Although more than 30,000 clinicians qualified to receive incentive payments in 2011, many physicians remain uncertain about the EHR Incentive Program and how to register for, report and attest to meaningful use, according to an article published May 14 in the Archives of Internal Medicine.
“2012 is the final year to receive maximum incentive payments, and many physicians still have questions regarding meaningful use objectives,” wrote Leah Marcotte, BA, from the Perelman School of Medicine at the University of Pennsylvania, Philadelphia, and colleagues.
The authors, who included Farzad Mostashari, MD, national coordinator for health IT, and David Blumenthal, former national coordinator for health IT, provided an overview of the Medicare and Medicaid EHR Incentive Program and a guide for physicians on how to achieve meaningful use of EHRs and receive incentive payments from Medicare and Medicaid.
The first step to receive payments is to register on the Centers for Medicare & Medicaid Services (CMS) website. First opened in January 2011, registration involves entering information such as National Provider Identifier number, provider type and business address. “In addition, clinicians can enter either the Medicare or Medicaid program in which they plan to participate and may submit the EHR certification number if available. Clinicians do not have to have already purchased a certified EHR to register for either program. Office managers or administrators may complete registration and subsequently document attestation for clinicians,” the authors wrote.
The final steps to grabbing incentive payments are reporting and attestation. However, because the requirements for attesting in the first payment year are different for the separate program, the authors lent a cheat sheet:
Medicare EHR Incentive Program
To receive incentive payments from the Medicare program, a clinician must attest to meeting all of the required objectives using certified EHR technology during the reporting period—90 days in the first payment year (Oct 3, 2012 deadline) and a full year beginning the second payment year. Attestation user guides and an attestation calculator available through the CMS website is available to clinicians to assess whether they have met all of the meaningful use objectives.
Medicaid EHR Incentive Program
While registration for every state's Medicaid incentive program occurs through the CMS registration site, each state must establish its own system for collecting attestations and rendering payments. Details regarding Medicaid attestation and incentives payments are state specific, and questions should be directed to individual states. Information on participating states may be found on the CMS website.
"In the first payment year, Medicaid programs offer physicians the option of receiving incentives for the adoption, implementation or upgrade of certified EHR technologies without the requirement to report on meaningful use objectives," the authors clarified. "Therefore, physicians who receive Medicaid incentives in the first participation year do not have to attest to Stage 1 meaningful use. However, to receive incentive payments after the first year, they will need to attest to meeting meaningful use objectives."
While incentive payments aim to alleviate the cost of implementing an EHR system, they do not reflect the cost for individual physicians or practices, which may be greater or less than meaningful use payments, the authors acknowledged.
“Meeting Stage 1 objectives is the initial step; however, it will likely be the most difficult one, especially for those physicians transitioning from paper medical charts,” the report concluded. “Subsequent stages of meaningful use will serve as a glide path from Stage 1 toward improved quality, efficiency, and patient-centeredness of care with effects extending far beyond the availability of incentive payments.”