This week, several health care organizations and stakeholders expressed a mix of praise and concern over CMS’ recently released final rule to delay parts of the meaningful use program, with some groups commending the efforts to improve flexibility, Healthcare Informatics reports (Perna, Healthcare Informatics, 9/2).
Under the 2009 economic stimulus package, providers who demonstrate meaningful use of certified electronic health records can qualify for Medicaid and Medicare incentive payments.
Last week, CMS announced in a final rule that providers and eligible professionals will receive an additional year to upgrade EHR systems to meet requirements for Stage 2 of the meaningful use program. The delay was originally proposed in May after just four hospitals had attested to Stage 2.
The final rule will provide additional flexibility by allowing eligible professionals, eligible hospitals and critical access hospitals to use the 2011 Edition certified EHR technology or a combination of 2011 and 2014 Edition certified EHR technology for the 2014 EHR reporting period. Providers will be able to attest to meaningful use under the 2013 reporting year definition and use the clinical quality measures from 2013. In addition, providers will not be penalized for failing to move to meaningful use Stage 2 during the 2014 reporting period, among other provisions (iHealthBeat, 9/2).
American Hospital Association Reaction
American Hospital Association Director of Policy Chantal Worzala in a statement said that AHA “appreciates the flexibility offered by CMS” in the final rule. However, Worzala criticized CMS for failing to shorten the reporting period for fiscal year 2015, noting that the “rule offers little relief” (Healthcare Informatics, 9/2).
American Medical Association Reaction
Similarly, American Medical Association President Robert Wah expressed alarm “that the meaningful use program continues to move full steam ahead without regard to the challenges faced by physicians and hospitals during the past few years, including a lack of interoperability.” He added, “Continued difficulties experienced in the current program are a clear sign that federal requirements must be revised” and that more flexibility is needed for physicians “to meet the meaningful use requirements and avoid unfair penalties” (Gold, “Morning eHealth,” Politico, 9/5).
Health IT Now Reaction
Health IT Now in a release also expressed measured praise of the final ruling, noting that the organization is “pleased to see that all eligible professionals … are required to use” EHRs that were certified in 2014 beginning in 2015. Health IT Now Executive Director Joel White said, “This will help clear up ambiguity about what standards and functionalities will be available in 2015.” However, White said that his organization “remain[s] concerned that multiple timing changes and delays put off interoperability between doctors and hospitals, which ultimately harms patients” (Health IT Now release, 9/2).
HIMSS EHR Association Reaction
Meanwhile, the HIMSS EHR Association generally praised CMS for working quickly to release the final rule, which it said limits confusion and delays for EHR providers and developers. Mark Segal, EHRA chair and vice president of Government and Industry Affairs at GE Healthcare IT, in a statement said, “We appreciate that many of our customers will have more flexibility in achieving meaningful use meaningful use for 2014 given the timing issues created by the Stage 2/2014 regulatory and certification schedule.”
Medical Group Management Association Reaction
Medical Group Management Association Senior Policy Adviser Robert Tennant said that while MGMA appreciates the rule’s focus on certified EHR software, many of the prevailing issues with the meaningful use program were not addressed. Specifically, he said the rule ignores that “some of the new [meaningful use] requirements have proven to be extremely onerous and forced [eligible providers] to rely on the actions of third parties.” He added that the agencies “dismissed all of the industry recommendations” (Healthcare Informatics, 9/2).
John Halamka, Beth Israel Deaconess Medical Center
Meanwhile, John Halamka, CIO of Beth Israel Deaconess Medical Center, called the rule “a welcome relief” but expressed concern that the rule limits the use of Stage 1 criteria by providers on Stage 2 timelines to those who could not completely implement EHRs certified in 2014 because of delays in certification availability. He said, “Although certified products may have been introduced into the marketplace, the time to implement, train and ensure safe use exceeded the Stage 2 time limits.”
Lyle Berkowitz, Northwestern Medicine
However, Northwestern Medicine Associate CMO of Innovation Lyle Berkowitz said the rule will do nothing to motivate providers who are not yet adopting EHRs to take action. In addition, Berkowitz questioned whether penalties under the meaningful use program will ever be implemented or whether the AMA and other professional groups “will push harder to have those repealed or at least delayed a few more years” (Walsh, Clinical Innovation & Technology, 9/2).