Meaningful Use is using certified electronic health record (EHR) technology to:
- Improve quality, safety, efficiency, and reduce health disparities
- Engage patients and family
- Improve care coordination, and population and public health
- Maintain privacy and security of patient health information
Meaningful Use sets specific objectives that eligible professionals (EPs) and hospitals must achieve to qualify for Centers for Medicare & Medicaid Services (CMS) Incentive Programs.
The American Recovery and Reinvestment Act of 2009 (ARRA) specifies three main components of Meaningful Use:
- The use of a certified electronic health record (EHR) in a meaningful manner, such as e-prescribing
- The use of certified EHR technology for electronic exchange of health information to improve quality of health care
- The use of certified EHR technology to submit clinical quality and other measures
Stages of Meaningful Use
The criteria for Meaningful Use was designed to be staged in three steps over the course of five years, beginning in 2011:
- Stage 1 sets the baseline for electronic data capture and information sharing
- Stage 2 intends to increase health information exchange between providers and promote patient engagement by giving patients secure online access to their health information.
- Stage 3 focuses on improved outcomes.
Meaningful Use Stage 1
Meaningful Use Stage 1 includes a core and menu set of objectives that are specific to eligible professionals (EPs) or eligible hospitals (EHs).
- EPs must meet 20 of 25 Meaningful Use Stage 1 objectives to qualify. There are 15 required core objectives. The remaining five objectives must be chosen from the list of 10 menu set objectives, one of which must be a public health objective
- EHs must meet 19 of 24 Meaningful Use objectives. There are 14 required core objectives. The remaining five objectives must be chosen from the list of 10 menu objectives
Clinical Quality Measures – Stage 1
To demonstrate Meaningful Use Stage 1 success, EPs, EHs and critical access hospitals (CAHs) are also required to report clinical quality measures.
- EPs must report on six clinical quality measures: three required core measures (substituting alternate core measures where necessary) and three additional measures (selected from a set of 38 clinical quality measures)
- EHs must report on all 15 of the designated EH clinical quality measures
Meaningful Use Stage 2
Meaningful Use Stage 2 includes a core and menu set of objectives that are specific to eligible professionals (EPs) or eligible hospitals (EHs).
- EPs must meet 17 core objectives and 3 menu objectives that they select from a total list of 6, or a total of 20 core objectives.
- EHs and CAHs must meet 16 core objectives and 3 menu objectives that they select from a total list of 6, or a total of 19 core objectives.
The Centers for Medicare & Medicaid Services (CMS) has provided comparison tables of the Stage 1 and Stage 2 core and menu objectives and measures, viewable by clicking on the links below:
Clinical Quality Measures – Stage 2
To demonstrate Meaningful Use Stage 2 success, EPs, EHs and CAHs are also required to report clinical quality measures.
- EPs must report on 9 of the 64 approved clinical quality measures
- Recommended core clinical quality measures include nine clinical quality measures for the adult population or nine clinical quality measures for the pediatric population. Also, NQF 0018 is strongly encouraged since controlling blood pressure is high priority goal in many national health initiatives.
- Selected clinical quality measures must cover at least three of the National Quality Strategy domains.
- EHs and CAHs must report on 16 of the 29 approved clinical quality measures
- Selected clinical quality measures must cover at least 3 of the National Quality Strategy domains.
Meaningful Use Checklists
The REC has developed Meaningful Use Checklists for EPs that details each core and menu set objective and associated measure at a quick glance.
Additionally, CMS has developed specification sheets for each Meaningful Use objective (scroll to bottom of page).
The Medicare and Medicaid EHR Incentive Programs provide EHR incentive payments to EPs and EHs as they adopt, implement, upgrade, or demonstrate Meaningful Use of certified EHR technology.
To determine eligibility for incentive payments under the Medicare and Medicaid programs, take this Eligibility Flow Chart created by CMS (tool is listed under “Payment and Eligibility for Professionals”) or view the chart below for specific credentials.
|Provider Type/License||Eligible for
|Eligible for Medicare Incentives|
|Medical Doctor (MD)||YES1,3||YES3|
|Doctor of Osteopathy (DO)||YES1,3||YES3|
|Nurse Practitioner (NP)||YES1,3||NO|
|Certified Nurse Midwife (CNM)||YES1,3||NO|
|Physician Assistant (PA)||YES5||NO|
Medicaid Incentive Information
- Maximum EHR incentive payments are $63,750 over six years (do not need to be consecutive)
- The first year EHR incentive payment is $21,250; $8,500 for next five years
- Must begin by 2016 to receive EHR incentive payments; last incentive payment year is 2021
- To qualify for an EHR incentive payment under the Medicaid EHR Incentive Program, an EP must meet one of the following criteria:
- Have a minimum 30% Medicaid patient volume
- Have a minimum 20% Medicaid patient volume, and is a pediatrician
- Practice predominantly in a FQHC or RHC and have a minimum 30% patient volume attributable to needy individuals.
For the Medicaid Incentive Program, states are responsible for attestation and payment.
- For details on the Arizona Medicaid EHR Incentive program, visit AHCCCS’ HIT webpage
CMS’ Frequently Asked Questions
CMS maintains up-to-date FAQs on its website, which provides details on many commonly asked questions.
Registration & Attestation
The Medicare EHR Incentive Program registration and attestation is handled at the federal level.
In order to receive your Medicare incentive payment, a provider must follow these three steps:
- Successfully register for the Medicare EHR Incentive Program
- Meet Meaningful Use criteria using certified EHR technology
- Successfully attest, using CMS’ web-based system, that you have met Meaningful Use criteria using certified EHR technology
Helpful Tools and Resources
- CMS’ Meaningful Use Attestation Calculator: Use prior to submitting your attestation to ensure successful demonstration of Meaningful Use.
- Attestation User Guide for Eligible Professionals
- Attestation User Guide for Eligible Hospitals
- Attestation Worksheet for Eligible Professionals
- Attestation Worksheet for Eligible Hospitals
The Medicaid EHR Incentive Program registration process begins at the federal level, but is then managed, including distribution of payments, at the state level. Details for registration and attestation for each program can be found below.
In order to receive a Medicaid incentive payment, a provider must follow these steps:
- Successfully register for the Medicaid EHR Incentive Program with CMS
- Successfully register for the Medicaid EHR Incentive Program with AHCCCS
- Attest to either adopting, implementing or upgrading (AIU) a certified EHR(Year 1) or meeting Meaningful Use using a certified EHR
AHCCCS’ Helpful Tools and Resources
- AHCCCS’ HIT webpage
- AHCCCS Updates & FAQs
- Arizona Medicaid Registration Toolkit for Eligible Professionals