HITPC: MU numbers continue incline, Mostashari addresses timeline concerns

More than 19,000 eligible professionals and almost 1,700 hospitals have attested for Meaningful Use (MU) under Medicaid, according to Robert Anthony of the Office of E-Health Standards & Services, who presented the latest numbers at the Sept. 4 Health IT Policy Committee.

"As of the end of July, nearly $16 billion in incentives were paid to more than 315,000 providers. That includes close to 200,000 Medicare eligible professionals and over 4,000 eligible hospitals." Anthony said 90 percent of all hospitals are registered to participate in the program with a little more than 80 percent of those hospitals having received an incentive payment.

Almost two-thirds (63 percent) of all Medicare EPs are in nonprimary care, Anthony said.

According to the presentation, a significant number of certified products have never been used in a MU attestation. Forty percent of ambulatory products and 50 percent of inpatient products have never been used in an attestation. These were products certified under the 2011 criteria and the Office of the National Coordinator for Health IT (ONC) expects a market shake out as part of the 2014 certification.

Of the 991 vendors that have a certified product under 2011 criteria, only 6 percent, or 56 vendors, have a product certified under the 2014 criteria.

Farzard Mostashari, MD, ScM, national coordinator for health IT, and other committee members had questions and comments about the data.

Mostashari addressed the concerns about the pace of the MU program as many organizations and associations have said the timeframe does not allow enough time to meet the requirements. "Even though we talk about 2014 being the time for people to step up to Stage 2, there are a lot of concerns about whether people will be able to get to Stage 2 by then," he said. "There is a personal escalator built into Stage 2. If you first attested by July 2012, then after two years at that status you need to step up to Stage 2 in 2014. The majority of hosptials who are in the small urban category will not need to be at Stage 2 until 2015. By extension, according to the rule, they also need to be at Stage 3 at 2016. If you’re in the more advanced half of hospitals or doctors and you were able to go earlier, you were able to get more of the money. That means that you also have to step up to Stage 2 in 2014 and Stage 3 in 2016. If you're in the less ready half, then you would not need to step up until 2015 for Stage 2 and 2017 for Stage 3."

Another committee member asked how much market consolidation has occurred. While that is unknown, Mostashari said that even though the 2014 certification criteria are much more rigorous, "I think we’ll see many more products certified. But, more consumer protections are being built in. It's going to be an unfolding story. It's something we need to observe and see if concerns are going to emerge or not."

Mostashari also said that no one knows whether providers are switching EHR systems because they want to upgrade to a better system or because their vendor has gone out of business. However, "what we’ve done around portability is a step in helping people navigate from system to system." ONC has put out contract guidelines of what buyers should consider before making a switch.