Defining “Meaningful Use” in ARRA

For the past two days the National Committee on Vital and Health Statistics has been hearing testimony from the industry on what constitutes the “meaningful use” of health IT. Defining the term is no small matter, as it triggers $17 billion in Medicare and Medicaid incentives for the adoption of electronic health record systems. The incentives are part of the American Recovery and Reinvestment Act, or ARRA.

Under the provision, an eligible professional can receive $44,000 in incentives beginning in 2011. After several years, that carrot turns into a stick. In 2015 eligible providers who are not meaningful EHR users will begin receiving reduced reimbursement. Reductions will reach 97 percent of the fee schedule in 2017.

Speaking at Tuesday’s hearings, newly named national coordinator for health IT David Blumenthal noted that defining meaningful use would also affect EHR product certification, funding, and training.

AHIMA offered comments during the hearings, advising that the elements of meaningful use improve the coordination of care, promote health information exchange, and improve the capture and use of data for secondary purposes such as quality and public health reporting.

AHIMA also stressed that expectations of meaningful use should be applied uniformly across the entire industry and not vary by payer, patient, or provider. Providers must not be faced with providing and documenting care one way for ARRA incentives and other ways for other industry parties and partners.

Further, AHIMA urged that meaningful use requirements should be consistent with the considerable standards, certification, and information exchange work of recent years.

AHIMA also recommends that HHS establish a road map for meaningful use measures, with requirements increasing over time. This would allow users and vendors to anticipate the requirements over a period of several years. Initial criteria should reflect what can be achieved with current technology.

NCVHS chairman Harry Reynolds indicated that the committee’s report on the hearing would be posted on the NCVHS site in several weeks.

It is not known if there will be more public hearings on meaningful use before Health and Human Services issues a proposed regulation on the definition, which could come this fall.

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