Published 4/1/2012
Thomas C. Barber, MD

Meaningful Use Incentives: The Money Is on the Table

Thomas C. Barber, MD

A recent report indicated that more than 800 orthopaedic surgeons have successfully implemented a certified electronic medical record (EMR) program and obtained Stage 1 meaningful use incentive payments from the federal government. With more than 22,000 orthopaedic surgeons in the AAOS who could potentially qualify for those payments, that’s disappointing, but not surprising.

If you have begun using an EMR, are you working to obtain Stage 1 incentive payments? If not, you should be!

Stage 1 qualification requirements
To qualify for the Stage 1 incentives, an orthopaedic surgeon must meet 15 core meaningful use measures and any 5 of 10 menu measures established by the Centers for Medicare & Medicaid Services (CMS). For example, among the Stage 1 core measures are requirements that an EMR system be able to record patient demographics, record and chart changes in a patient’s vital statistics, and maintain an up-to-date list of current problems and diagnoses. Menu objectives include the ability to generate patient lists by specific conditions, send patient reminder emails, and identify patient-specific education resources.

The AAOS has developed extensive information on implementing an EMR, as well as a Meaningful Use Toolkit. The toolkit dissects the requirements for each core and menu set measurement and provides tips to help you successfully apply for Stage 1 incentives. You can download the Meaningful Use Toolkit at www.aaos.org/emrtoolkit (Member login required)

Since the federal government began accepting applications for incentive payments, many of the requirements have been clarified. If you are working toward meeting Stage 1 meaningful use requirements, you can track the updates, clarifications, and implementation guidance online.

Steps to take now
Depending on your present EMR implementation status, you can take several actions now to complete the multidisciplinary effort needed to gain incentive payments. Consider taking the following actions:

  1. Download and review the free AAOS EMR Meaningful Use Toolkit.
  2. Review updates and clarifications at the CMS website.
  3. Determine your present status for each core and menu measurement.
  4. Define the steps or actions necessary to meet any remaining meaningful use core and menu requirements.
  5. Create a plan to address any gaps; work with your EMR vendor, if necessary.
  6. Conduct a meeting of your group to review each orthopaedic surgeon’s status. Set your goals; communicate the goals to all employees.
  7. Make a final determination of your 90-day reporting period. For Stage 1, each orthopaedic surgeon must demonstrate meaningful use for 90 consecutive days.
  8. Document your numerators and denominators for each measurement; learn how to make the calculations necessary for each item.
  9. Identify who will attest and when as part of the CMS/ONC application process.
  10. Complete the online attestation form and submit your data.

The money is there
What is the benefit? The incentive payment for meeting the Stage 1requirements is $18,000 per orthopaedic surgeon, with up to $44,000 per orthopaedic surgeon available over 5 years. There is still time to register and attest to receive incentive payments for 2012.

To obtain payments for meeting meaningful use criteria in 2012, you will need to demonstrate Stage 1 meaningful use for any 90 consecutive days during the calendar year. Stage 2 represents another chance for you to gain additional incentive payments.

Thomas C. Barber, MD, is chair of the AAOS EMR Project Team and a member of the Kaiser Oakland Department of Orthopaedic Surgery. He can be reached at thomas.c.barber@kp.org

Stage 2 regulations
CMS released proposed regulations for Stage 2 in late February. The proposed regulations included several changes, which are currently being analyzed by the Academy’s EMR Project Team. The project team will then submit its comments to CMS on behalf of the AAOS membership.

Some Stage 2 regulations have greater applicability to specialty physicians. The Stage 2 requirements are substantial and in addition to regulations for implementing 5010 claims filing and adopting the ICD–10 code set in the future.