The Centers for Medicare & Medicaid Services announces a delay of meaningful use, and on Dec. 6, 2013, proposed an extension of Stage 2 through 2016 and beginning Stage 3 in 2017 for those providers that have competed at least two years in Stage 2.
In a post on its site, Robert Tagalicod, CMS’ director of Office of E-Health Standards and Services and Jacob Reider, MD, acting national coordinator for Health Information Technology of ONC, the goal of the change is two-fold: “First, to allow CMS and ONC to focus efforts on the successful implementation of the enhanced patient engagement, interoperability and health information exchange requirements in Stage 2; and second, to utilize data from Stage 2 participation to inform policy decisions for Stage 3.
“The phased approach to program participation helps providers move from creating information in Stage 1, to exchanging health information in Stage 2, to focusing on improved outcomes in Stage 3. This approach has allowed us to support an aggressive yet smart transition for providers.”
The two also point out that the timeline allows for enhanced program analysis of Stage 2 data to inform to the improvements in care delivery outcomes in Stage 3, the primary goal of the extension, to give all involved more time to prepare for the future of the reform.
According to CMS, the proposed timeline for meaningful use would have a number of benefits, such as:
- More analysis of feedback from stakeholders on Stage 2 progress and outcomes;
- More available data on Stage 2 adoption and measure calculations – especially on new patient engagement measures and health information exchange objectives;
- More consideration of potential Stage 3 requirements;
- Additional time for preparation for enhanced Stage 3 requirements;
- Ample time for developers to create and distribute certified EHR technology before Stage 3 begins, and incorporate lessons learned about usability and customization.
Meaningful use has spurred the use of the EHR technology across the marketplace since it was signed into law. CMS claims that EHR adoption nearly doubled among physicians and more than tripled among hospitals, though, there continues to be some discussion as to how many are actually using the technology.
CMS says 85 percent of eligible hospitals and more than six in 10 eligible professionals had received a Medicare or Medicaid EHR incentive payment. Moreover, nine in 10 eligible hospitals and eight in 10 eligible professionals had taken the initial step of registering for the Medicare or Medicaid EHR Incentive Programs as of October 2013.
With the delay, Stage 3 rulemaking will come in the fall of 2014; the final rule with all requirements would follow in the first half of 2015. Eligible providers who have completed at least two years of Stage 2 would begin Stage 3 in 2017. Eligible professionals would begin in January 2017, at the start of the calendar year, and eligible hospitals and critical access hospitals would begin in October 2016, at the start of the federal fiscal year.
Industry experts expect the delay to face few hurdles, according to Healthcare IT News, for example.
HIMSS, agrees, issuing the following press release in support of the decision: “HIMSS is gratified that the U.S. Department of Health and Human Services, the Centers for Medicare and Medicaid Services, and the Office of the National Coordinator for Health IT have heard concerns from health stakeholders and extended Meaningful Use Stage 2 by one year. This additional time to attest offers an opportunity for increased feedback and analysis on technology implementation, eClinical Quality Measure reporting, and progress toward interoperability that will enhance the ability of eligible hospitals and eligible professionals to meaningfully use health IT, and thus improve the quality and cost-effectiveness of patient care.”
Finally, an interesting point made by John Lynn of EMRandHIPAA.com: meaningful use stage 3 won’t go into effect until after the Medicare EHR incentives have passed, scheduled to be paid through 2016. “You won’t have to show MU Stage 3 for Medicare EHR incentive money, you will have to attest to meaningful use stage 3 in 2017 if you want to avoid the EHR penalties. In 2017, those EHR penalties will be at 3 percent.”