Meaningful Use Impact: Diagnostic imaging's billion dollar question

Meaningful Use Impact: Diagnostic imaging's billion dollar question

February 08, 2011
Jonathon Dreyer
From the January/February issue of HealthCare Business News magazine
This report originally appeared in the February 2011 issue of DOTmed Business News

By Jonathon Dreyer

Although nearly everyone in the medical profession has heard of meaningful use, ambiguity about its impact remains amongst physicians and practice groups. Those with the most unanswered questions include professionals in medical specialties such as diagnostic imaging.

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Impact on radiology
While the Centers for Medicare and Medicaid Services and electronic health records incentive programs are clearly geared towards the primary care environment, diagnostic imaging, and many other medical specialties are eligible to participate under the program’s final rule. With more than 30,000 practicing radiologists in the United States, the total incentive opportunity for the diagnostic imaging community is well over $1 billion and penalties for non-compliance could cost the industry hundreds of millions of dollars over the next decade.

At its core, the program consists of three stages, each with a specific set of objectives and measures to be reported on over a prescribed timeframe. With each stage comes the requirement that providers must possess and “meaningfully use” a complete or combination of “certified” EHR technologies. While achieving widespread adoption of certified technology may be more challenging for specialists than general practitioners, there is an increasing number of resources available from specialty societies, industry publishers and online educational centers. In addition, software providers are beginning to offer certified solutions.

While the requirements may appear complex at first, physicians are only called to demonstrate meaningful use for 90 consecutive days in their first year of participation and provide attestation to CMS to receive payment – making deadlines more attainable. Once a health care provider has proven to be a “meaningful user,” and continues to report data after their first year, they will receive annual incentive payments until the program concludes in 2015.

Determining your eligibility and financial impact
The first step in approaching meaningful use is to determine your group’s eligibility and better understand the financial impact of the incentive programs on your individual practice. If you have several physicians with similar practice scenarios, you can aggregate your information and calculate the collective impact.

Let’s begin with eligibility. In order to determine your group’s eligibility you will need to understand what constitutes an eligible professional (EP). As defined by this program, if less than 90 percent of your services are performed in a hospital inpatient (CMS POS21) or emergency room (CMS POS23) care setting you are not considered hospital-based, and therefore, you are eligible to participate in the Medicare EHR Incentive Program as an EP. Based on the definition, approximately 90 percent of practicing radiologists will qualify for the Medicare program.

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