Successfully demonstrating meaningful use and qualifying for the EHR incentive program requires the physician to report a number of meaningful use objectives to the Centers for Medicare & Medicaid Services (CMS). Twenty-five meaningful use objectives have been identified and divided into two groups—a core set and a menu set. The core set, which includes 15 meaningful use objectives, must be reported by the physician unless an exclusion exists. Exclusions are present for certain meaningful use objectives as defined in the final rule. These exclusions allow the physician to attest to the fact that a specific meaningful use objective is beyond his/her scope of practice.
The menu set consists of 10 additional meaningful use objectives. For stage 1 the physician may “defer” 5 of the 10 objectives; that is, the physician is only required to report 5 of the 10 menu objectives. CMS provides the physician with the latitude to select the 5 menu objectives they wish to report with one caveat: the 5 selected must include at least one of the public health objectives (reporting syndromic surveillance data to a public health agency or reporting immunization data to a regional immunization registry).
In the absence of exclusions, the successful physician is expected to report a total of 20 meaningful use objectives—the 15 core objectives and 5 from the menu set. A closer look at the meaningful use objectives reveals two distinct types of measures. One type establishes a threshold, or percentage, which must be met by the physician in order to achieve the objective and be a successful meaningful user. The percentage targets for the 16 measures with a threshold are displayed in the meaningful use objective table referenced above.
The second type of measure requires the physician to simply attest to the fact the objective was met. There are 5 core set measures and 4 menu set measures that fall into this category. To be a successful meaningful user, the physician must attest to the fact that he/she successfully met these objectives.
In summary, demonstrating meaningful use in 2011 and 2012 will require the nephrologist to meet 20 meaningful use objectives. These 20 objectives include 15 core objectives and 5 objectives the nephrologist selects from the menu set. Some of the objectives have threshold targets that must be cleared, while others require a simple “yes/no” answer. Conveying this information to CMS will occur via attestation in 2011, a process I will discuss in a future post. Also, check the blog in coming weeks to learn about the nuance of specific objectives as they relate to the practice of nephrology.
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