Achieving Meaningful Use in Private Practice

Achieving Meaningful Usein Private PracticeA close examination of Stage 2 requirements

AbstractAs part of the American Recovery and Reinvestment Act of 2009, the Federal Governmentlaid the groundwork for the nationwide implementation of electronic health records (EHR)systems as a measure to improve patient care, reduce healthcare costs, and increase thelevel of overall public health. The Health Information Technology for Economic and ClinicalHealth (HITECH) program requires providers to demonstrate meaningful use (MU) of anelectronic health record system to be eligible for monetary incentives. The implementationof EHR and compliance with meaningful use regulations, should be a top priority for alleligible healthcare professionals (EPs).To demonstrate meaningful use, providers must attest through certified electronic healthrecord software, such as AdvancedMD, which allows providers to comply with federalmeaningful use regulations and thus qualify for monetary incentives.Understanding the Benefits of EHRThe American Recovery and Reinvestment Act of 2009 provides reimbursement incentives for eligible professionals throughthe Centers for Medicare and Medicaid Services over several years if they demonstrate meaningful use of an EHR. 1 Theimplementation of EHR systems is not intended solely to advance technology, but rather to improve patient care and populationhealth while reducing the overall cost of healthcare. The implementation of an EHR system is a move toward a moreefficient and complete healthcare system. Access to complete health histories allows both providers and patients to makebetter-informed decisions about treatment and health management.Complete and accurate information. Healthcareprofessionals may access complete and accurate patienthealth history immediately through EHR systems. Quick,reliable access to patient information and history allowsproviders to assess potential side effects and interactionsearly in treatment process before complications occur.Patient empowerment. Patients who have access todoctors’ orders, test results, and prescribed treatments aremore likely to follow medical advice. A patient access portalto view electronic records is a valuable step to empoweringpatients and improving population health. 2Better access to information. EHR retrieval is almostinstantaneous, which is especially important in emergencysituations. Eliminating the need for manual file retrievaland test result phone calls, EHRs increase the quality ofcare, as health information is readily available.AdvancedMD EHR features streamline meaningful use processes:• The ONC-ATCB certified EHRstatus is in compliance withgovernment MU guidelines.• Tools are specifically designed tomeet the core objectives of MU.• Software workflow is user-friendlyfor both healthcare providersand office staff.• The attestation process is more easilyaccomplished to achieve CMS monetaryincentives through MU reporting dashboards.• Freedom to practice remotely is facilitatedthrough iPad and other devices that utilizecloud software and cloud storage.• The all-in-one software suite approachmaximizes efficiency and increases revenue.1. Department of Health and Human Services Centers for Medicaid and Medicare, Federal Register, Vol. 75. No. 144. July 28, 20122. Electronic Records and Meaningful Use. www.healthhit.hhs.gov

Are eligible providers participating?Physicians began receiving monetary incentives throughthe Medicare and Medicaid EHR Incentive Programs inMay 2011. EHR early adopters are complying with newmeaningful use regulations, but the majority of eligibleproviders have not taken advantage of the federal incentiveprogram. Eligible providers may apply for federal incentivemonies through their certified medical software or with theirstate Medicaid program. AdvancedMD will streamline theincentive application process and meaningful use reportingfor your practice, allowing you to receive reimbursement asearly as possible.Meeting Deadlines forMeaningful Use IncentivesEPs must meet specific deadlines for implementationand attestation to qualify for Medicare and Medicaidincentives. With monetary incentive payouts up to $44,000over five years for Medicare EHR Incentive Program 4 andup to $63,750 through Medicaid EHR Incentive Program,meeting established deadlines is critical. Additionally,these incentives decrease each year compounding theimportance of applying early. EPs must adopt certifiedEHR technology, such as ADP AdvancedMD, and use itto achieve specific objectives. The underlying purposefor the three stages requires: “The collection of specific“For the first time, physicians and other healthprofessionals received more cash in MedicareMU bonuses than hospitals got in a single month.Medicare Payment Advisory Commission datashows that the vast majority of physicians haveyet to collect a dime of government incentivesfor their use of electronic health records.” 3quality measures: in particular, 15 inpatient and 6outpatient quality measures that will have to be collectedand reported to meet these criteria. The Stage 2 criteriafor quality measures will raise the bar further. Broadly,the goal is that Stage 2 will encourage providers to beginimproving process, whereas Stage 3 will result inimproved outcomes.” 5Stage 1: 2011-2012 Stage 2: 2014 Stage 3: 2015Electronically capturing health information in astandardized formatMore rigorous health information exchangeImproving quality, safety, and efficiency, leadingto improved health outcomesUsing that information to track key clinicalconditionsIncreased requirements for eRxand incorporating lab resultsDecision support for nationalhigh-priority conditionsCommunicating that informationfor care coordination processesElectronic transmission of patient caresummaries across multiple settingsPatient access to self-management toolsInitiating the reporting of clinical qualitymeasures and public health informationMore patient-controlled dataUsing information to engage patients and theirfamilies in their carehttp://www.healthit.gov/providers-professionals/how-attain-meaningful-use3. Dolan, Pamela Lewis. “More Physicians Awarded Meaningful Use Money”, American Medical News April 19, 2012.4. How to Attain Meaningful Use, www.healthit.gov5. Bates, David W. and Classen, David C. Finding Meaning in Meaningful Use, New England Journal of Medicine, 365, 855-858, September 1, 2011.

Understanding Stage 2 RequirementsProviders who have already met Stage 1 requirements can begin reporting compliance with Stage 2 meaningful useobjectives. Stage 2 focuses on many Stage 1 requirements, however, many optional objectives will become mandatory,including a special focus on electronic health record exchange with patients and other providers.Providers applying for Stage 2 incentives must meet 17Core Objectives and a minimum of 3 Menu ObjectivesStage 2 Meaningful Use Core Objectives 6 Stage 2 Menu Objectives 6Use computerized provider order entry (CPOE) formedication, laboratory and radiology ordersIncorporate clinical lab-test results intocertified EHR technology.Submit electronic syndromic surveillancedata to publichealth agencies.Generate and transmit permissibleprescriptions electronically.Generate lists of patients by specificcondition for quality improvement,reduction of disparities, research,or outreach.Record electronic notesin patient records.Record demographic information.Use clinically relevant information toidentify patients who should receivereminders for preventive/follow-up care.Imaging results accessible throughCEHRT.Record and chart changes in vital signs.Use certified EHR technology to identifypatient-specific education resources.Record patient family health history.Record smoking status for patients 13 years oldor older.Perform medication reconciliation.Identify and report cancer cases to a Statecancer registry.Use clinical decision support to improveperformance on high-priority health conditions.Provide summary of care record for eachtransition of care or referral.Identify and report specific cases to aspecialized registry (other than a cancerregistry).Provide patients the ability to view online,download and transmit their health information.Submit electronic data to immunizationregistries.Provide clinical summaries for patientsfor each office visit.Use secure electronic messaging tocommunicate with patients on relevanthealth information.Protect electronic health information created ormaintained by the certified EHR technology.6. Center for Medicare and Medicaid Services. (2012, August). Stage 2 Overview Tipsheet. www.cms.gov7. Scheps, Linda. The Low-Down on Future Meaningful Use Penalties, EMR & HIPPA Forum www.emrandhippa.com, November 28, 2011.

Avoiding Potential PenaltiesProviders who do not prove meaningfuluse of an EHR system may standto lose substantial compensationthrough Medicare payment reductions.Medicare providers who fail to provemeaningful use, even if they haveimplemented an EHR system, will bepenalized beginning January 2015.The percentage decreases by onepercent in 2015 and continues through2017 with an additional one percentdecrease in reimbursement amountsper year. (Possible penalties maycontinue through 2019, although thishas not been officially stipulated.)Although there are currently nopenalties associated with Medicaid,if Medicaid providers don’t complywith EHR requirements by the endof 2014, the revenue they receiveunder Medicare will also be subjectto the existing adjusted fee schedule. 7Payment adjustments have alreadybeen imposed for Medicare providerswho do not utilize ePrescribing—MUpenalties will compound revenue loss.Early adopters of EHR systems aremore likely to meet meaningfuluse deadlines and receive federalincentives. Many industry professionalsare concerned that late adopterswill be unable to obtain, implement,and manage their electronic recordsystem by the established deadlines.Providers risk being added to waitinglists or paying elevated prices asdeadlines approach and softwarecompanies try to meet increasingdemand. The best way to avoid feeadjustments and penalties is toimplement EHR software as early aspossible and ensure adequate timeand resources for meeting meaningfuluse requirements. ADP AdvancedMDmakes it easy to start the EHRprocess now. Practitioners whoinvest in the system early will avoidthe last-minute rush and headachebefore federal deadlines.AdvancedMD as a Powerful Tool in Meaningful UseThe Department of Health and Human Services outlines the criteria required to prove meaningful use of electronic healthrecords. The criteria are varied and include many stipulations, which can be cumbersome to navigate. ADP AdvancedMDEHR is a certified, cloud suite that meets Meaningful Use criteria while streamlining the organizational processes of yourpractice. Consider some features that comply with MU stipulations:• Patient Portal permits the patient to login remotely to see recommendations andtreatment plans, encouraging the patientto be more involved in their health.• Interoperability exchanges medicalinformation and records securelybetween providers and care facilities.• ePrescribing allows quick transmissionof prescriptions to pharmacies andmanagement of medications to reduce risk.• Patient encounter provides the electroniccharting feature of the EHR including aneNote library, integration with MicrosoftWord, and incorporation of charts.• Clinical quality measures enabletracking and reporting with ease.• HealthWatcher serves as areminder for follow-up visits andencourages preventive care.• Remote access allows a providerto access a patient’s recordsanywhere with Internet access.• Electronic record submission makes thefederal incentive application process easy.• Quality reporting feature captures qualitydata during routine visit documentation.

Achieving ResultsHealthcare providers are already experiencing the benefits of electronic health records. AdvancedMD allows practices tomeet and attest to MU criteria while providing tools to manage your day-to-day operations. The details of patient care anddocumentation are streamlined into one secure electronic health record, which maximizes efficient use of time and money.Claims reimbursement results in a 95% first-pass claims approval rate and boosting your long-term revenue. Additionally,as providers attest to MU compliance, they receive monetary bonuses up to $44,000 from the Medicare Incentive Programand $63,750 through Medicaid Incentive program.When your healthcare office implements AdvancedMD EHR and practice management tools, all aspects of billing, claims,coding, and EHR are unified into one powerful package.Visit advancedmd.comor call 800 825-0224© 2012 ADP, INC. ALL RIGHTS RESERVED. THE ADP LOGO AND ADP LETTERS ARE REGISTERED TRADEMARKS OF ADP, INC.ADVANCEDMD IS A REGISTERED TRADEMARK OF ADP ADVANCEDMD SOFTWARE, INC.