ARRA, The HITECH Act, and Meaningful Use- An Overview

May 7, 2012

Unless you’ve been living under a rock, you’ve probably heard quite a bit of buzz surrounding ARRA, the Health Information Technology for Economic and Clinical Health (HITECH) Act, and the very important term, “meaningful use.”  All of these things have a substantial impact on the health information technology world and it is especially important for electronic medical record users and system providers to have an understanding of how this legislation affects them.  While there is too much information out there to cover everything in one blog, let’s examine some fundamental aspects of each concept.

Signed into law by President Obama in 2009, the American Recovery and Reinvestment Act (ARRA) of 2009 was created in an effort to jumpstart and provide a stimulus for our economy.  The Act spans many areas, with sections devoted to modernizing the country’s infrastructure, the energy sector, expanding educational opportunities, tax relief, and improving affordable healthcare.  The measures of the act are worth a staggering $840 billion.  More information about ARRA can be found on the Recovery.Gov website.

With an Act so broad, health information technology professionals may be wondering, “what does this have to do with me?”  In short, the answer is plenty.  One part of the ARRA is the Health Information and Technology for Economic and Clinical Health (HITECH) Act, which was designed to modernize healthcare by promoting and expanding the adoption of health information technology, particularly the use of electronic medical records.  In addition, this billion dollar act includes initiatives for purchasing health IT systems across the country, health IT training, researching the impact of electronic health data exchange, and administrative efforts to create HIT privacy and security standards and regulations, among other things.  More information about this breakdown can be found here.

EHR Incentives and Meaningful Use
To achieve full (and eventually mandatory) participation of the adoption and use of EMR systems nationwide, the HITECH Act authorizes Medicare and Medicaid to provide incentive payments to those hospitals and clinicians who demonstrate “meaningful use” of electronic health records.  Participation in the bonus program was an option for eligible entities in 2011 and will continue until 2016.  However, beginning in 2015, penalties will begin to be issued by Medicare for those who fail to demonstrate meaningful use.  The eligibility criteria for hospitals and professionals ranges.  For Medicare incentives, eligible hospitals include subsection (d) hospitals that are paid under the Inpatient Prospective Payment Systems (IPPS), critical access hospitals, and Medicare advantage hospitals.  Eligible professionals include doctors of medicine or osteopathy, doctors of dental surgery or dental medicine, doctors of podiatry, doctors of optometry, and chiropractors.  For Medicaid incentives, acute care hospitals (including critical access hospitals and cancer hospitals) with at least 10% Medicaid patient volume and children’s hospitals are eligible.  Professionals who are eligible include physicians, nurse practitioners, certified nurse-midwives, dentists, and physician assistants who furnish services in a federally qualified health center or rural health clinic that is led by a physician assistant.  See more about eligibility on the CMS website.

It is important to remember that only those professionals and hospitals who demonstrate meaningful use of EMRs will receive a portion of the approximately $18 billion in incentive payments.  Meaningful use includes three main components:

-The use of certified EHR in a meaningful manner
-The use of electronic exchange of health information to improve quality of healthcare
-The use of certified EHR technology to submit clinical quality and other measures

The definition of meaningful use is somewhat broad, but the government attempts to make it more concrete by stating that meaningful use means providers “need to show they’re using certified EHR technology in ways that can be measured significantly in quality and in quantity.”  See the HRSA website for more about details surrounding meaningful use.  Meaningful use will be rolled out in three stages.  Stage one began in 2011 and we are currently in the midst of Stage two.  Each phase carries with it a new set of meaningful use requirements.

Certified EHR Technology
As mentioned, one of the components of meaningful use is that the EHR system clinicians and/or hospitals use be certified.  This “Final Rule” was created to ensure that the EMR systems that are being utilized are able to maintain data confidentiality, can work with other systems to share information, and are able to perform a specific set of functions.  This criteria supports the establishment and maintenance of standards and regulations within the HIT industry (  Top EMR software providers such as Epic, Nextgen, Allscripts, and McKesson all offer EHR certified solutions.

Overall, the implementation of the HITECH Act and meaningful use already has and will continue to transform the HIT industry.  Although these mandates create substantial work for HIT professionals and healthcare providers, the end goal is really person-focused.  EMR systems will ultimately offer improved healthcare by allowing for complete and accurate information, better access to information, and patient empowerment.

Excite Health Partners is pleased to offer EMR services to clients nationwide that focus on maintaining compliance with meaningful use standards and achieving optimal EHR incentive payments.  Contact us today at 877-803-5804 or visit us online for more information.