Meaningful Use

Meaningful use is a set of specific objectives which eligible professionals and hospitals must achieve to qualify for the Centers for Medicare & Medicaid Services (CMS) incentive payments for electronic health records (EHRs).  CMS issues specific qualifications that if met will allow providers to show they have achieved “meaningful use.” Each defined stage of achievement has a different focus that typically builds upon what was achieved in the previous stage.  Failure to show “meaningful use” results in a reduction in Medicare reimbursement.  Penalties began in 2015.

Medicare and Medicaid eligible professionals, eligible hospitals, and critical access hospitals (CAHs) may participate in the EHR Incentive Program. Although most hospitals will be able to receive a payment from both programs, eligible professionals must choose between either the Medicare or Medicaid EHR Incentive Program.

Medicare EHR Incentive Program

Medicaid EHR Incentive Program

Run by CMS

Run by State Medicaid Agency

Maximum incentive amount is $44,000

Maximum incentive amount is $63,750

Payments over 5 consecutive years

Payments over 6 years, does not have to be consecutive

Payment adjustments will begin in 2015 for providers who are eligible but decide not to participate

No Medicaid payment adjustments

Providers must demonstrate meaningful use every year to receive incentive payments.

In the first year providers can receive an incentive payment for adopting, implementing, or upgrading EHR technology. Providers must demonstrate meaningful use in the remaining years to receive incentive payments.

The three stages involved span over five years with a specific focus for each stage, though CMS has delayed stages.

  • Stage 1 (2011-2012) Data Capture and Sharing
  • Stage 2 (2016) Advance Clinical Processes (originally scheduled for 2014)
  • Stage 3 (2017) Improved Outcomes (originally scheduled for 2016)

Final rules for Stages 1 -3 have been issued that set the standards that must be met to achieve meaningful use in that particular stage. While providers must meet a certain number of standards in each stage, they are allowed to select which ones from those listed. 

Penalties began in 2015, though some leniency has been offered by CMS in the form of “hardship exceptions.”  Providers may be able to receive an exception to penalties under certain circumstances. An application to CMS must be made to avoid a penalty.