Last week, the American Medical Association sent a letter urging CMS Administrator Marilyn Tavenner and National Coordinator for Health IT Karen DeSalvo to relax the compliance requirements and financial penalties related to the meaningful use program in order to better improve patient care and efficacy, Healthcare IT News reports.
Under the 2009 economic stimulus package, health care providers who demonstrate meaningful use of certified electronic health records can qualify for Medicaid and Medicare incentive payments (Miliard, Healthcare IT News, 5/13).
Details of Letter
In the letter, AMA said that failing to change meaningful use compliance requirements and financial penalties for physicians would increase the likelihood that:
- Physicians would drop out of the meaningful use program;
- Patient care will be less efficient and interrupted more frequently because existing EHR systems will be unable to share data or facilitate coordinated care;
- “Thousands” of non-compliant physicians will face substantial financial penalties that will hinder future technology purchases and limit resources that would otherwise be used to advance patient care; and
- Outcomes-based delivery models based on data-driven approaches will be put at risk.
In its letter, AMA wrote, “We recognize that both CMS and ONC are focusing on moving to Stage 3 of the [meaningful use] program; however, physicians are still struggling with the first” stages. It added, “Without assistance, we believe many physicians will not be capable of moving on to Stage 3.”
As a result AMA is recommending that the agencies change stages 1 and 2 by:
- Replacing the meaningful use program’s “all-or-nothing” approach with a 75% pass rate; and
- Protecting physicians who meet at least 50% of meaningful use program requirements from financial penalties (AMA letter, 5/8).
The group said that “adding flexibility, both to the threshold required to earn the [meaningful use] incentives and to avoid the penalties, is the single most pressing change needed to ensure physicians can successfully participate” in the program.
AMA added that current requirements are too “primary care-centric” and that requiring all physicians to comply with the same standards “despite varying specialties and patient populations is an ill-defined approach that is not working.”
The organization said that the program’s 20% dropout rate will “grow substantially unless the all-or-nothing approach is removed” (Healthcare IT News, 5/13).
AMA recommended that the 75% pass rate and the financial penalty changes also be made to Stage 3 of the program, as well as additional changes, including:
- Removing the distinction between “menu” and “core” requirements;
- Streamlining the number of requirements and refocusing them;
- Eliminating requirements that physicians cannot control;
- Aligning quality control programs;
- Making the meaningful use program requirements evidence-based;
- Linking those requirements to “tested and high-performing standards” and implementation guides; and
- Calling on physicians to consider implementation costs (AMA letter, 5/8).