What Transitioning from Meaningful Use to Interoperability Means for Your Clinic

There are many ways electronic health records (EHRs) ensure data is accurate and healthcare operations run smoothly, allowing specialty care providers and their teams to better serve patients. The Centers for Medicare & Medicaid Services (CMS) recognized these benefits – including enhanced coordination of care, improved public health reporting, increased patient engagement, and better security – and created the Meaningful Use program in 2011 to encourage providers to incorporate EHRs into their operations. This program has changed over the years, and there are important requirements and updates all practices should brush up on to maintain compliance.

What is Meaningful Use? 

The Meaningful Use program promotes the use of certified EHR systems in healthcare. It was launched by CMS in 2011. To receive full reimbursements from Medicare, a healthcare practice must now meet the requirements set out by this program, with practices that exceed expectations earning bonuses through the Merit-based Incentive Payment System (MIPS). Failure to meet these conditions may result in penalties. 

While CMS originally referred to the program as the Meaningful Use Program, it has since been renamed the Promoting Interoperability Program. Today, practices need to adopt a certified EHR and demonstrate meaningful use of that EHR to maximize financial incentives and avoid penalties for non-compliance.

Why Is Meaningful Use Important?

Meaningful Use is part of the Health Information Technology for Economic and Clinical Health (HITECH) act. The HITECH act aimed to improve healthcare by encouraging practices to use certified EHRs.

HITECH’s five goals can be accomplished by adhering to meaningful use program requirements:

• Enhance efficiency, quality, and safety
• Protect patient privacy
• Improve community health
• Engage patients
• Increase care coordination
  

When CMS finalized the current Meaningful Use laws in 2018, they wrote, “We believe that the Meaningful Measures Initiative will improve outcomes for patients, their families, and health care providers, while reducing burden and costs for clinicians and providers, as well as promoting operational efficiencies.”

The History of Meaningful Use

Following the recession of 2008, the federal government passed the American Recovery and Reinvestment Act of 2009. As part of that act, they introduced HITECH with the aim to make healthcare more efficient and patient-centered, including specific mention of the importance of proper EHR utilization. In 2011, the meaningful use requirements went into effect. 

Originally, the requirements took the shape of the Electronic Health Record Incentive program. CMS rolled this program out slowly for both Medicare and Medicaid. To help healthcare practices, they also provided guidelines on how to find a certified, quality EHR.

At first, the program had few bonuses for compliance or penalties. That changed when the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) passed, which meant meaningful use of an EHR impacted MIPS bonuses and penalties. In 2018, CMS renamed the EHR Incentive Programs to the Medicare and Medicaid Promoting Interoperability program. The name change drew attention to interoperability, the ability for different software systems to share data among providers. To this day, interoperability can still be a challenge for practices using EHRs.

In 2021, the Cures Act passed. Part of this act established information-blocking practices healthcare providers and EHR providers should avoid. This helped clarify what meaningful use and promoting interoperability looked like. In 2022, the Medicaid portion of the program ended. Today, the program is now referred to as the Promoting Interoperability program and only applies to Medicare.

Meaningful Use vs. Interoperability 

The CMS Meaningful Use program incentivized healthcare providers to adopt and effectively use EHRs to improve patient care, while the Interoperability program expands upon that by emphasizing seamless data exchange between systems to enhance care coordination and patient access to health information.

There are still hurdles to achieving interoperability. Over time, some of these challenges have diminished as EHRs have become more advanced, but the smooth exchange of data can still be difficult without the right technology. If a patient sees a new specialist who uses a different EHR than their primary care provider, the primary care provider or their technology provider may make the patient data transfer process slow and confusing — or that data transfer could fail to happen entirely. The lack of patient data could mean the specialist:

• Doesn’t have a patient’s medical history, making it difficult to provide a proper diagnosis
• Recommends treatments a patient already tried
• Finds it difficult to share information about treatment with the primary care provider

These are just a few potential outcomes, though they demonstrate how a lack of interoperability negatively impacts patients and healthcare providers. To shine light on the lack of interoperability in the healthcare space, the Meaningful Use program changed its name to the Medicare Promoting Interoperability program. With the name change, CMS also made interoperability a bigger factor when evaluating how healthcare practices managed patient data. 

For practices using a certified EHR, interoperability requirements should be easy to meet. However, a practice must do more than simply have a certified EHR to meet these requirements. They must also show how their practice uses the EHR, including documentation of interoperability. This new requirement can impact whether a practice receives bonuses or penalties from Medicare. It also improves patient care and creates better working relationships with other healthcare practices.

Transitioning from Meaningful Use to Interoperability

The 2018 program change made it even more important for practices to demonstrate how they shared data with patients and other practices. To illustrate interoperability, a practice should check that patient data, while secure, is also available to patients and other providers when requested. For patient needs, this could involve investing in a patient portal that’s easy to use and readily accessible. When collaborating with other practices, the best path to optimal interoperability starts by choosing a certified EHR that makes it easy to share patient data across EHR systems.

Meaningful Use Requirements

Each year, practices must demonstrate that they meet meaningful use and interoperability requirements in a few ways. First, they have to demonstrate use of a certified EHR and submit a continuous, self-reported EHR reporting period of at least 180 days. They also need to answer a yes/no questionnaire on if they adhered to the Protect Patient Health Information objective.

CMS also scores practices based on four different objectives:

• Electronic prescribing
• Health information exchange
• Provider to patient exchange
• Public health and clinical data exchange

Practices receive individual scores and a cumulative score, which must be 60 or above in order to meet meaningful use requirements in 2025. 

The final requirement is to self-report a year’s worth of information on:

• The safe use of opioids Electronic Clinical Quality Measures (eCQM)
• The severe obstetric complications eCQM; and the cesarean birth eCQM
• 3 other self-selected eCQMs, for a total of 6 ECQMs

As of January 2025, practices can begin self-reporting their interoperability data for the 2024 fiscal year. While this information is self-reported, CMS reserves the right to audit practices as they see fit, similar to how the IRS can audit individuals or businesses. 

How To Meet Meaningful Use Requirements

The first, and most important, thing practices can do is work with a certified EHR company. When looking for an EHR, don’t just stop at the certification. Look for a technology partner that makes it easy for your staff to navigate data and has practices in place to promote interoperability. Ideally, that partner will also have training and resources on getting the MIPS bonus, including how to meet meaningful use requirements.

It’s important to explore your options because not every EHR provider offers high-level guidance and a user-friendly system. For example, Dermatology Associates of West Texas had never received a MIPS bonus and struggled to keep up with MIPS changes with its previous EHR system, and they decided to switch. They wanted to at least avoid being assessed penalties and to have a technology provider who provided updates on MIPS changes. After switching to Nextech’s dermatology-specific EHR and leveraging their consulting expertise, the practice received its first MIPS bonus 

“We had never received MIPS bonuses before,” said Kitty Arp, office manager. “Now we are receiving that incentive money, and we want to keep that going.”

2025 Interoperability Updates

The final rules for the 2025 Medicare Hospital Inpatient Prospective Payment System (IPPS) and Long-Term Care Hospital (LTCH) Prospective Payment System (PPS) were recently released. A main goal of both was to improve patient healthcare and ensure no healthcare workers were underpaid. This ruling didn’t change the interoperability requirements directly, though it could impact the reimbursements for these facilities in 2025.

Are There Incentives and Penalties Related to Meaningful Use? 

Those who fail to meet the meaningful use requirements are penalized via their reimbursements through the MIPS program. Not meeting interoperability requirements results in MIPS penalties, negatively impacting practice revenue. 

Exceeding interoperability requirements brings in MIPS bonuses, placing annual revenue above projections. This allows for your practice to grow and have a greater impact improving the health and well-being of a larger population in your community.

Demonstrating Meaningful Use

Meaningful use data is self-reported. To check that this data is accurate, CMS randomly audits practices. If audited, a practice should make it easy for CMS to access patient data. A quick check-in with practice staff should indicate if this is the case; if an EHR is organized and easy for staff to navigate, your practice should be prepared for a quick and thorough response to an audit. However, if your practice is having difficulties using an EHR, ask your EHR provider for training materials or consider investing in a new EHR provider that offers more comprehensive training and responsive support. 

Huron Ophthalmology’s staff found it difficult to use their old EHR. When they switched to Nextech, they quickly discovered how easy it was to use and to apply learnings from the training provided. Tori Elkins, practice administrator at Huron Ophthalmology reflects, “Learning the EHR system is an important, and sometimes challenging, part of training technicians. But Nextech is a very user-friendly system all around.”

How To Choose an EHR that Best Covers Meaningful Use Requirements 

When choosing an EHR, make sure it covers the essentials: the provider is certified, the EHR is specialty-specific, and its interface is intuitive. Beyond that, read case studies or speak to practices who currently use that EHR. For meaningful use specifically, ask how those practices’ MIPS scores changed before and after making the switch. 

You also want to ask for a demo of any EHR you’re considering. During that demo, check if it’s easy to navigate the software. Also ask the provider’s representative how the company stores patient data and shares it with patients or other providers when necessary.

Finally, ask about the EHR company’s training. Your team members aren’t EHR experts; the staff of your EHR provider should be. Ideally, an EHR provider should offer extensive training during onboarding, as well as opportunities and resources after onboarding to keep your team updated on regulatory changes.

Certified EHR is a foundational component of Nextech’s technology platform, delivering smooth and secure data transfer among providers and systems to satisfy interoperability requirements. Request a demo to learn how our specialty-specific technology helps practices stay up to date on MIPS changes, as well as how our EHR can save your practice time and help you deliver a better patient experience.