Time is key for meaningful use, experts say

Doctors have a year to prepare for stage 2 requirements. The trouble is, CMS has yet to define them.

By — Posted April 28, 2011

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Christopher Tashjian, MD, a family physician at the River Falls (Wis.) Medical Clinic, was among the first physicians who signed on to the Centers for Medicare & Medicaid Services website on April 18 to enter data to show he had met the criteria to earn the first installment of Medicare meaningful use incentive pay.

Meeting the stage 1 requirements that earned Dr. Tashjian $18,000 took more than a year. Adopting the required technology was part of a larger strategy intended to improve patient care. The extra money for doing so was merely the impetus to speed that process along, he said.

Experts agree that earning incentive money shouldn't be the driving force behind adopting an electronic medical record system. Even though money is available for doing so, rushing to qualify for incentive pay could have unintended consequences for some doctors, said Mitch Morris, MD, principal in Deloitte Consulting's Life Sciences and Health Care practice.

From the time a physician qualifies for stage 1, he or she has one year to prepare for stage 2 requirements. The problem? CMS has not yet defined stage 2. The CMS office overseeing the incentive program has sent strong clues about what will be included in stage 2. But it's a guessing game what the rules will entail until they are finalized, Dr. Morris said.

Thus, there are advantages to waiting, he said. Doctors can wait until the end of next year to attest and still get the maximum amount available. By then, they should know the stage 2 requirements.

Doctors qualifying for Medicare meaningful use incentives over five years can earn up to $44,000. For Medicaid, they can receive as much as $63,750 over six years.

The Medicaid incentive program is administered by each state. As of April, 11 states had a program up and running.

Douglas Foreman, DO, a solo family physician in Warwick, R.I., said that if a physician has a qualified EMR system, there's no reason to wait to apply for incentives. He went through the process on April 18 after preparing for several months. He said he's not concerned about qualifying for stage 2 in a year and said physicians shouldn't wait.

Dr. Morris said he is not suggesting that physicians wait to implement an EMR.

"You should be doing that full steam ahead right now and you'll be all that much ready to attest and get all the funds you are potentially able to get," he said.

But having the extra year may be a huge help for some practices in the long-term, he said.

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