September 4, 2013

Jason Aquilante

Why Start MU Now?

Before I try to convince you that you need to take a serious look at purchasing a certified Meaningful Use solution…let me first start by saying that this is not a sales pitch.
Now that we got that out of the way, let’s start discussing some valid arguments around why providers should begin MU now.

  1. I have seen many providers who believe they are immune to MU penalties because they participate in the Medicaid program. Not so fast: the penalty will affect ANYONE that bills for Medicare patients. If you are a provider who plans to participate in the Medicaid program, but you do bill Medicare for any patients, you need to purchase a Meaningful Use solution before January 1, 2014 or you will be penalized by CMS. MU penalties take shape in 2015, but those penalties are based on attesting for MU by October 1, 2014. Some may be wondering why they have to have an MU solution in place before the end of 2013. Great question. The key to avoiding penalties is that the provider must be a meaningful user of a certified solution to avoid the penalty. The only way to achieve this is by actually using the system. For those familiar with MU and the Medicaid program, you know that your first year of MU requires that you simply need to Adopt, Implement, or Upgrade (AIU) an EHR. The second year is when you are required to attest for a 90-day period. Translation: buy in 2013 and attest for a 90 day period in 2014 (before October 1) and you will avoid the penalty. If you buy on January 1, 2014, you won’t be able to start your 90-day period until 2015, thus making you susceptible to the penalty.
  2. If you are a provider who plans to participate in the Medicare program, you really have two very good reasons to begin participation. First, if you plan to participate in Meaningful Use, you will want to capitalize on as many incentive dollars as possible. If you first attest for a 90-day reporting period in 2013, you could receive up to $39,000 in incentive payments per provider. However, if you wait to first attest for a reporting period in 2014, your maximum incentive collected would be $24,000 per provider. Please keep in mind that you won’t get these payments in one year, these incentives are broken out over several years. The second reason is that you will benefit from two 90-day reporting periods rather than just one. CMS has stated that all reporting periods in 2014 will be a full calendar quarter (for Medicare EPs) regardless of how many years you have participated in MU. So, if you begin your first year of MU in 2013, you will have a 90-day period in 2013 and a (roughly) 90-day period in 2014 for MU compliance. If you begin in 2014, you will have a (roughly) 90-day reporting period in 2014 and a full-year reporting period in 2015. My suggestion is to take advantage of the extra, shortened reporting period.
  3. My last point of emphasis on why you should begin MU in 2013 is that the MU program is set to expire in 2021, and I truly believe that the MU funds set aside by the government will be drained by that time. I do not see any indication that the penalties will discontinue for non-participation, but the incentives will expire in 2021. As of June 30, 2013, CMS reports that roughly $15 billion has been paid-out to providers and hospitals for their successful participation in Meaningful Use. I haven’t seen a definitive number for the total amount of money that was allocated for the MU program, but an October 2012 Government Health IT publication pegs the dollar amount dedicated to Meaningful Use at $27 billion. Now, simple math tells us that over 50% of the available funds have already been distributed, and we are only 25% into the 10-year program. I realize that the MU payments are front loaded, with the majority of incentives paid out during a provider’s early years of participation. But, a May 22, 2013, CMS press release said that, more than 50% of providers and 80% of hospitals have established EHRs. So, there are still (roughly) 40-50% of providers and 20% of hospitals that are eligible to collect their top-heavy incentive payments. Providers need to think about whether it’s wise to wait and depend upon the remaining $12B being around a few years down the road. Although I think we are well past the point of seeing the government overturn MU (which was a point of speculation in the past), I do think it will be a hard sell to add billions more to the MU piggy bank if the funds do run dry.

There will always be providers or hospitals that will refuse to participate in any government program, penalties or no penalties. But, for those teetering as to when to join, take a good hard look at the arguments posed above. If you are being muscled into a program, you may as well make the most of it.
If you’d like to learn more about Meaningful Use, please download our whitepaper: A Guide to Understanding and Qualifying for Meaningful Use Incentives.

About Jason Aquilante