Electronic Health Records

Policy & Regulation News

CMS Finalizes Rule Modifying Meaningful Use Requirements

By Kyle Murphy, PhD

- In what should come as good news for eligible professionals and hospitals alike, the Centers for Medicare & Medicaid Services (CMS) has officially finalized modifications to meaningful use requirements between 2015 and 2017 and postponed Stage 3 Meaningful Use as mandatory for eligible providers until 2018.

CMS finalized meaningful use modifications

“We have a shared goal of electronic health records helping physicians, clinicians, and hospitals to deliver better care, smarter spending, and healthier people,” Patrick Conway, MD, MSc, Deputy Administrator for Innovation and Quality and Chief Medical Officer, said in an official statement Tuesday. 

“We eliminated unnecessary requirements, simplified and increased flexibility for those that remain, and focused on interoperability, information exchange, and patient engagement,” he continued. “By 2018, these rules move us beyond the staged approach of ‘meaningful use’ and focus on broader delivery system reform.”

Also of significance in today’s rulemaking is the inclusion of a 60-day comment period along with the final rule that will help CMS appropriately shape future meaningful use requirements per a Department of Health & Human Services (HHS) statement:

In addition, we will engage in actively listening to key stakeholders through meetings and outreach. HHS is committed to working with physicians, clinicians, hospitals, consumers, and other stakeholders to make these programs as effective as possible. We want to use this time to pause and reflect about how the safe, secure exchange of actionable electronic health information can best be used to deliver better patient care and how to create an infrastructure that supports that. We also want to use this time to talk to stakeholders about their views on the vision we have laid out today, as well as what should be done in the future.

Aligning the EHR Incentive Programs with the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) and the Merit-based Incentive Payment System (MIPS) was a driving force behind the comment period.

Here’s what we know so far about the modifications to meaningful use requirements over the next two years (in no particular order).

First, the number of meaningful use objectives is reduced:

We reduced the number of objectives from 20 to less than 10 and provided flexibility so that providers may choose measures that are most relevant to their practice. We also aligned certain aspects of the reporting of clinical quality measures with other CMS Medicare quality reporting programs, enabling providers to report once and receive credit for multiple programs.

Two, all eligible providers have a 90-day reporting period in 2015:

Commenters asked us to give them adequate time to implement changes to program requirements, so we are allowing 90 day reporting for all providers in 2015, extending the 90 day reporting period to new providers in 2016 and 2017, and to anyone choosing to adopt the 2018 measures a year early.

Third, Stage 3 Meaningful Use is optional in 2017 and not effective for all providers until 2018.

Four, health information exchange is a key component of required measures:

Commenters recommended we emphasize measures that focus on interoperability instead of those that focus on data entry. We modified the measures so that more than 60 percent of measures rely upon exchange of health information, compared to 33 percent previously.

Fifth, all providers will report according to the calendar year.

As for Stage 3 Meaningful Use CMS has listed four major provisions of this stage:

  • 8 objectives for eligible professionals, eligible hospitals, and CAHs:  In Stage 3, more than 60 percent of the proposed measures require interoperability, up from 33 percent in Stage 2.
  • Public health reporting with flexible options for measure selection.
  • CQM reporting aligned with the CMS quality reporting programs.
  • Finalize the use of application program interfaces (APIs) that enable the development of new functionalities to build bridges across systems and provide increased data access. This will help patients have unprecedented access to their own health records, empowering individuals to make key health decisions.

For its part, the Office of the National Coordinator for Health Information Technology also published the final rule for 2015 Edition health IT certification.

More to come on these developments over the next few days.



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