CMS Provides Physicians Some Flexibility in EHR Incentive Qualification Process

CMS released the final rule for adopting a certified electronic health record (EHR) system. The rule includes CMS' definition of “meaningful use” of an EHR system and requirements for physician practices to qualify for up to $44,000 in Medicare incentive payments over the next four years, beginning in 2011.

The final rule does not take into consideration certain concerns raised by the medical community and members of Congress. Keeping the proposed rule fairly intact, CMS has instead moved forward with fairly rigorous standards that will be a challenge for specialty physicians. Physicians will have to report on:

A core set of 15 meaningful use objectives (e.g., recording patient demographics and recording/charting changes in vital signs)
An additional menu set of objectives at the discretion of the physician and other providers (the menu set consists of 10 objectives, but the provider only has to select five)
Three additional quality measures

Providers will no longer have to report on specialty-specific measures; instead, they must pick three quality measures from the general quality measure list.

In general, CMS has reduced the reporting thresholds and has postponed the majority of practice management-based functions to a yet-to-be-determined stage. CMS did agree that transmitting lab and diagnostic testing results through an EHR in Phase I would not be realistic and it is not a requirement, but results must be contained in the EHR.

The first phase of adopting an EHR system is outlined in the rule in detail. Meaningful-use requirements to qualify for the incentive payments will get more demanding as the phases progress. To qualify for the first-year (full) incentive, a physician must demonstrate meaningful use of a certified EHR system for at least 90 continuous days, starting in either 2011 or 2012.

All physician specialties can receive the EHR incentive money. However, it will be up to the physician to determine whether the initial requirements (first phase) are worth reporting on, due to the fact pjysicians may have to change practice patterns. CMS will define the additional stages of meaningful use through rulemaking over the next three years, reflecting technology advances. The Department of Health and Human Services HIT Standards Committee has already started to identify quality measures for the additional stages.

Last Revision: July 14, 2010