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CMS Finalizes Changes to Hospital Meaningful Use Requirements

The final rule revises meaningful use requirements for eligible hospitals and critical access hospitals.

By Sara Heath

CMS has finalized the outpatient prospective payment system (OPPS) rule and with it meaningful use requirements for eligible hospitals and critical access hospitals in the coming years, the federal agency announced.

The final rule makes changes to the Medicare and Medicaid EHR Incentive Programs starting in 2017, ideally making the program more flexible and feasible for eligible hospitals and critical access hospitals. The rule applies to hospitals alone as a result of the Quality Payment Program final rule which eliminates meaningful use for eligible clinicians.

“Today, CMS is making changes under the Medicare EHR Incentive Program for eligible hospitals and critical access hospitals attesting to CMS, including hospitals that are eligible to participate in both the Medicare and Medicaid EHR Incentive Programs (dual-eligible hospitals),” the agency said.

“These additions both increase flexibility, lower the reporting burden for providers, and focus on the exchange of health information and using technology to support patient care.”

The final rule eliminates clinical decision support and computerized provider order entry, as well as lowers the threshold for other measure sets primarily included in Modified Stage 2 Meaningful Use.

For example, the rule reduces view, download, and transmit requirements to at least one patient for Modified Stage 2 and Stage 3 Meaningful Use.

“The revised requirements focus on reducing hospital administrative burden, allowing eligible hospitals and CAHs attesting to CMS to focus more on providing quality patient care, as well as focus on updating and optimizing CEHRT functionalities to sufficiently meet the requirements of the EHR Incentive Program and prepare for Stage 3 of meaningful use,” the final rule says.

Additionally, the final rule reduces the reporting period in 2016 and 2017 down to 90 days, changes the reporting requirements for new meaningful use participants in 2017, and changes the policy on measure calculations outside of reporting periods.

The final rule also offers a hardship exception in the 2018 payment adjustment for eligible professionals attesting to meaningful use for the first time in 2017 and are also transitioning to the Merit-based Incentive Payment System (MIPS).

The final rule also maintains some measures included in Stage 3 Meaningful Use.

For example, the final rule still requires application programming interfaces (APIs) and clinical information reconciliation. Additionally, the final rule maintains a full-year reporting period once Stage 3 Meaningful Use begins in 2018.

According to CMS officials, these requirements reflect its commitment to achieving quality, value-based care while still catering to provider needs.

“We spoke to stakeholders across the outpatient community who care about the quality and value of care that Medicare patients receive,” said Sean Cavanaugh, Deputy Administrator and Director of the Center for Medicare at CMS. “The policies finalized in today’s rule will not only improve the value of care provided to Medicare beneficiaries, but are also responsive to health care providers who are crucial to outpatient care.”

However, some industry experts have mixed reviews of the rule. The American Hospital Association has released a statement, noting that the rule has both positives and negatives.

“We are pleased to see some greater flexibility on the Meaningful Use program as hospitals work to optimize health information technology that facilitates high-quality care for patients,” said Ashley Thompson, AHA senior vice president for public policy analysis and development.

According to Thompson, the 90-day reporting period in 2016 and 2017, as well as reporting requirement adjustments, are both steps in the right direction.

The rule also has its pitfalls, Thompson explained.

“The changes do not sufficiently align the hospital requirements with those that physicians will face under the Medicare Quality Reporting Program,” she said. “We are disappointed that CMS finalized a mandatory start of Stage 3 in 2018.”

AHA also raised issue with some of the information sharing requirements included in Stage 3 Meaningful Use.

“We remain concerned about requirements for providers to provide third-party access to their systems through application program interfaces without evidence that a relevant standard is ready for nationwide use and despite concerns that this will create security risks,” Thompson said.

The final rule will go into effect on January 1, 2017. Industry stakeholders may also submit public comments on the rule until December 31, 2016.

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