The final meaningful use rule has many changes and clarifications in its 864 pages, testimony to the degree to which federal officials listened to stakeholders following publication of the proposed rule. But one major component--the amount of available incentive money--remains the same.

Physicians still can get up to $44,000 from Medicare and few thousand more if they practice in underserved areas, or up to $63,750 from Medicaid. Hospitals still are looking at millions of dollars in incentives, an average of $6 million (two thirds from Medicare, one-third from Medicaid) for a typical hospital with a couple hundred beds. "We've really got an amazing opportunity here," says Erica Drazen, managing partner of Computer Sciences Corp., a Falls Church, Va.-based consultancy.

Drazen, along with an attorney and four provider CIOs, spoke on July 16 during a Health Data Management Web seminar that that offered early insights on the final meaningful use rule to about 530 attendees.

The Children's Hospital in Aurora, Colo., is "in pretty good shape" to meet meaningful use criteria, but still has a lot of work ahead to get there, says Mary Ann Leach, vice president and CIO. Hospital officials are seeking medical leadership to lead the initiative, which is necessary for all provider organizations, she believes. As part of its preparations, the hospital is considering conducting a mock 90-day reporting period starting this September to get ready for the real thing in 2011.

Core EHR systems aren't the only ones that likely will need to be certified as supporting meaningful use, says Pamela McNutt, senior vice president and CIO at Methodist Health System in Dallas. Many ancillary systems, such as those responsible for medication reconciliation and computerized provider order entry, also will need certification.

The softened criteria and flexibility are appreciated, but many physicians remain highly skeptical of the promised incentives, says Chuck McDevitt, CIO at Self Regional Healthcare in Greenwood, S.C. "There's still a pretty heavy doubt in our physician community about the incentive payments, but no doubt about the penalties."

Linn Freedman, a partner in the law firm Nixon Peabody LLP, cautions that while quality reporting requirements are relaxed under Stage 1 meaningful use requirements, the pause will be short-lived. Federal officials, she predicts, will significantly ramp up such reporting in just a couple of years to support provisions of the health reform law. "There's every indication that in Stages 2 and 3, they're really going to be focusing on quality reporting."

A recording of the Web seminar soon will be available at

--Joseph Goedert


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