CHIME lauds final rule, but calls Stage 1 targets 'aggressive'
The final rules governing the meaningful use objectives for EHRs in Medicare and Medicaid incentive programs will improve providers' chances of qualifying for government stimulus funding, according to an early analysis by the College of Healthcare Information Management Executives (CHIME).
The final rules, released last week, include “desperately needed flexibility” that will give eligible hospitals and physicians a better opportunity to qualify for incentive funding in the early years of the program, CHIME said in a statement.
The 1,400-member group, based in Ann Arbor, Mich., is conducting a closer analysis of the final rule and plans to produce a list of questions that need clarification for the final rule, the organization said.
The Centers for Medicare & Medicaid Services (CMS) responded to some of the most significant concerns of those who commented on the proposed rule, which was issued in January, said Pamela McNutt, senior vice president and CIO at Methodist Health System and chair of CHIME’s Policy Steering Committee.
In particular, CHIME was pleased the final rules give providers some flexibility in choosing how to qualify for stimulus funding. The final rules include 14 core objectives for hospitals and 15 for eligible professionals; in addition to achieving those, providers generally must meet five other objectives from a menu of 10 additional objectives.
“CHIME believes the flexibility in choice in the final rule provides more opportunity for providers to qualify for funding in the first years of the program,” the statement said.
In addition, many of the compliance threshold levels for meaningful use objectives were relaxed in the final rule, which will make it "easier" for healthcare organizations to be rewarded for their early efforts to use EHRs, which better reflects the early state of EHR adoption, said David Muntz, CIO at Baylor Health Care System and chair of CHIME’s Advocacy Leadership Team.
Although the organization is encouraged by the relaxation in objectives for this first stage of the EHR incentive program, CHIME views the Stage 1 objectives in the final rule as an aggressive target for the majority of U.S. hospitals.
In addition, CHIME predicts that many hospitals will have a difficult time qualifying for stimulus funding in subsequent stages of the incentive program, as meaningful use objectives increase in number and become harder to meet, and as other aspects of the stimulus program become more challenging. The college also lauded the relaxation in requirements for reporting quality metrics. Reducing reporting requirements in the early years of the incentive program "aligns industry responsibility with current capabilities of commercially available EHR systems and CMS’ own ability to receive quality data electronically.
CMS is asking for more clarification on some aspects of the final rule, including whether use of computerized physician order entry (CPOE) by medical professionals will enable providers to meet the objective for CPOE usage.
CHIME also supports the inclusion of EHR usage in emergency departments as helping hospitals achieve meaningful use objectives. Emergency department (ED) patients often become inpatients, "so the inclusion of ED records is consistent with the goal of improving quality across the continuum of care," the organization stated.
The final rule limits states’ abilities to increase certification requirements for EHRs, which is important for vendors, which have to create the systems, and for providers that operate sites in more than one state.
"CHIME continues to evaluate and seek clarification on all the implications of the regulation and will be issuing further analyses," the statement concluded.
The final rules, released last week, include “desperately needed flexibility” that will give eligible hospitals and physicians a better opportunity to qualify for incentive funding in the early years of the program, CHIME said in a statement.
The 1,400-member group, based in Ann Arbor, Mich., is conducting a closer analysis of the final rule and plans to produce a list of questions that need clarification for the final rule, the organization said.
The Centers for Medicare & Medicaid Services (CMS) responded to some of the most significant concerns of those who commented on the proposed rule, which was issued in January, said Pamela McNutt, senior vice president and CIO at Methodist Health System and chair of CHIME’s Policy Steering Committee.
In particular, CHIME was pleased the final rules give providers some flexibility in choosing how to qualify for stimulus funding. The final rules include 14 core objectives for hospitals and 15 for eligible professionals; in addition to achieving those, providers generally must meet five other objectives from a menu of 10 additional objectives.
“CHIME believes the flexibility in choice in the final rule provides more opportunity for providers to qualify for funding in the first years of the program,” the statement said.
In addition, many of the compliance threshold levels for meaningful use objectives were relaxed in the final rule, which will make it "easier" for healthcare organizations to be rewarded for their early efforts to use EHRs, which better reflects the early state of EHR adoption, said David Muntz, CIO at Baylor Health Care System and chair of CHIME’s Advocacy Leadership Team.
Although the organization is encouraged by the relaxation in objectives for this first stage of the EHR incentive program, CHIME views the Stage 1 objectives in the final rule as an aggressive target for the majority of U.S. hospitals.
In addition, CHIME predicts that many hospitals will have a difficult time qualifying for stimulus funding in subsequent stages of the incentive program, as meaningful use objectives increase in number and become harder to meet, and as other aspects of the stimulus program become more challenging. The college also lauded the relaxation in requirements for reporting quality metrics. Reducing reporting requirements in the early years of the incentive program "aligns industry responsibility with current capabilities of commercially available EHR systems and CMS’ own ability to receive quality data electronically.
CMS is asking for more clarification on some aspects of the final rule, including whether use of computerized physician order entry (CPOE) by medical professionals will enable providers to meet the objective for CPOE usage.
CHIME also supports the inclusion of EHR usage in emergency departments as helping hospitals achieve meaningful use objectives. Emergency department (ED) patients often become inpatients, "so the inclusion of ED records is consistent with the goal of improving quality across the continuum of care," the organization stated.
The final rule limits states’ abilities to increase certification requirements for EHRs, which is important for vendors, which have to create the systems, and for providers that operate sites in more than one state.
"CHIME continues to evaluate and seek clarification on all the implications of the regulation and will be issuing further analyses," the statement concluded.