EHR Meaningful Use (MU) Overview

The Medicaid EHR Incentive Program provides a financial incentive for the "meaningful use" of certified EHR technology to achieve health and efficiency goals. By putting into action and meaningfully using an EHR system, providers will reap benefits beyond financial incentives such as: reduction in errors, greater accessibility of records and data, reminders and alerts, clinical decision support, and e-prescribing/refill automation.


MU and utilization of certified EHR technology will:

  • Improve quality, safety, efficiency and reduce health disparities.
  • Improve care coordination.
  • Improve population and public health.
  • Engage patients and families in their healthcare.
  • Ensure adequate privacy and security protections for personal health information.

The American Recovery and Reinvestment Act of 2009 describes three main components of MU:

  1. The use of a certified EHR in a meaningful manner, such as e-prescribing.
  2. The use of certified EHR technology for electronic exchange of health information to improve quality of health care.
  3. The use of certified EHR technology to submit clinical quality and other measures.

Simply put, "meaningful use" means providers need to show they are using certified EHR technology in ways that can be measured significantly in quality and in quantity.

Three Stages of Meaningful Use

Stage 1

Eligible providers who have attested to adopting, implementing, or upgrading (A/I/U) certified EHR technology will work toward achieving Stage 1 Meaningful Use in their second year of participation in the EHR Incentive Program. For provider type-specific information regarding Stage 1 attestation, please select one of the following categories for detailed information.

Eligible Professionals (EP) Logo     Eligible Hospital (EH) Logo

For the most recent changes to Stage 1, please view the Stage 1 Changes Tipsheet.


Stage 2

CMS published a final rule that specifies the Stage 2 criteria that eligible professionals (EPs), eligible hospitals, and critical access hospitals (CAHs) must meet in order to continue to participate in the Medicare and Medicaid Electronic Health Record (EHR) Incentive Programs. All providers must achieve meaningful use under the Stage 1 criteria before moving to Stage 2.

For additional information, please follow the links below:

Core and Menu Objectives

To demonstrate meaningful use under Stage 2 criteria,

  • EPs must meet 17 core objectives and 3 menu objectives that they select from a total list of 6, or a total of 20 core objectives.
  • Eligible hospitals and CAHs must meet 16 core objectives and 3 menu objectives that they select from a total list of 6, or a total of 19 core objectives.

Note: For Menu Measure, providers will no longer be permitted to count an exclusion toward the minimum of 3 menu objectives on which they must report if there are other menu objectives which they can select. In other words, a provider cannot select a menu objective and claim an exclusion for it if there are other menu objectives they can meet.

To help providers better understand Stage 2 Meaningful Use requirements, CMS developed Stage 2 Meaningful Use Specification Sheets for EPs and Eligible Hospitals that provide detailed information on each Stage 2 objective, including:

  • How to calculate the numerator and denominator
  • How to qualify for an exclusion
  • Definitions of important terms
  • Requirements for achieving the objectives

Clinical Quality Measures (CQMs)

In Stage 2, CQMs are no longer a core meaningful use objective; however, EPs, EHs and CAHs are still required to submit CQMs in order to successfully participate in the program.

Beginning in 2014, all providers, regardless of whether they are in Stage 1 or Stage 2 of Meaningful Use, will be required to report on the 2014 CQMs finalized in the Stage 2 Rule.

In addition, all providers must select CQMs from at least 3 of the 6 key health care policy domains recommended by the Department of Health and Human Services’ National Quality Strategy:

  • Patient and Family Engagement
  • Patient Safety
  • Care Coordination
  • Population and Public Health
  • Efficient Use of Healthcare Resources
  • Clinical Processes/Effectiveness

Download CQMs table here

Stage 2 Timeline

The earliest that the Stage 2 criteria will be effective is in fiscal year 2014 for eligible hospitals and CAHs or calendar year 2014 for EPs. The table below illustrates the progression of meaningful use stages from when Arizona Medicaid providers begin participation in the program.

1st Year

Stage of Meaningful Use

2012

2013

2014

2015

2016

2017

2018

2019

2020

2021

2012

1

1

2

2

3

TBD

TBD

TBD

TBD

TBD

2013

1

1

2

2

3

TBD

TBD

TBD

TBD

2014

 

1

1

2

2

3

TBD

TBD

TBD

2015

 

 

1

1

2

2

3

TBD

TBD

2016

 

 

 

1

1

2

2

3

TBD

In the first year of participation, providers must demonstrate Meaningful Use for a 90-day (three-month quarter) EHR reporting period; in subsequent years, providers will demonstrate Meaningful Use for a full year EHR reporting period (an entire fiscal year for hospitals or an entire calendar year for EPs) except in 2014, which is described below. Providers who participate in the Medicaid EHR Incentive Programs are not required to demonstrate Meaningful Use in consecutive years as described by the table above, but their progression through the stages of Meaningful Use would follow the same overall structure of two years meeting the criteria of each stage, with the first year of meaningful use participation consisting of a 90-day EHR reporting period.

My EHR Participation Timeline Tool

For 2014 only, all providers regardless of their stage of meaningful use are only required to demonstrate meaningful use for a 3-month EHR reporting period. For Arizona Medicaid providers, this 3-month reporting period is fixed to the quarter of either the fiscal (for eligible hospitals and CAHs) or calendar (for EPs) year in order to align with existing CMS quality measurement programs, such as the Physician Quality Reporting System (PQRS) and Hospital Inpatient Quality Reporting (IQR). CMS is permitting this one-time 3-month reporting period in 2014 only so that all providers who must upgrade to 2014 Certified EHR Technology will have adequate time to implement their new Certified EHR systems.

EHR certification and standards

For resources related to EHR certification and standards, please follow these links to resources from the Office of the National Coordinator of Health IT (ONC):


Stage 1 Reference Grid: Stage 1 meaningful use objectives for 2014 Certified EHR Technology and correlated certification criteria and standards
Stage 2 Reference Grid: Stage 2 meaningful use objectives for 2014 Certified EHR Technology and correlated certification criteria and standards

Public Health Information

For Stage 2 Public Health information, please visit http://www.azdhs.gov/meaningful-use/index.htm

Also, please check CMS website for more information regarding Stage 2 Meaningful Use

Stage 2 Data Elements Tipsheet for Eligible Professionals


Stage 3

Stage 3 criteria have not yet been promulgated by CMS; there is no current timeline for the release of the proposed and final rules.