NOTES FROM THE JOURNEY
After debate, speculation, and anxiety throughout the industry, the first
physicians and hospitals have embarked on stage 1 of the meaningful use
program. So far… so good.
By Chris Dimick
THE FIRST PHYSICIANS and hospitals
have embarked on stage 1 of the meaningful use journey; it has been nine months
since the program launched. And while it
is a long voyage to the new world, the first
reports are positive. The winds have been
a little light, the seas have been rough in
patches, but the boats are launched and no
one appears to have sunk.
None of this was a certainty last summer
when the final rule was published. The rule
attempted to balance Congress’s intent to
drive dramatic improvements in care outcomes through health IT with the reality of
the industry’s readiness—both providers
and vendors—to take on dramatic change.
At the time, there was little agreement
over the balance it struck. Some in the
industry said the requirements were too
easy; others said they were too hard. Now
both groups appear to be right. Although
some challenges have been widely shared,
the difficulty providers had in achieving
the stage 1 requirements largely reflected
how much prior experience with health IT
Even the program’s relatively slow start
may not be surprising given how difficult it
was to predict how many providers would
join the program in its initial months.
However, what does seem certain at this
point is that the program is working. Some
providers are struggling more than others,
but overall it appears that everything is going according to plan.
The Results—So Far
Congress set aside funds for an EHR incentive program in the American Recovery
and Reinvestment Act of 2009. It left the
details up to the Centers for Medicare and
Medicaid Services (CMS), which issued a
final rule detailing the first stage of the program in July 2010.
Through the program, developed with
the Office of the National Coordinator for
Health IT (ONC), eligible providers were
offered incentive payments for meeting a
set of criteria for the meaningful use of certified health IT systems. On the Medicare
side of the program, physicians can earn
up to $44,000, with hospitals eligible for
millions based on specific criteria. A similar but separate program was created for
Medicaid, administered through the states.
CMS and ONC introduced the concept of
stages in an attempt to ease providers into
the program. With each stage, the objectives and their requirements will become
Registration for the program opened in
January 2011. Attestation began in April
2011, and some providers were in line to
receive the first incentive payments. Some,
but not most.
Speaking at an August 3 meeting of
ONC’s Health IT Policy Committee, CMS
representatives reported that 2,383 eligible
professionals and approximately 100 hospitals had attested for the Medicare program though July.