National Quality Strategy. Specifically, it encourages the use of health information technology for continuous quality improvement at the point of care and the exchange of information in the most structured format possible.

Increasingly robust expectations for health information exchange in stages 2 and 3 will support the goal that information follows the patient. The same core and menu set objectives in stage 1 have been maintained for stage 2, and eligible professionals must successfully complete 20 objectives. However, eligible professionals must now meet 17 required core objectives or qualify for an exclusion and only 3 of 5 menu set objectives. To demonstrate Meaningful Use successfully, eligible professionals are also required to report Clinical Quality Measures.

Measuring the quality of patient care helps to drive improvement in health care. CQMs help identify areas that require improvement in care delivery, identify differences in care among various populations, and may improve care coordination among health care providers. Eligible professionals must report a total of 6 clinical quality measures: 3 required core measures substituting alternate core measures if these are not applicable and 3 additional measures selected from a set of 38 Clinical Quality Measures.

To qualify for incentive payments, Meaningful Use requirements must be met in 1 of the following programs:. There is an additional incentive for eligible professionals who provide services in a Health Professional Shortage Area. Eligible professionals must successfully demonstrate Meaningful Use of certified EHR technology every year that they participate in the program. They must successfully demonstrate Meaningful Use for subsequent participation as defined below.

Acquired and installed certified EHR technology. For example, professionals can show evidence of installation. Began using certified EHR technology.

For example, professionals can provide staff training or data entry of patient demographic information into the EHR. Expanded existing technology to meet certification requirements. For example, professionals can upgrade to certified EHR technology or add new functionality to meet the definition of certified EHR technology.

For the Medicaid EHR Incentive Program, providers follow a similar process by using the attestation system in their state. Table 1 demonstrates the incentive payment plan. Eligible professionals who participated in the program in or are able to receive the maximum payment for 5 years. Note: — — indicates that incentive payment is not applicable during that year. After , the incentive payments become payment reductions for those who do not demonstrate Meaningful Use.

Table 2 demonstrates the proposed payment reduction schedule starting in Most diagnostic radiologists qualify for the program under the category of eligible professionals.

Only radiologists who completely practice in hospital-based settings are not eligible. However, outpatient hospital settings are not considered hospital-based. Many radiologists in academic or hospital-based practices are now eligible for the program. The following are several challenges for radiologists to overcome to participate in Meaningful Use:. The ACR continues to advocate for radiologists by providing comments and suggestions to the CMS for better integration of radiologists in the Meaningful Use program.

There are many important reasons for radiologists to participate in Meaningful Use:. Patient privacy and provider efficiency are at the heart of the Meaningful Use incentive program.

These considerations are extremely important because badly designed, insecure, and improperly used EHRs and e-Prescribing systems pose serious data-breach, medication error, and fraud risks. These risks pose serious threats to patients and their PHI. However, when EHR and e-Prescribing systems are used securely and effectively, they can ease provider workflow problems, safeguard PHI, and improve patient outcomes. CMS outlines specific requirements for meeting Meaningful Use goals. These requirements are distributed into stages, so that healthcare facilities and individual providers have enough time to properly implement and integrate their new EHR and e-Prescribing measures.

Note that the Meaningful Use requirements for individual practitioners and hospitals differ significantly. For more information about these differences and the specific stages, requirements, and financial incentive programs for Meaningful Use, please see the CMS website. In order to leverage the maximum effectiveness from these technologies there are some important strategic decisions you can make:.

Why is Meaningful Use important?

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Skip directly to site content Skip directly to search. Meaningful Use of Electronic Health Records. Minus Related Pages. Stay Informed twitter govd. Links with this icon indicate that you are leaving the CDC website.

Linking to a non-federal website does not constitute an endorsement by CDC or any of its employees of the sponsors or the information and products presented on the website. You will be subject to the destination website's privacy policy when you follow the link. CDC is not responsible for Section compliance accessibility on other federal or private website. Cancel Continue. Churn can result in access barriers as well as additional administrative costs.

Estimates indicate that among full-benefit beneficiaries enrolled at any point in , About 4. Another analysis examining a cohort of children newly enrolled in Medicaid in July found that churn rates more than doubled following annual renewal, signaling that many eligible children lose coverage at renewal.

By halting disenrollment during the PHE, the continuous enrollment provision has also halted this churning among Medicaid enrollees. CMS requires states to develop operational plans for how they will approach the unwinding process.

These plans must describe how the state will prioritize renewals, how long the state plans to take to complete the renewals as well as the processes and strategies the state is considering or has adopted to reduce inappropriate coverage loss during the unwinding period. An Information Bulletin CIB posted on January 5 included timelines for states to submit a renewal redistribution plan. According to a KFF survey conducted in January , states were taking a variety of steps to prepare for the end of the continuous enrollment provision Figure 4.

Twenty-eight states indicated they had settled on plan for prioritizing renewals while 41 said they planning to take 12 months to complete all renewals the remaining 10 states said they planned to take less than 12 months to complete renewals or they had not yet decided on a timeframe.

A majority of states also indicated they were taking steps to update enrollee contact information and were planning to follow up with enrollees before terminating coverage. But the situation is evolving—as of December 2, , 35 states had posted their full plan or a summary of their plan publicly. How states approach the unwinding process will have implications for the ability of eligible individuals to retain coverage and those who are no longer eligible to transition to other coverage.

Outcomes will differ across states as they make different choices and face challenges balancing workforce capacity, fiscal pressures, and the volume of work. Some states suspended renewals as they implemented the continuous enrollment provision and made other COVID-related adjustments to operations. Completing renewals by checking electronic data sources to verify ongoing eligibility reduces the burden on enrollees to maintain coverage. However, in many states, the share of renewals completed on an ex parte basis is low.

As states return to routine operations when the continuous enrollment provision ends, there are opportunities to promote continuity of coverage among enrollees who remain eligible by increasing the share of renewals completed using ex parte processes and taking other steps to streamline renewal processes which will also tend to increase enrollment and spending.

CMS notes in recent guidance that states can increase the share of ex parte renewals they complete without having to follow up with the enrollee by expanding the data sources they use to verify ongoing eligibility. However, when states do need to follow up with enrollees to obtain additional information to confirm ongoing eligibility, they can facilitate receipt of that information by allowing enrollees to submit information by mail, in person, over the phone, and online.

While nearly all states accept information by mail and in person, slightly fewer provide options for individuals to submit information over the phone 39 states or through online accounts 41 states. A proposed rule , released on September 7, , seeks to streamline enrollment and renewal processes in the future by applying the same rules for MAGI and non-MAGI populations, including limiting renewals to once per year, prohibiting in-person interviews and requiring the use of prepopulated renewal forms.

As states prepare to complete redeterminations for all Medicaid enrollees once the continuous enrollment provision ends, many may face significant operational challenges related to staffing shortages and outdated systems. To reduce the administrative burden on states, CMS announced the availability of temporary waivers through Section e 14 A of the Social Security Act. These waivers will be available on a time-limited basis and will enable states to facilitate the renewal process for certain enrollees with the goal minimizing procedural terminations.

When the continuous enrollment provision ends and states resume redeterminations and disenrollments, certain individuals will be at increased risk of losing Medicaid coverage or experiencing a gap in coverage due to barriers completing the renewal process, even if they remain eligible for coverage. Enrollees who have moved may not receive important renewal and other notices, especially if they have not updated their contact information with the state Medicaid agency.

In , one in ten Medicaid enrollees moved in-state and while shares of Medicaid enrollees moving within a state has trended downward in recent years, those trends could have changed in and A recent analysis of churn rates among children found that while churn rates increased among children of all racial and ethnic groups, the increase was largest for Hispanic children, suggesting they face greater barriers to maintaining coverage.

Additionally, people with LEP and people with disabilities are more likely to encounter challenges due to language and other barriers accessing information in needed formats. A recent analysis of state Medicaid websites found that while a majority of states translate their online application landing page or PDF application into other languages, most only provide Spanish translations Figure 7.

That same analysis revealed that a majority of states provide general information about reasonable modifications and teletypewriter TTY numbers on or within one click of their homepage or online application landing page Figure 8 , but fewer states provide information on how to access applications in large print or Braille or how to access American Sign Language interpreters.

CMS guidance about the unwinding of the continuous enrollment provision stresses the importance of conducting outreach to enrollees to update contact information and provides strategies for partnering with other organizations to increase the likelihood that enrollee addresses and phone numbers are up to date.

CMS guidance also outlines specific steps states can take, including ensuring accessibility of forms and notices for people with LEP and people with disabilities and reviewing communications strategies to ensure accessibility of information. Ensuring accessibility of information, forms, and assistance will be key for preventing coverage losses and gaps among these individuals. As the end of the continuous enrollment provision approaches, states can collaborate with health plans and community organizations to conduct outreach to enrollees about the need to complete their annual renewal during the unwinding period.

CMS has issued specific guidance allowing states to permit MCOs to update enrollee contact information and facilitate continued enrollment; however, states can also work with community health centers, navigators and other assister programs, and community-based organizations to provide information to enrollees and assist them with updating contact information before the continuous enrollment period ends, completing the Medicaid renewal process, and transitioning to other coverage if they are no longer eligible.

According to a recent survey of Medicaid programs, 39 states indicated they plan to work with other state agencies and stakeholders, including 32 that plan to partner with MCOs, to assist non-MAGI Medicaid enrollees during the unwinding period. A similar survey conducted earlier in the year found that 25 states said they were planning to request MCOs to contact MAGI Medicaid enrollees to update mailing addresses.

States can take advantage of actions potential partners are already taking or planning to take to prepare for the unwinding. Similarly, a recent survey of Marketplace assister programs found that assister programs were planning a variety of outreach efforts, such as public education events and targeted outreach in low-income communities, to raise consumer awareness about the end of the continuous enrollment provision Figure 9.

Additionally, nearly six in ten assister programs said they had proactively reached out to their state to explore ways to help consumers; supported the state sharing contact information with them on individuals who need to renew their Medicaid coverage; and were planning to recontact Medicaid clients to update their contact information.

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Meaningful use policy requires significant resources to make sure that EHR databases and interfaces adhere to the standards. This is associated with increased costs that hospitals cannot reimburse. Since IT budgets in health care organizations are usually rather limited, authorities are forced to spend money on compliance assurance rather than on the development of functions and features that stakeholders need. As a result, meaningful use resulted in low flexibility and quality of EHR systems Slight et al.

Thus, CMS should focus on modifying the policy to make it more flexible without decreasing the quality of information security. Centers for Medicare and Medicaid Services. Slight, S. This paper was written and submitted to our database by a student to assist your with your own studies. You are free to use it to write your own assignment, however you must reference it properly.

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Meaningful Use of Electronic Health Records. Minus Related Pages. Stay Informed twitter govd. Links with this icon indicate that you are leaving the CDC website. Linking to a non-federal website does not constitute an endorsement by CDC or any of its employees of the sponsors or the information and products presented on the website.