As you know, the Centers for Medicare & Medicaid Services (CMS) issued final requirements for meaningful use stage 2 on August 23. Since then, it’s clearly been one of the most discussed topics in healthcare technology circles, perhaps this site aside.
While the dust finally settles, the nuances of the regulation are being turned over and devoured. Providers and practice leaders are examining the 17 core (required) measures and wondering which of the three menu items will allow them the clearest path to overcome the hurdles of stage 2.
Successfully meeting the meaningful use measures aside, for me the meaningful use exceptions for noncompliance are what stand out here.
Let’s have a look.
CMS established hardship exceptions to the penalties practices and providers will face for noncompliance of meaningful use. Exemptions are available for physicians who:
- Have insufficient Internet access for any 90-day continuous period between Jan. 1, 2013, and July 1, 2014.
- Are new to Medicare.
- Encounter extreme circumstances outside the physicians’ control, such as practices closing, natural disasters, EHR vendors going out of business and similar scenarios.
- Practice in multiple locations and have a lack of control over the availability of EHR systems.
- Have a lack of face-to-face visits or other patient interactions, or the need to provide follow-up care.
I’d love to know your favorite exception. Feel free to let me know in the comment section below. What caught my eye, though, is the third exception. Specifically: “EHR vendors going out of business.”
Perhaps I’m giving this single point more importance than it deserves, but I find this to be wonderful foresight on the part of CMS. Kind of like the nation’s forefathers providing exceptions to the success of the United States; a caveat to hedge against the Constitution’ failure.
Here, tucked in with acts of God and insufficient Internet access, CMS ensures that physicians need not worry about their EHR vendor putting plywood over the windows in the middle of your attestation process.
Clearly, contraction in the vendor market is going to happen. It’s a matter of time. Those of us in the vendor space have speculated on this very fact for several years. Analysts have provided their opinions and they agree, as do my counterparts.
Perhaps the next year won’t bring a dramatic change to the EHR vendor landscape, but we all know it is coming. The fact is, there’s just not enough physicians and care providers to support between 400 and 600 vendors.
Stage 2 is most likely going to prove too complex for many of the smaller shops. Those without a tool that’s robust enough to make the meaningful use push or companies without a sizable enough footprint to be an attractive acquisition target are going to fold. Their clients may expect them to weather the storm, but a ship without a sail is nothing more than a lost vessel without direction.
So, with all the other exceptions that can cause a set back, and given the level of commitment required to meet stage 2, the easiest exception to avoid may in fact be making a vendor switch now. Given the set backs a vendor collapse could cause your practice, I might prefer taking my chances with an act of God because at least I might be able to pray my way out of it.