News
Doctors will have 1 more year – until Jan. 1, 2018 – to comply with Stage 3 meaningful use requirements for electronic health records (EHRs), the Centers for Medicare & Medicaid Services announced.
In its long-awaited final rule, released Oct. 6, CMS also announced simplifications to the program designed to align meaningful use with other incentive programs and shift the overall focus of the programs to make them tools for improving overall health.
Dr. Patrick Conway
The announced changes “will ease the reporting burden for providers, increase simplicity and flexibility, support interoperability and information exchange, and improve patient outcomes,” CMS Acting Principal Deputy Administrator and Chief Medical Officer Patrick Conway noted during an Oct. 6 conference call with the media.
Dr. Conway noted that the final rule reduces the number of objectives from about 20 to 8 to allow doctors to find the measures that are most relevant to their practice. Measures also are better aligned, so that a single measure can allow providers to earn credit across multiple incentive programs.
CMS also explained in a separate fact sheet that it was removing many of the “check box” process measures and enhancing the focus on aspects of patient care, such as clinical decision support, e-prescribing, and information exchange.
The agency also finalized a 90-day reporting period in 2015 for all providers currently active in the meaningful use program. Given that the rule was finalized with fewer than 90 days left in the year, Dr. Conway provided additional clarity regarding the flexibility physicians will have to meet those requirements.
If doctors were using an electronic health record on Oct. 1, 2015, “they actually will not report until the end of February, and if we need to extend that time frame, we would look at that at the end of February 2016,” he said. “So, they still have almost 5 months before the reporting actually occurs.”
Dr. Conway added that even if a provider launched an EHR system after Oct. 1, “the thresholds for the program are not 100%. So, even if they were to deploy it tomorrow [and] use it successfully through the end of the year, they could then report that performance in 2016 and avoid a penalty.”
Providers also can use the exemption process if there have been implementation issues, which CMS reviews on a case-by-case basis.
Stage 2 concerns linger
There was concern that the changes did not go far enough, particularly as they relate to modifications of Stage 2 meaningful use.
Dr. Kim Allan Williams Sr.
“Many of the requirements for Stage 2 proved unattainable,” American College of Cardiology President Kim Allan Williams Sr. said in a statement. “Large numbers of providers either haven’t met them or, after trying and failing, have given up. That is why it is vital that CMS consider participation data from the current stage to see what is working and what isn’t before outlining an upcoming stage.”
By 2018, all providers will have to meet Stage 3 meaningful use requirements, because the earlier stages will no longer be available to help new entrants transition into the program. However, if a provider chooses to adopt the 2018 requirements a year early, they will have only a 90-day reporting requirement.
What about MACRA?
Even with the extended time line, CMS is drawing criticism for progressing with Stage 3.
“We still have some concerns about how the program is going,” Ms. Laura C. Wooster, vice president of public policy at the American Osteopathic Association, said in an interview.
One prime area of concern is the current meaningful use time line’s intersection with the start of the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) reforms, which will replace the Medicare Sustainable Growth Rate payment system, Ms. Wooster noted.
“Stage 3 begins voluntarily in 2017 and then is required for all physicians in 2018. MACRA begins in 2019, and electronic health record reporting will still be part of the Merit-Based Incentive Payment System.”
Dr. Steven Stack
She expressed concern that physicians are going to have to make changes for Stage 3 meaningful use in 2018, only to have to make more changes to account for MACRA a year later.
The American Medical Association expressed similar concerns.
“The AMA recognizes that physicians continue to struggle with the meaningful use program,” AMA President Steven Stack said in a statement. “However, we hope the decision by CMS to leave Stage 3 open to additional comment will allow for further improvements in the program and promote technological innovation that supports patient care,” Dr. Stack added.