Since 2011, pediatricians have participated in their states’ Medicaid Electronic Health Record (EHR) Incentive Program (commonly known as meaningful use), which aimed to accelerate the adoption and use of EHRs in medical care.
Pediatricians with at least a 20% Medicaid patient volume were eligible to enroll in their state’s program and receive incentive payments for implementation of certified electronic health record technology (CEHRT) in their practice.
As part of the 2019 Physician Fee Schedule Final Rule, the Centers for Medicare & Medicaid Services (CMS) changed the name of the program to the Promoting Interoperability (PI) Program and introduced amendments to program requirements for 2019.
“Meaningful use has been great at achieving greater adoption of EHRs,” said Eli M. Lourie, M.D., M.B.I., FAMIA, FAAP, medical director for meaningful use at the Children’s Hospital of Philadelphia. “The new name of ‘Promoting Interoperability’ points to what really needs to happen across the country, which is true interoperability across systems for the benefit of patients.”
For calendar year 2019, eligible professionals (EPs) participating in their state’s PI program must use CEHRT certified to the 2015 edition requirements and report on any continuous 90-day period in the calendar year.
Stage 3 meaningful use prioritizes interoperability and the exchange of health information from clinician to clinician and from clinician to patient. The PI objectives and measures reflect these priorities:
Objective 1: Protect Patient Health Information
Objective 2: Electronic Prescribing
Objective 3: Clinical Decision Support
Objective 4: Computerized Provider Order Entry
Objective 5: Patient Electronic Access to Health Information
Objective 6: Coordination of Care through Patient Engagement
Objective 7: Health Information Exchange
Objective 8: Public Health and Clinical Data Registry Reporting
EPs must report on each of these objectives. Each objective has at least one measure an EP must meet to satisfy that objective. As in past years, EPs will attest as to whether they have met each measure within the objective.
“In stage 3, CMS bundled some measures into larger objectives. This might make it easier for pediatricians to be successful in meeting some objectives,” Dr Lourie said. “For example, in the Coordination of Care objective, there are three measures. EPs have to report on all three measures, but they only have to meet two measures to successfully complete the objective.”
CMS recommends that EPs hold onto their supporting documentation in paper or electronic format for six years after their attestation, in case their state Medicaid agency selects them for a post-payment review.
In addition to reporting on their use of CEHRT with the measures above, participants must report on a selection of electronic clinical quality measures (eCQMs). The reporting period for eCQMs is the calendar year. EPs may choose any six eCQMs related to their scope of practice, including at least one outcome measure or one high-priority measure. All of the available eCQMs align with the eCQMs available for eligible clinicians under 2019 Merit-based Incentive Payment System rules. Several of the eCQMs specific to pediatric care also are aligned with Healthcare Effectiveness Data and Information Set measures.
The Medicaid Promoting Interoperability Program will end in 2021. CMS has not yet issued rules or guidance as to if or how the use of health information technology (HIT) will be tied to payment or incentives for Medicaid providers after the PI program ends. The AAP, with leadership from the Child Health Informatics Center and the Council on Clinical Information Technology, will continue to work closely with CMS to ensure that pediatricians’ needs are considered in future HIT programs.
Copyright © 2019 American Academy of Pediatrics