Meaningful Use … Your Practice, an EHR, and the EHR Incentive Program

Lea Chatham April 8th, 2013

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By Barbara Drury, FHIMSS

Did you know that The American Recovery and Reinvestment Act (ARRA) has nothing to do with the health of you, your patients, or your practice? Really!

ARRA was a job stimulus bill designed to stimulate the US economy. I remember the first time a physician colleague said that to me, and I had to agree. ARRA was a multi-pronged approach to get the economy going. However, Congress used the HITECH section of ARRA to outline how the acquisition of electronic tools and the meaningful use of these tools would create and enable data collection. During the time between President Bush’s 2004 State of the Union Address where he called for elimination of paper medical records within a decade and President Obama’s signing of ARRA in 2009, the natural adoption rate of EMRs was about 5% a year. In multiple studies by the CDC (“National Ambulatory Medical Care Survey, 2001-2012), the definition of a “full-featured EMR” versus a “basic system” showed mixed indicators of functions offered and/or used as well as differences in the rate of regional adoption.

ARRA has certainly changed everybody’s world since 2009: government, EHR vendors, and practices like yours. You now need to pay closer attention to patients’ compliance while monitoring and reporting on quality measures. However, despite this need for enhanced care management and tracking, for many practices, today’s EHR incentive program is still not enough to drive adoption. In part this is because for many the costs outweigh the benefits—for now.

For example, an OB/Gyn practice that does not have enough Medicare or Medicaid to qualify for the EHR Incentive may not see a reason to adopt an EHR. In addition, incentive payments are not given for mid-level providers except in a few situations. For many practices that have expanded their approach to team care to include PAs, this means incurring the cost of a provider license in the EHR for the mid-level without receiving an incentive for that provider. Unfortunately, whatever your reasons for not attesting to meaningful use, you will be eligible for the 1% 2015 Medicare penalty unless Congress quickly intervenes—and Congress is focused on other issues.

Even if you choose not to be a “meaningful user” as ARRA has defined it, , I do think that every practice needs to understand how they are affected by the Meaningful Use Program. I also believe that there are many other short and long-term benefits (practice data for contracting discussions, shift from quantity to quality payment programs, etc.) to implementing and using an EHR. Knowing all the ins and outs helps you to make informed decisions.

If you are interested in learning more, join me on Wednesday, April 24 for Everything You Need to Know about Meaningful Use Now. I’ll review the details of meaningful use and discuss some of what we’ve discovered about the EHR Incentive Program in the real world. Register Now.

Note: This Meaningful Use information is subject to change. For the latest updates, visit

About the Author:

Join Barbara Drury to find out what you need to know about meaningful use now

Barbara Drury, BA, FHIMSS, is President of Pricare Inc., an independent health information technology consulting firm founded in 1982. She frequently lectures and writes about the impact of office-based computer systems and electronic medical record systems for entities such as medical societies, healthcare organizations, and others. Ms. Drury is an appointee to the ONC’s Technical Expert Panel on Unintended Consequences of HIT Adoption. She has achieved Fellow Status with the Healthcare Information and Management Systems Society (HIMSS) and currently serves on the HIMSS Public Policy Committee. Ms. Drury is also a frequent speaker at the HIMSS Annual Conference and is the recipient of the December 2004 and the April 2009 Spirit of HIMSS award.

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