Associations react to MU Stage 2

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After the Centers for Medicare & Medicaid Services (CMS) published its long-awaited final rule for Stage 2 of meaningful use (MU) last week, professional associations with stakes in health IT were quick to respond with some positive and some negative feedback.

Essentials
Several policy decisions were especially "significant," according to the Healthcare Information and Management Systems Society (HIMSS), including: 
  • Setting 2014 as the MU Stage 2 start date;
  • Setting 2013 as the attestation deadline to avoid Medicare payment adjustments
  • Allowing a 90-day reporting period in the first year of Stage 2; and 
  • Completing clinical quality measure submission specifications.

The final rule contains a number of recommendations HIMSS made in response to a proposed rule for Stage 2, the group noted in an Aug. 24 statement.

The Good
Professional associations specific to health IT are generally more supportive of mandating a quicker pace for health IT adoption compared with those comprised of a broader population of providers, and their feedback on Stage 2 continued the trend.

“The Medical Group Management Association [MGMA] is pleased that CMS responded to our concerns regarding several of the proposed Stage 2 meaningful use requirements,” said the group’s president and CEO, Susan Turney, MD. “Extending the start for Stage 2 until 2014 was a necessary step to permit medical groups sufficient time to implement new software. Permitting group reporting will reduce administrative burden, as will lowering the thresholds for achieving certain measures such as mandatory online access and electronic exchange of summary of care documents.”

The College of Healthcare Information Management Executives (CHIME) and American Healthcare Information Management Association (AHIMA) also supported CMS’ shift to push the Stage 2 start date from the initially planned 2013 to 2014, which will allow more providers to participate. Instituting 90-day reporting rather than year-round reporting accomplishes the same and that move was also praised.

“By allowing providers to demonstrate meaningful use through a 90-day EHR reporting period for 2014, government rulemakers have ensured greater levels of program success,” said CHIME President and CEO Richard A. Correll in an Aug. 24 statement.

The finalized core measures required for attestation received more mixed support among the health IT associations than did the extended deadlines, with AHIMA and MGMA giving some difficult-to-reach measures more praise than CHIME.

“We are pleased to see that CMS has heard our calls for increased alignment of quality reporting programs and acknowledgement of making an effort to reduce the reporting burden and duplication of reporting,” said AHIMA Senior Director of Federal Relations Allison Viola, MBA, in an Aug. 23 Journal of AHIMA article.

The Bad
Unlike the health IT associations, the American Hospital Association saw little to support in the Stage 2 final rule.

“While we appreciate that CMS has allowed for a shorter meaningful use reporting period for 2014, we are disappointed that this rule sets an unrealistic date by which hospitals must achieve the initial meaningful use requirements to avoid penalties,” said AHA's Senior Vice President of Public Policy Analysis & Development Linda E. Fishman, in an Aug. 23 statement. “In addition, CMS complicated the reporting of clinical quality measures and added to the meaningful use objectives, creating significant new burdens.”

At issue is a measure requiring providers to report that at least 5 percent of their patients have electronic access to their health information. Statements from MGMA and AHIMA reflect a willingness to let providers struggle with insufficient technology in order to promote the goal of patient inclusion, but CHIME stops its support there.

“The final rule still puts providers still puts providers at risk of not demonstrating meaningful use based on measures that are outside their control,” Correll said. “Some areas of clarification include some of the exclusionary language as well as nuances around health information exchange provisions, clinical quality measures and accessing images through a certified EHR.”

While Stage 2 has been finalized and several professional associations have spoken to support and express concern, the 672-page rule contains plenty to talk about and more commentary is expected to come.

“We are assessing impacts of each final rule regarding clinical quality measurement, reporting options, standards specifications and alignment with other federal quality reporting and performance improvement programs,” HIMSS’ statement read. “We look forward to continuing to work with the federal government and our members to ensure that the EHR incentive program makes impactful improvements to the quality of healthcare delivery.”

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