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Certification and Meaningful Use – What is it?

Author: ; Published: Mar 17, 2013; Category: Certification; Tags: ; No Comments

UC Charting Solutions, Inc. has invested considerable effort assessing the needs of urgent care practices and patient charting. We have also spent considerable time studying the various government programs and initiatives designed to incent medical practices to adopt technology to improve their efficiency and the patient experience. We have become quite knowledgeable about these initiatives by virtue of the time and resources that we have invested over the past three years. As a result, we have insights, advice and solutions to offer that we believe are unique and well designed.

Let’s start with certification. ONC-ATCB Certification is set of federal standards established by the U.S. Department of Health and Human Services (HHS) under which financial incentives are made available to eligible medical providers (EP’s) who acquire and adopt “certified” technology solutions. Eligible certified technology solutions include features such as recording patient demographics, support for e-prescribing and order entry, which means having the ability to communicate with external systems through standard protocols like email, fax, etc. HHS has defined a total of 37 certification standards that are divided into three separate categories: Core, Menu Set, and Security Criteria. While incomplete “modular” certifications are available, in order for a vendor solution to receive “complete” certification the system must, through an examination conducted by an HHS-approved testing body, meet ALL 37 test conditions.

Meaningful Use was also established by HHS within the 2009 ARRA legislation but it applies solely to providers as opposed to practices. The program was designed to ensure that providers are, in fact, fully implementing their newly-purchased certified solutions in a timely fashion. It’s important to realize that Meaningful Use MUST be demonstrated in order for a provider to be eligible for ANY Medicare/Medicaid (ARRA) reimbursement dollars! Specifically, in order for a provider to successfully demonstrate Meaningful Use for 2012 they must use their certified solution for at least a 90 day period, meet or exceed the defined reporting thresholds for all (15) of the Core objectives, and meet 5 of the 10 Menu Set objectives.

Remember: In an ambulatory care setting (which includes Urgent Cares as defined by HHS) the process of demonstrating Meaningful Use is performed by providers and NOT by practices. Any reimbursement of HHS Meaningful Use dollars is also made by provider and not by practice, meaning that each provider within a practice can qualify for the maximum $44,000 reimbursement benefit!

The final step in demonstrating Meaningful Use is for the provider to sign a legal attestation of the results. The actual amount of reimbursement dollars potentially available to a provider is based on the year in which Meaningful Use is successfully demonstrated.

Meaningful Use Reimbursement Table

If you purchase a certified system AND attest to having successfully implemented that system in 2012 as defined by the Meaningful Use requirements, providers will be eligible for up to $44,000 in reimbursements per provider over 5 years. After 2012 the amount of the total reimbursement declines annually and completely goes away after 2014.

In practical terms, a certified and Meaningful Use-capable solution means that the system you buy not only has the potential to add value to the patient experience but does so in a manner consistent with the overall health information technology goals of HHS. Value seems to be defined as providing a documented record of each patient visit and a report at the end of each visit that is given to a patient that outlines the various diagnoses that the doctor has recommended and what the implications of following or not following the doctor’s advice might be. For medical practices that either choose not to or are unable to meet the Meaningful Use standard, they will eventually be penalized based on their Medicare and Medicaid reimbursements. In other words, government regulators cannot reach beyond Medicare and Medicaid practitioners to incent medical practices to adopt systems that meet the “meaningful use” standard.

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