It’s no secret that Americans spend more money on healthcare than any other developed nation in the world. But does spending more money equate to higher quality healthcare? According to a recent publication by the Commonwealth Fund, it does not. In fact the report, Mirror, Mirror on the Wall, 2014 Update: How the U.S. Health Care System Compares Internationally, ranks the U.S. dead last, number 11 out of 11 countries studied, including Canada, France, and the United Kingdom. The criteria included the cost, safety, and quality of healthcare as well as access to care. While studies and opinions may vary on where we rank there is no debate that improvements need to be made to the healthcare system. One way the Affordable Care Act attempts improve the quality of healthcare is through “Meaningful Use.”
“Meaningful Use” (MU) is the term used for an incentive program encouraging the adoption and effective use of Electronic Health Records (EHR) systems. There are 3 stages of requirements spanning 6 years with objectives and measures that healthcare providers must meet in order to receive incentive payments from the Centers for Medicare and Medicaid Services (CMS).
Meaningful Use Basics (this only an abbreviated summary):
Stage 1 – 2011 – 2013
- Purchase and begin using a certified EHR system
- Input health information
- Use health information to track conditions & engage patients in care
- 13 required core objectives & 5 menu objectives
Stage 2 – 2014 – 2015
- Must meet Stage 1 requirements first
- Health information exchange requirements
- 60% of prescriptions & lab work ordered electronically
- 17 required core objectives & 3 menu objectives
Stage 3 – 2016
- Must meet Stage 1 & 2 requirements first
- Must prove improved health outcomes in quality, safety, and efficiency
- Patient access to health information for self-management
- Patient-centered Health Information Exchange (HIE)
- Core objectives are being developed
Providers can earn up to $43,000 in the Medicare program and up to $63,000 in the Medicaid program if they meet all the requirements over the entire plan. While the incentives are an attractive carrot, there is also a stick to keep providers motivated. In 2015 Medicare and Medicaid reimbursements will be reduced for those that do not meet the MU requirements.
For malpractice insurance companies the use of EHRs is viewed as both a risk management tool that can help reduce the threat of medical malpractice claims and an increased risk if there are errors when health information is captured and entered into an EHR system. Experts also expect an increased risk of cyber liability and HIPAA violations with the sharing of protected health information electronically. So while CMS intends to improve patient safety and the quality of care there are other risks that need to be considered.
Physicians would be wise to talk to their malpractice insurance brokers about insurance protection for these additional risks.
As providers try to keep up with the deadlines required to get their incentive payments for MU, many are asking an important question: Will Meaningful Use actually improve the quality of healthcare in the U.S.? The answer to that question remains to be seen and physicians and administrators have various opinions. Some believe it is just more government bureaucracy and a bunch of hoops to jump through to keep from getting penalized. Others see it as a necessary part of a larger plan that should lead to better patient care and access for all Americans.