Meaningful Use

Meaningful Use and Your Practice

Read the FAQ

Get the answers to your MU questions with our FAQ.

On October 6, 2015, the Department of Health and Human Services and the Centers for Medicare and Medicaid Services (CMS) issued a final rule covering meaningful use (MU) changes for 2015 through 2017(www.federalregister.gov). The rule affected the 2015 reporting year and eliminated Stage 1, incorporating it into the new Modified Stage 2, and finalized the requirements for Stage 3. Criteria to meet MU Modified Stage 2 thresholds were made easier to meet under the proposal, but penalties for MU were slated to increase until the year when MU, the Physician Quality Reporting System, and the Electronic Prescribing Incentive Programs are rolled into the new Merit-based Incentive Payment System (MIPS).

Modifications to individual objectives and measures for Stage 2 of MU include:

  • A change of the threshold for patient electronic access measure that requires patients to view, download, or transmit their health information from “5 percent” of patients to:
    • “Equal to or greater than 1” patient for 2015 and 2016
    • 5 percent of patients for 2017
    • Note: The measure to have 50 percent of patients to have available access is still in place
  • A change of the threshold for secure electronic messaging from being a percentage-based measure, to:
    • “Equal to or greater than 1” patient for 2015 and 2016
    • 5 percent of patients for 2017
  • Consolidation of all public health reporting objectives into one objective with measure options following the structure of the Stage 3 public health reporting objective.
  • Elimination of the distinction between menu and core measures. Retained objectives and measures would be required for the program.
  • Reporting on nine objectives and one consolidated public health reporting objective for both Stage 1 and Stage 2.

See all the objectives and measures from the October 2015 final rule »

Download EHR Incentive Programs for Eligible Professionals: What You Need to Know for 2016 Tipsheet »**(www.cms.gov)

**CMS issued a proposed rule(www.gpo.gov) in the July 14, 2016 Federal Register that would, among several other policy changes, make changes to the Medicare and Medicaid Electronic Health Record (EHR) Incentive Programs. The final rule is expected in the fall of 2016, which will clarify whether the following proposed change will be adopted:

"A 90-day EHR reporting period in 2016 for all eligible professionals (EP’s), which is any continuous 90-day period between January 1, 2016 and December 31, 2016."

Stage 3

The future of Stage 3 is uncertain and clarity is expected within the final rule in the fall of 2016.

Year-by-Year Breakdown

In order to best explain the proposed MU changes, here is a year-by-year breakdown of the rule proposals.

2015

There are two potential cohorts, depending on the first year the physician attested to MU.

For those who first attested from 2011 through 2013, your reporting period will be 90 days, and you will have to meet the Modified Stage 2 criteria. You are not allowed to use any of the alternative measures or exclusions.

For those who first attested from 2014 through 2015, your reporting period will also be 90 days, and you will also have to meet the Modified Stage 2 criteria. However, since you were scheduled to attest to Stage 1, you can use any of the alternative measures or exclusions.

2016

Everyone is required to meet the Modified Stage 2 criteria.
View a complete list of the 2016 program requirements from CMS »(www.cms.gov)

The EHR Registration and Attestation system will automatically identify those who are eligible for alternate exclusions. EPs eligible for alternate exclusions may choose to use alternate exclusions during attestation, but are not required to use them. Many of the alternate exclusions that were available in 2015 are not applicable in 2016. Two objective offer alternate exclusions in 2016(www.cms.gov):

2017 and Beyond

In 2017, the EHR Incentive Program is transitioning from Meaningful Use to the Advancing Care Information (ACI) component of the Merit-based Incentive Payment System (MIPS). Details are expected within the final rule in the fall of 2016.

Redundant, Duplicative, or Topped out Objectives and Measures

CMS has identified the following list of objectives and measures from MU Stage 1 and Stage 2 as redundant, duplicative, or topped out. Many of these objectives and measures may be valuable, and CMS encourages their continued use, but under the proposal, they will not require reporting.

Objectives and Measures for Eligible Professionals

Objectives and Measures for Eligible Professionals

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Computerized Provider Order Entry (CPOE) (beginning in 2017 per current proposed rule)

Objectives and Measures for Eligible Professionals

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Clinical Decision Support (CDS) (beginning in 2017 per current proposed rule)

Objectives and Measures for Eligible Professionals

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Record Demographics

Objectives and Measures for Eligible Professionals

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Record Vital Signs

Objectives and Measures for Eligible Professionals

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Record Smoking Status

Objectives and Measures for Eligible Professionals

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Clinical Summaries

Objectives and Measures for Eligible Professionals

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Structured Lab Results

Objectives and Measures for Eligible Professionals

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Patient List

Objectives and Measures for Eligible Professionals

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Patient Reminders

Objectives and Measures for Eligible Professionals

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Summary of Care (Measure 1 – Any Method; Measure 3 – Test)

Objectives and Measures for Eligible Professionals

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Electronic Notes

Objectives and Measures for Eligible Professionals

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Imaging Results

Objectives and Measures for Eligible Professionals

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Family Health History

Background

CMS's EHR Medicare and Medicaid Incentive Program provides incentive payments to expedite and encourage EPs, eligible hospitals (EHs), and critical access hospitals (CAHs) to adopt, implement, or upgrade certified-EHR technology, and to demonstrate the "meaningful use" of certified-EHR technology.

EPs, EHs, and CAHs must demonstrate MU by meeting certain requirements. Those who fail to meet those requirements under the program will forfeit their incentive payment. However, starting in 2015, providers failing to meet criteria under the program face downward payment adjustments.

The program was designed to consist of three stages of MU, with each stage consisting of increasing requirements. Providers advance through each stage.

Stage 1 was intended to establish requirements for the electronic capture of clinical data, including providing patients with electronic copies of their health information.

Stage 2 focused on the data captured in Stage 1 being exchanged among health care providers and patients in order to improve coordination of care. Stage 2 also implemented a set of clinical quality measures (CQMs) for all providers to report in 2014, regardless of which stage they were in.

Stage 3 focuses on the advanced use of EHR technology to promote improved patient outcomes by increasing interoperability of health data and sharing among providers.

References

Acumen Physician Solutions. Meaningful use in 2015-2017: Only 9 objectives? http://www.acumenmd.com/blog/meaningful-use-in-2015-2017-only-9-objectives/(www.acumenmd.com). Accessed May 29, 2015.

Centers for Medicare and Medicaid Services. Federal register: Medicare and Medicaid programs; electronic health record incentive program—modifications to meaningful use in 2015 through 2017; proposed rule. Department of Health and Human Services. 2015. DHHS80(72)42CFR(495). http://www.cms.gov/Regulations-and-Guidance/Legislation/EHRIncentivePrograms/Downloads/Modifications_MU_Rule.pdf(www.cms.gov). Accessed May 29, 2015.

Healthcare Information and Management Systems Society (HIMSS). New CMS NPRM offers significant meaningful use flexibility in 2015 through 2017 program years. http://www.himss.org/News/NewsDetail.aspx?ItemNumber=41714(www.himss.org). Accessed May 26, 2015.

Hinshaw Health Law Alert. CMS issues proposed Stage 3 meaningful use standards. http://www.hinshawlaw.com/assets/htmldocuments/Articles/HealthLawAlert_LongBranded_04062015.pdf(www.hinshawlaw.com). Accessed May 27, 2015.

Last update: September 16, 2016