Hospitals can capture nearly $50,000 for every doctor they employ through the meaningful use (MU) program.The Office of the National Coordinator (ONC) has designed the meaningful use program to offset the costs of EMR adoption by hospitals. The program provides hospitals that are “meaningfully using” their EMRs and proving it with a substantial cash infusion. For every eligible provider (doctor, NP, PA) employed by the hospital, CMS will pay that hospital $44,000 over a five-year period.
In order to access the money, hospitals have to meet specific criteria. Community-based organizations (CBOs) - like area agencies on aging - have the potential to significantly help hospitals meet these MU requirements. In doing so, CBOs can gain significant leverage over hospitals and potentially justify hospitals investing in CBOs to meet MU requirements.
MU requirements come in three stages. The current stage for most hospitals is stage 2 (MU2). The following three MU2 requirements can be directly met by hospitals referring patients to CBOs for services. For CBOs that are offering care transition services to hospitals, there is a double incentive for hospitals to refer: 1) decrease readmissions through the care transition program, and 2) meet MU2 requirements. That means CBOs can help hospitals not only decrease their 30-day readmission penalties, but also capture thousands and maybe millions of dollars available to them through the MU program.
The following three of 16 MU2 criteria can be directly met by a community-based care transitions program that is using mHealth technology:
Criteria #6: Provide patients with the ability to view online, download and transmit their health information about a hospital admission via a patient portal.
Criteria #10: Use clinically relevant information to identify patient-specific education resources and provide those resources to the patient.
Criteria #12: The hospital that transitions a patient to another setting of care should provide a summary care record for each transition of care or referral.
CBOs can also meet another MU2 criteria unique to provider groups: Use clinically relevant information to identify patients who should receive reminders for preventive/follow-up care and send these patients the reminders, per patient preference.
The implications here are substantial. If a typical community hospital employs 200 eligible providers, then the hospital is eligible to receive $44,000 X 200 providers = $8,800,000 over five years. If a CBO helps the hospital meet three of 16 MU2 requirements over a one-year period, then the CBO is directly enabling the hospital to receive three of 16 criteria x one of five years x $8,800,000 = $330,000 in a year.
With $330,000 of value being provided by the CBO to the hospital, why aren’t CBOs being paid for providing that value?
Andrey Ostrovsky, MD, is the co-founder and chief executive officer of Care At Hand, Inc., and a pediatric resident at Children's Hospital Boston and Boston Medical Center.