The HITECH ACT

The final package of the American Recovery and Reinvestment Act of 2009 (or ARRA), was signed into law by President Barack Obama on February 17, 2009. The HITECH Act refers to the projected $20 to $30 billion set aside to provide incentives and other support. for Health Information Technology (HIT) infrastructure and EMR adoption.

The ARRA HITECH Act specifies incentive payments for hospitals, clinicians, and other eligible healthcare professionals. The incentive programs require that the provider demonstrate “Meaningful Use” of a certified EMR product. The Office of the National Coordinator (ONC) for Healthcare IT is responsible for Standards and Certification; it defines the criteria by which EMR technology will be certified and whom will be accredited to certify such technology.

Stages of Meaningful Use

The HITECH Act creates a gradual approach to achieving increasingly rigorous Meaningful Use, with three distinct stages, expected to be updated every two years.

Stage I objectives and measures have been fully defined and are being implemented now.

Proposed rules for Stage II and Stage III criteria are targeted for completion by the end of 2011 and 2013 respectively with finalization during 2012 and 2014. Each stage will incorporate additional reporting and information exchange requirements and practices will have to adjust their workflows accordingly.

Financial incentives and eligibility for Meaningful Use

Financial incentives and eligibility for Meaningful Use Through its Centers for Medicare and Medicaid Services (CMS), the Department of Health and Human Services will provide financial incentives to Meaningful Users through either its Medicare or Medicaid programs. Unlike hospitals, eligible professionals (EPs) can only participate in one of these incentive programs, but not both. Medicaid eligible professionals with 30% of their volume attributable to Medicaid (20% for pediatricians) can receive up to $63,750 over a six-year period. Medicare incentive recipients can receive up to $44,000 over a five-year period. For Meaningful Users whose first payment year is 2011, Medicare incentive payments can be disbursed as early as May 2011 if all requirements are met (payments made in a lump sum). States will begin their Medicaid incentive programs on a rolling basis starting in 2011, subject to CMS approval of the state Medicaid HIT plans. Not all states had their Medicaid incentive programs operational by the start of 2011. Medicaid payments for the first year do not require meaningful use, just adoption, implementation or upgrade.

Program priorities, care goals and Meaningful Use objectives & measures

Meaningful use is structured around five health outcomes policy priorities as established by CMS: care coordination; engage patients and families; improve quality, safety, efficiency, and reduce health disparities; ensure privacy and security protections for personal health information; and improve population and public health. The diagram below highlights the five health outcomes policies and some of the functionalities that certified EHRs, such as possess to support Meaningful Use.

A full list of Stage 1 Meaningful Use objectives and measures can be viewed at: http://www.cms.gov/EHRIncentivePrograms/Downloads/MU_Stage1_ReqSummary.pdf.