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EHR Incentive Programs: Where We Go Next (Message from Andy Slavitt and Karen DeSalvo)

Where We’ve Been

As we mentioned in a speech last week, the Administration is working on an important transition for the Electronic Health Record (EHR) Incentive Program. We have been working side by side with physician organizations and have listened to the needs and concerns of many about how we can make improvements that will allow technology to best support clinicians and their patients. While we will be putting out additional details in the next few months, we wanted to provide an update today.

In 2009, the country embarked on an effort to bring technology that benefits us in the rest of our lives into the health care system. The great promise of technology is to bring information to our fingertips, connect us to one another, improve our productivity, and create a platform for a next generation of innovations that we can’t imagine today.

Not long ago, emergency rooms, doctor’s offices, and other facilities were sparsely wired. Even investing in technology seemed daunting. There was no common infrastructure. Physician offices often didn’t have the capital to get started and it was hard for many to see the benefit of automating silos when patient care was so dispersed. We’ve come a long way since then with more than 97 percent of hospitals and three quarters of physician offices now wired.

It’s taken a tremendous commitment by physicians, hospitals, technologists, patient groups and experts from all over the country to make the progress we’ve made together in a few short years. The EHR Incentive Programs were designed in the initial years to encourage the adoption of new technology and measure the benefits for patients. And while it helped us make progress, it has also created real concerns about placing too much of a burden on physicians and pulling their time away from caring for patients.

Transitioning From Measuring Clicks to Focusing on Care

Last year, the Administration and Congress took two extraordinary steps to put patients at the center of how we pay for care and support physicians. First, the Administration set a goal that 30 percent in 2016 and 50 percent in 2018 of Medicare payments will be linked to getting better results for patients, providing better care, spending healthcare dollars more wisely, and keeping people healthy.  And, second, Congress advanced this goal through the passage of the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), which considers quality, cost, and clinical practice improvement activities in calculating how Medicare physician payments are determined. While MACRA also continues to require that physicians be measured on their meaningful use of certified EHR technology for purposes of determining their Medicare payments, it provides a significant opportunity to transition the Medicare EHR Incentive Program for physicians towards the reality of where we want to go next.

What Comes Next

We have been working side by side with physician and consumer communities and have listened to their needs and concerns. As we move forward under MACRA, we will be sharing details and inviting comment as we roll out our proposed regulations this spring. All of this work will be guided by several critical principles:

  1. Rewarding providers for the outcomes technology helps them achieve with their patients.
  2. Allowing providers the flexibility to customize health IT to their individual practice needs. Technology must be user-centered and support physicians.
  3. Leveling the technology playing field to promote innovation, including for start-ups and new entrants, by unlocking electronic health information through open APIs – technology tools that underpin many consumer applications.  This way, new apps, analytic tools and plug-ins can be easily connected to so that data can be securely accessed and directed where and when it is needed in order to support patient care.
  4. Prioritizing interoperability by implementing federally recognized, national interoperability standards and focusing on real-world uses of technology, like ensuring continuity of care during referrals or finding ways for patients to engage in their own care. We will not tolerate business models that prevent or inhibit the data from flowing around the needs of the patient.

What This Means for Doctors and Hospitals 
As we work through a transition from the staged meaningful use phase to the new program as it will look under MACRA, it is important for physicians and other clinicians to keep in mind several important things:

  1. The current law requires that we continue to measure the meaningful use of ONC Certified Health Information Technology under the existing set of standards. While MACRA provides an opportunity to adjust payment incentives associated with EHR incentives in concert with the principles we outlined here, it does not eliminate it, nor will it instantly eliminate all the tensions of the current system. But we will continue to listen and learn and make improvements based on what happens on the front line.
  2. The MACRA legislation only addresses Medicare physician and clinician payment adjustments. The EHR incentive programs for Medicaid and Medicare hospitals have a different set of statutory requirements. We will continue to explore ways to align with principles we outlined above as much as possible for hospitals and the Medicaid program.
  3. The approach to meaningful use under MACRA won’t happen overnight. Our goal in communicating our principles now is to give everyone time to plan for what’s next and to continue to give us input.  We encourage you to look for the MACRA regulations this year; in the meantime, our existing regulations – including meaningful use Stage 3 – are still in effect.
  4. In December, Congress gave us new authority to streamline the process for granting hardship exception’s under meaningful use.  This will allow groups of health care providers to apply for a hardship exception instead of each doctor applying individually. This should make the process much simpler for physicians and their practice managers in the future. We will be releasing guidance on this new process soon.

These principles we’ve outlined here reflect the constructive and clear articulation of issues and open sharing of views and data by stakeholders across the health care system, but they also promote our highest priority – better care for the beneficiaries of the Medicare and Medicaid program and patients everywhere.

The challenge with any change is moving from principles to reality. The process will be ongoing, not an instant fix and we must all commit to learning and improving and collaborating on the best solutions. Ultimately, we believe this is a process that will be most successful when physicians and innovators can work together directly to create the best tools to care for patients. We look forward to working collaboratively with stakeholders on advancing this change in the months ahead.

January 19, 2016 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

HHS issues rules to advance electronic health records with added simplicity and flexibility

Public comment period offers forum to gather additional feedback and inform future policies

The Centers for Medicare & Medicaid Services (CMS) and Office of the National Coordinator for Health Information Technology (ONC) today released final rules that simplify requirements and add new flexibilities for providers to make electronic health information available when and where it matters most and for health care providers and consumers to be able to readily, safely, and securely exchange that information. The final rule for 2015 Edition Health IT Certification Criteria (2015 Edition) and final rule with comment period for the Medicare and Medicaid Electronic Health Records (EHRs) Incentive Programs will help continue to move the health care industry away from a paper-based system, where a doctor’s handwriting needed to be interpreted and patient files could be misplaced.

“We have a shared goal of electronic health records helping physicians, clinicians, and hospitals to deliver better care, smarter spending, and healthier people.  We eliminated unnecessary requirements, simplified and increased flexibility for those that remain, and focused on interoperability, information exchange, and patient engagement. By 2018, these rules move us beyond the staged approach of ‘meaningful use’ and focus on broader delivery system reform,” said Dr. Patrick Conway, M.D., M.Sc., CMS deputy administrator for innovation and quality and chief medical officer. “Most importantly we are seeking additional public comments and plan for active engagement of stakeholders so we take time to get broad input on how to improve these programs over time.”

HHS heard from physicians and other providers about the challenges they face making this technology work well for their individual practices and for their patients. In recognition of these concerns, the regulations announced today make significant changes in current requirements. They will ease the reporting burden for providers, support interoperability, and improve patient outcomes.  Providers can choose the measures of progress that are most meaningful to their practice and have more time to implement changes to program requirements. Providers are encouraged to apply for hardship exceptions if they need to switch or have other technology difficulties with their EHR vendor. Additionally, the new rules give developers more time to create user-friendly technologies that give individuals easier access to their information so they can be engaged and empowered in their care.

As part of today’s regulations, CMS announced a 60-day public comment period to gather additional feedback about the EHR Incentive Programs going forward, in particular with the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), which established the Merit-based Incentive Payment System and consolidates certain aspects of a number of quality measurement and federal incentive programs into one more efficient framework. We will use this feedback to inform future policy developments for the EHR Incentive Programs, as well as consider it during rulemaking to implement MACRA, which we expect to release in the spring of 2016.

In addition to the final rule for the EHR Incentive Programs, ONC is also announcing the final rule for the 2015 Edition Health IT Certification Criteria. This rule focuses on increasing interoperability – a secure but seamless flow of electronic health information – and improving transparency and competition in the health IT marketplace.

“This rule is a key step forward in our work with the private sector to realize the shared goal of making actionable electronic health information available when and where it matters most to transform care and improve health for the individual, community and larger population.   It will bring us closer to a world in which health care providers and consumers can readily, safely and securely exchange electronic health information,” said Karen B. DeSalvo, M.D., M.P.H., M.Sc., national coordinator for health IT.

For more information about today’s announcement visit: http://cms.gov/Newsroom/MediaReleaseDatabase/Fact-sheets/2015-Fact-sheets-items/2015-10-06.html

For more information on the CMS final rule with comment period, click here:http://cms.gov/Newsroom/MediaReleaseDatabase/Fact-sheets/2015-Fact-sheets-items/2015-10-06-2.html

For more information on ONC’s editions of certification criteria visit:
https://www.healthit.gov/sites/default/files/factsheet_draft_2015-10-06.pdf

October 6, 2015 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

CHIME, Congressional Leaders Continue Call for Delay in Meaningful Use Stage 3 Rulemaking

Statement by CHIME Board of Trustees Chair Charles E. Christian, CHCIO, LCHIME, FCHIME

 

Ann Arbor, MI, September 28, 2015 – A bipartisan group of congressional leaders today sent a letter to the Obama administration calling for a delay in final rulemaking for Meaningful Use Stage 3.

We commend Reps. Renee Elmers (R-NC), Tom Price (R-GA) and David Scott (D-GA) for their leadership on this effort and the 100-plus lawmakers who signed on in support. The College of Healthcare Information Management Executives (CHIME) and its 1,700 members support the overarching intent of the Meaningful Use program. We are committed to the adoption, use and optimization of electronic health records as a means to improve the quality of patient care. However, many hospitals and physician practices are still struggling to meet requirements under Stage 2. According to data from the Centers for Medicare & Medicaid Services, only 1,826 hospitals successfully attested to Stage 2 in 2014. That’s just 38 percent of hospitals that registered for the program. By comparison, 4,379 hospitals successfully attested for Stage 1 at least during the past five years.
CHIME staff held a high-level briefing with administration officials last Friday detailing how a delay would give all stakeholders time to address challenges to continued success of the Meaningful Use program. Several policy and industry barriers must be removed before providers are able to advance to Stage 3, not the least of which is creating true interoperability between EHRs. A pause in final rulemaking for Stage 3 would give policymakers, providers and vendors time to address the barriers to interoperability.
As the congressional letter to Secretary Sylvia Burwell and Office of Management and Budget Director Shaun Donovan points out, CMS should also evaluate how new Medicare payment models will impact Stage 3 regulations. In particular, the Merit-Based Payment System (MIPS) and Alternative Payment Models (APMs) were finalized after Stage 3 regulations were developed.
CHIME will continue to work with congressional leaders and the administration to ensure that the Meaningful Use program moves forward in a responsible way.
About CHIME:
The  College of Healthcare Information Management Executives (CHIME) is an executive organization dedicated to serving chief information officers and other senior healthcare IT leaders. With more than 1,600 CIO members and over 150 healthcare IT vendors and professional services firms, CHIME provides a highly interactive, trusted environment enabling senior professional and industry leaders to collaborate; exchange best practices; address professional development needs; and advocate the effective use of information management to improve the health and healthcare in the communities they serve. For more information please visit www.chimecentral.org

September 28, 2015 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

Statement on Call to Delay Meaningful Use Stage 3

Statement from CHIME Vice President of Congressional Affairs Leslie Krigstein
Ann Arbor, MI, September 16, 2015 – The College of Healthcare Information Management Executives (CHIME) applauds Sen. Lamar Alexander (R-TN) for calling on the Obama administration to take a more reasoned approach to the next phases of the Meaningful Use program.

During a Senate Health, Education, Labor and Pensions Committee (HELP) hearing today, Chairman Alexander called on the administration to delay until 2017 final rulemaking for Stage 3. We appreciate his recognition that hospitals and health systems are still working to meet requirements under Stages 1 and 2.

Additionally, hospitals, physicians and their vendor partners continue to wait for a much-anticipated rule modifying certain requirements for meeting Stage 2 in 2015. The continued delays in the release of this final rule only jeopardize the long-term outcomes of the program. We must get the modification rule in the hands of providers as soon as possible to ensure that the well-intentioned relief offered by Centers for Medicare & Medicaid Services in the proposed rule can be realized.

Sen. Elizabeth Warren’s (D-MA) comments on the importance of being able to accurately match patients to their health records and the need to address the other challenges impeding the development of an interoperable healthcare system were also notable.

Patients will be best served when as many providers as possible are successfully participating in the Meaningful Use program. CHIME is committed to ensuring that digital health tools are deployed safely and securely for the betterment of patient care.

We look forward working with the Chairman Alexander and the HELP Committee to ensure the ultimate lasting legacy of the Meaningful Use program is improved patient care through interoperable health records.

About CHIME:
The College of Healthcare Information Management Executives (CHIME) is an executive organization dedicated to serving chief information officers and other senior healthcare IT leaders. With more than 1,600 CIO members and over 150 healthcare IT vendors and professional services firms, CHIME provides a highly interactive, trusted environment enabling senior professional and industry leaders to collaborate; exchange best practices; address professional development needs; and advocate the effective use of information management to improve the health and healthcare in the communities they serve. For more information please visit www.chimecentral.org

September 16, 2015 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

CHIME Applauds Bill (Flex-IT 2 Act) that Makes Necessary Improvements to Meaningful Use Program

Statement from CHIME CEO and President Russell P. Branzell, FCHIME, CHCIO and CHIME Board of Trustees Chair Charles E. Christian, CHCIO, LCHIME, FCHIME

ANN ARBOR, MI, July 30, 2015 – We commend Congresswoman Renee Ellmers for introducing the Further Flexibility in HIT Reporting and Advancing Interoperability Act of 2015 or “Flex-IT 2 Act” and appreciate her continued leadership on this critically important issue.

While CHIME remains committed to the success of Meaningful Use, and to making sure improved patient care is its lasting legacy, we believe significant changes are needed to address increased dissatisfaction with EHRs and growing provider dissatisfaction with the program. The introduction of the Flex-IT 2 Act serves to strengthen accountability and effectiveness of an e-enabled healthcare system and ensure long-term vitality of Meaningful Use.

There is no doubt that the EHR Incentive Payments program has been a vital and successful driver of health IT adoption nationwide, setting the foundation for better population health, improved care delivery and lower costs. However, the ongoing challenges with program implementation must be addressed. Our members believe in the intent and promise of Meaningful Use, but providers and hospitals alike have been hamstrung by its often overly prescriptive requirements. We view the Congresswoman’s legislation as an opportunity to reevaluate and reorient this vital program that will provide the digital infrastructure to support a 21st century healthcare system.

We look forward to working with Congresswoman Ellmers, our membership, and colleague provider organizations toward the passage of this important bill.

About CHIME:

The College of Healthcare Information Management Executives (CHIME) is an executive organization dedicated to serving chief information officers and other senior healthcare IT leaders. With more than 1,600 CIO members and over 150 healthcare IT vendors and professional services firms, CHIME provides a highly interactive, trusted environment enabling senior professional and industry leaders to collaborate; exchange best practices; address professional development needs; and advocate the effective use of information management to improve the health and healthcare in the communities they serve.

July 30, 2015 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

HIMSS Submits Comments on CMS Meaningful Use Stage 3; 2015 Edition Health IT Certification Criteria

Focused on better health through the best use of information technology, HIMSS points to critical components of the draft regulations and suggests improvements to advance the secure and consistent digital exchange of patient health information.      

Arlington, VA (May 29, 2015) – On Thursday, May 28, HIMSS submitted comments to the Department of Health and Human Services on  the Meaningful Use Stage 3 proposed rule and the 2015 Edition Health IT Certification Criteria.  The two letters, sent to Acting CMS Administrator, Andrew Slavitt, and National Coordinator for Health IT, Dr. Karen DeSalvo, respectively, strongly urge CMS and ONC to:

  • Decrease the prescriptive nature of the EHR Incentive program,
  • Increase focus on the substantial capabilities established earlier in the program, and
  • Reduce complexity in the 2015 Certification Criteria.

HIMSS voiced its continued support for the Meaningful Use Program as a tool to positively transform health and healthcare in the United States. Identifying meaningful use as a “critical tool for enabling healthcare transformation,” the response cites HIMSS Analytics data – collected annually on all non-federal US hospitals, and more than 30,000 tethered US ambulatory facilities – that “70% of hospitals have made a positive progression in the advancement of their EHR capabilities over the last five years, with over 60% of ambulatory facilities showing similar progress in the last three years.”

HIMSS reiterated its long-standing commitment to interoperability:  “HIMSS is committed to a culture in which IT is fundamental to transforming healthcare; improving quality of care, enhancing the patient experience, containing cost, improving access to care, and optimizing effectiveness of public payment.”

The full comments on HIMSS response to the CMS Meaningful Use Stage 3include:

  • HIMSS remains strongly committed to making the Electronic Health Record Incentive program less prescriptive and more focused on encouraging and assisting providers to take advantage of the substantial capabilities established in Meaningful Use Stages 1 and 2, including interoperability.
  • HIMSS applauds a proposal in the NPRM for a single definition of Meaningful Use starting in calendar year 2018, no matter when a provider began to participate in the EHR Incentive Program.
  • HIMSS supports the work being done by CMS to align the EHR Incentive Program with other CMS quality reporting programs that also use certified health IT.  HIMSS believes such efforts will lessen the burden on providers.
  • HIMSS is committed to ensuring patient safety remains paramount to the development, implementation, and wide-spread use of health IT systems.
  • HIMSS reiterates its long-standing assertion that 18 months is the minimum length of time needed between the final rules on Meaningful Use, certification, and standards, and the start of any stage of Meaningful Use.  An 18-month timeline allows stakeholders to help educate and prepare providers on the upcoming new stage.  The current timeline for transitioning to Meaningful Use, Stage 3 in 2017 and 2018 does not include 18 months.

The full HIMSS comments  on the 2015 Edition Health IT Certification Criteria include:

  • ONC must address the overall complexity of the 2015 Edition Certification Rule by reducing the total number of criterion, as well as the standards and functionalities included.
  • HIMSS acknowledges that ONC and CMS attempted to reduce the complexity of the requirements for the 2015 edition certification criteria and Meaningful Use Stage 3 in their respective NPRMs for this cycle.  However, given all the new requirements included in this NPRM, HIMSS urges ONC to reconsider the requirements needed for the 2015 edition certification criteria and consider approaches to minimize and simplify the options presented.
  • HIMSS remains cautiously supportive of ONC’s efforts to establish innovative certification and testing programs that utilize health IT.  Certification in support of a Learning Health System must be specific, carefully planned, focused on the areas that have the greatest impact on interoperability, and closely aligned with programmatic goals.
  • ONC or another agency should establish the programmatic goals before commencing with any certification program associated with the effort.  It is important that certification criteria be closely evaluated and aligned with the functionalities necessary to meet the goals of the program in question as the move continues beyond EHR-specific certification.
  • HIMSS supports greater harmonization and alignment across the programs covered by certification.
  • HIMSS supports the idea of including the level of adoption and maturity among standards as an important consideration when evaluating inclusions for certification programs.

HIMSS will continue to monitor the progress on CMS Meaningful Use Stage 3 program and the 2015 Edition Health IT Certification Criteria. Look for updated information at the Policy Center on the HIMSS website. 

About HIMSS

HIMSS is a global, cause-based, not-for-profit organization focused on better health through information technology (IT). HIMSS leads efforts to optimize health engagements and care outcomes using information technology.

HIMSS is a cause-based, global enterprise producing health IT thought leadership, education, events, market research and media services around the world. Founded in 1961, HIMSS encompasses more than 58,000 individuals, of which more than two-thirds work in healthcare provider, governmental and not-for-profit organizations across the globe, plus over 640 corporations and 400 not-for-profit partner organizations, that share this cause.  HIMSS, headquartered in Chicago, serves the global health IT community with additional offices in the United States, Europe, and Asia.

May 29, 2015 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

HHS announces proposed rules to support the path to nationwide interoperability

Electronic Health Record Incentive Programs and 2015 Edition Health IT Certification Criteria rules proposed

The U.S. Department of Health and Human Services, Centers for Medicare & Medicaid Services (CMS) and Office of the National Coordinator for Health Information Technology (ONC) today announced the release of the Stage 3 notice of proposed rulemaking for the Medicare and Medicaid Electronic Health Records (EHRs) Incentive Programs and 2015 Edition Health IT Certification Criteria to improve the way electronic health information is shared and ultimately improve the way care is delivered and experienced. Together, these proposed rules will give providers additional flexibility, make the program simpler, and drive interoperability among electronic health records, and increase the focus on patient outcomes to improve care.

The proposed rules are one part of a larger effort across HHS to deliver better care, spend health dollars more wisely, and have healthier people and communities by working in three core areas: to improve the way providers are paid; improve the way care is delivered; and improve the way information is shared. Together, these improvements can support better care and lower costs in the health care system.

“The flow of information is fundamental to achieving a health system that delivers better care, smarter spending, and healthier people. The steps we are taking today will help to create more transparency on cost and quality information, bring electronic health information to inform care and decision making, and support population health,” said HHS Secretary Sylvia M. Burwell.

The Meaningful Use Stage 3 proposed rule issued by CMS specifies new criteria that eligible professionals, eligible hospitals, and critical access hospitals must meet to qualify for Medicaid EHR incentive payments. The rule also proposes criteria that providers must meet to avoid Medicare payment adjustments (Medicaid has no payment adjustments) based on program performance beginning in payment year 2018. The rule give more flexibility and simplifies requirements for providers by focusing on advanced use of electronic health records and eliminating requirements that are no longer relevant.

The 2015 Edition Health IT Certification Criteria proposed rule aligns with the path toward interoperability – the secure, efficient, and effective sharing and use of health information –identified in ONC’s draft shared Nationwide Interoperability Roadmap. The proposed rule builds on past editions of adopted health IT certification criteria, and includes new and updated IT functionality and provisions that support the EHR Incentive Programs care improvement, cost reduction, and patient safety across the health system.

“This Stage 3 proposed rule does three things: it helps simplify the meaningful use program, advances the use of health IT toward our vision for improving health delivery, and further aligns the program with other quality and value programs,” said Dr. Patrick Conway, M.D., M.Sc., CMS acting principal deputy administrator and chief medical officer. “And, in an effort to make reporting easier for health care providers, we will be proposing a new meaningful use reporting deadline soon.”

“ONC’s proposed rule will be an integral component in the shared nationwide effort to achieve an interoperable health system,” said Karen DeSalvo, M.D., M.P.H, M.Sc., national coordinator for health IT. “The certification criteria we have proposed in the 2015 Edition will help achieve that vision through provisions that consider the range of health IT users and uses across the care continuum, including those focused on interoperable standards, data portability, improved transparency, privacy and security capabilities, and increased oversight through ONC’s Health IT Certification Program.”

Under the Health Information Technology for Economic and Clinical Health Act, doctors, health care professionals and hospitals, including critical access hospitals, can qualify for Medicare and Medicaid incentive payments when they adopt and meaningfully use health IT technology certified by ONC. Since the programs began in 2011, more than 433,000 eligible professionals and eligible hospitals have received an incentive payment representing about 60 percent of eligible professionals in either the Medicare or Medicaid programs and about 95 percent of eligible hospitals.

The Stage 3 proposed rule’s scope is generally limited to the requirements and criteria for meaningful use in 2017 and subsequent years. CMS is considering additional changes to meaningful use beginning in 2015 through separate rulemaking. Read more about this announcement on Dr. Conway’s blog.

The Stage 3 proposed rule may be viewed at here and the comment period ends on May 29, 2015. The 2015 Edition proposed rule may be viewed at here and the comment period ends on May 29, 2015. The Draft 2015 Edition Certification Test Procedures may be viewed at HealthIT.gov, and the comment period ends on June 30, 2015.

More information on meaningful use can be found on the CMS EHR Incentive Programs website at http://www.cms.gov/Regulations-and-Guidance/Legislation/EHRIncentivePrograms/index.html.

More information on ONC’s editions of certification criteria can be found at http://www.healthit.gov/policy-researchers-implementers/standards-and-certification-regulations.

March 20, 2015 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

Healthcare Leaders Praise Reintroduction of the Flex-IT Act

Strong, Bipartisan Support for Increasing Meaningful Use Flexibility

ANN ARBOR, MI, January 12, 2015 – Healthcare leaders praised the reintroduction of the Flexibility in Health IT Reporting (Flex-IT) Act of 2015, a bipartisan bill granting the nation’s healthcare providers additional flexibility in meeting Meaningful Use (MU) requirements through a shortened reporting period in 2015. Swift action by Congress is needed to help providers already in the 2015 reporting year for Meaningful Use, several healthcare organizations said today.

Officials from the American Academy of Family Physicians (AAFP), American Hospital Association (AHA), American Medical Association (AMA), College of Healthcare Information Management Executives (CHIME), Healthcare Information Management Systems Society (HIMSS) and Medical Group Management Association (MGMA) applaud the leadership shown by bill sponsor Representative Renee Ellmers (R-NC-02) and a bipartisan list of original cosponsors, including Marsha Blackburn (R-TN-07), Ron Kind (D-WI-03), Glenn Thompson (R-PA-05) and David Scott (D-GA-13).

“We commend the leadership demonstrated by a bipartisan group of House Members on this critically important issue,” said CHIME President and CEO Russell P. Branzell, FCHIME, CHCIO. “With such across-the-isle support, Congress has underscored how fundamental this program is to the future of healthcare in the U.S.

“While CHIME remains committed to the success of Meaningful Use, and to making sure improved patient care is the program’s lasting legacy, we believe significant changes are needed to address increased dissatisfaction with EHRs and growing disenchantment with the program,” Branzell added. “This bill, if passed, would begin that much-needed course correction.”

The Flex-IT Act was introduced in September 2014, following a national joint call to action last year. The new Flex-IT Act of 2015 would adjust the Meaningful Use reporting timeline, giving providers the option to choose any three-month quarter for EHR reporting in 2015.

“America’s hospitals are strongly committed to the adoption of EHRs, because of their potential to increase the quality of care and reduce costs for patients,” said Rick Pollack, Executive Vice President of the American Hospital Association. “The health care field is faced with many major challenges and changes, all hitting at the same time. We need to be practical and responsible in terms of implementation timetables. That’s why hospitals need flexibility. This legislation is a positive first step toward ensuring the program is a success, and America’s hospitals look forward to working to achieve its passage.”

“Our nation needs a more efficient, cost-effective and patient-centered healthcare system. HIMSS applauds the efforts taken by these Congressional leaders and fully supports the Flexibility in Health IT Reporting (Flex-IT) Act of 2015 as essential to giving providers and hospitals a realistic chance to meet the 2015 Meaningful Use requirements,” said Carla Smith, MA, CNM, FHIMSS, Executive Vice President, HIMSS North America

According to the latest data available from the Centers for Medicaid & Medicare Services (CMS), more than one-third of hospitals expected to demonstrate Stage 2 Meaningful Use in 2014 had to file for a hardship exception or meet Stage 1 requirements again. In 2015, CMS data indicate more than 3,900 hospitals and 260,000 physicians will have to meet Stage 2 requirements. However, CHIME estimates that more than half of these EHs will likely seek further hardship exceptions or face penalties in 2015. And with CMS estimating that more than 257,000 EPs will receive penalties in 2015, the likelihood of robust physician participation is doubtful.

“We greatly appreciate the willingness of this bipartisan group of legislators to address this critical issue,” stated Anders Gilberg, Senior Vice President, Government Affairs, for the Medical Group Management Association. “Stage 2 of Meaningful Use has proven extremely challenging and, absent this reporting flexibility, a significant number of physicians will be unable to participate in the program and unfairly penalized. Passage of the Flex-IT Act is a critical step to allow physician practices to continue down the pathway of effective adoption and use of EHR technology,” added Gilberg.

“We are pleased with renewed efforts to provide greater flexibility in the Meaningful Use program and hope that this is the first of several steps to make the program work better for physicians and other providers so that the full potential of these technologies to improve care and value can be realized,” said American Medical Association President-Elect Steven J. Stack, MD.

In October 2014, the AMA unveiled their Meaningful Use blueprint, outlining several recommendations meant to improve participation in the EHR Incentive program. Among the high-level recommendations, AMA officials urged that policymakers adopt a more flexible approach for meeting Meaningful Use to allow more physicians to successfully participate; better aligning quality measure requirements including reducing the reporting burden on physicians and helping relieve them from overlapping penalties; and restructure EHR certification to focus on key areas like interoperability.

“As some of the earliest adopters of certified electronic health records technology, family physicians have demonstrated their belief that interoperable EHR – like primary care itself – is an essential component of a higher-quality, lower-cost health system,” said Robert Wergin, MD, president of the American Academy of Family Physicians. “However, as family medicine continues to do its part in building the EHR infrastructure – a massive undertaking – CMS should not set benchmarks so high that it discourages participation in the program. We applaud Reps. Ellmers and Kind for introducing the Flexibility in Health IT Reporting Act, which will allow eligible physicians to achieve Meaningful Use of EHR by reporting for a three-month period in 2015. The American Academy of Family Physicians believes this flexibility will help physicians stay on track in building an EHR system that works.”

About CHIME
The College of Healthcare Information Management Executives (CHIME) is an executive organization dedicated to serving chief information officers and other senior healthcare IT leaders. With more than 1,400 CIO members and over 140 healthcare IT vendors and professional services firms, CHIME provides a highly interactive, trusted environment enabling senior professional and industry leaders to collaborate; exchange best practices; address professional development needs; and advocate the effective use of information management to improve the health and healthcare in the communities they serve. For more information, please visit www.chimecentral.org.

January 12, 2015 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

Low 2014 MU 2 Attestation Numbers Validate Need for Shortened Reporting Period in 2015

CHIME reiterates call to HHS for immediate, sensible action
ANN ARBOR, MI, December 9, 2014 – As substandard Meaningful Use attestation figures for program year 2014 continue, the College of Healthcare Information Management Executives (CHIME) reiterated its call to immediately shorten the reporting period for 2015.

According to the data, released today by the Centers for Medicaid and Medicare Services (CMS) during the Health IT Policy Committee meeting, less than 35 percent of the nation’s hospitals have met Stage 2 Meaningful Use requirements. And while eligible professionals (EPs) have until the end of February to report their progress, just 4 percent have met Stage 2 requirements thus far.

“Despite policy efforts to mitigate a disastrous program year, today’s release of participation data confirms widespread challenges with Stage 2 Meaningful Use,” said CHIME President and CEO Russell P. Branzell, FCHIME, CHCIO.

Roughly 1 in 3 hospitals scheduled to meet Stage 2 in 2014 had to use alternative pathways to meet MU, administrative data current through December 1 indicates.

“This trend demonstrates how vital new flexibilities were in 2014 and again, underscores the need for the same flexibility in 2015,” said Branzell. “It is imperative officials take immediate action to put this critical transformation program back on track. Shortening the time frame for MU reporting in 2015 will help to ensure the program delivers on its promise to advance the transformation of healthcare in this country.”

CHIME and several other national provider associations have repeatedly told CMS that without more program flexibility and a shortened reporting period in 2015, the future of Meaningful Use is in jeopardy.

CMS data indicates that more than 3,900 hospitals must meet Stage 2 measures and objectives in 2015 and more than 260,000 EPs will need to be similarly positioned by January 1, 2015. Given the low attestation data for 2014 and the tremendous number of providers required to meet Stage 2 for a full 365-days in 2015, leaders in the Congress have pressed for a shortened reporting period in 2015 with the introduction of H.R. 5481, theFlexibility in Health IT Reporting Act, or Flex-IT Act.

“CHIME commends Representatives Renee Ellmers and Jim Matheson for their steadfast leadership and continued support for a 90-day reporting period in 2015,” said Branzell. “Swift passage of the Flex-IT bill before Congress adjourns will provide the certainty that healthcare providers deserve to ensure the safe implementation and use of their EHR systems.”

Representative Ellmers (R-NC-2) and Representative Matheson (D-UT-4) introduced H.R. 5481, the Flex-IT Act, in mid-September with resounding support from industry groups including CHIME, American Medical Association (AMA), American Hospital Association (AHA) and Health Information and Management Systems Society (HIMSS). The bipartisan bill has reached over 21 cosponsors since being introduced.

Meaningful Use Stage 2 Attestation Numbers

 

About CHIME
The College of Healthcare Information Management Executives (CHIME) is an executive organization dedicated to serving chief information officers and other senior healthcare IT leaders. With more than 1,400 CIO members and over 140 healthcare IT vendors and professional services firms, CHIME provides a highly interactive, trusted environment enabling senior professional and industry leaders to collaborate; exchange best practices; address professional development needs; and advocate the effective use of information management to improve the health and healthcare in the communities they serve. For more information, please visit www.cio-chime.org.

December 9, 2014 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

Disappointing Meaningful Use Data Prompts Industry Leaders to Urge HHS to Take Immediate Action

WASHINGTON, DC November 4, 2014 –  Healthcare leaders from across the nation today renewed calls for the Centers for Medicaid and Medicare Services (CMS) to shorten the Meaningful Use (MU) reporting period in 2015 and provide more program flexibility, citing concerns with lower-than-expected Medicare numbers and continued reports detailing nationwide difficulty in meeting Federal guidelines for electronic health records (EHR) requirements.

According to newly released CMS numbers, less than 17 percent of the nation’s hospitals have demonstrated Stage 2 capabilities. Further, less than 38 percent of eligible hospitals (EHs) and critical access hospitals (CAHs) have met either Stage of Meaningful Use in 2014, highlighting the difficulty of program requirements and foretelling continued struggles in 2015.  And while eligible professionals (EPs) have until the end of February to report their progress, only 2 percent have demonstrated Stage 2 capabilities thus far.

Officials from the American Medical Association (AMA), College of Healthcare Information Management Executives (CHIME), Healthcare Information and Management Systems Society (HIMSS) and Medical Group Management Association (MGMA) called the results disappointing, yet predictable.

“Meaningful Use participation data released today have validated the concerns of providers and IT leaders.  These numbers continue to underscore the need for a sensible glide-path in 2015,” said CHIME President and CEO Russell P. Branzell, FCHIME, CHCIO.  “Providers have struggled mightily in 2014, in many instances for reasons beyond their control.  If nothing is done to help them get back on track in 2015, we will continue to see growing dissatisfaction with EHRs and disenchantment with Meaningful Use.”

CMS data required by Congress indicate that more than 3,900 hospitals must meet Stage 2 measures and objectives in 2015 and more than 260,000 eligible professionals (EPs) will need to be similarly positioned by January 1, 2015.  Given the low attestation data for 2014 and the tremendous number of providers required, but likely unable to fulfill, Stage 2 for a full 365-days in 2015, healthcare leaders have pressed for a shortened reporting period in 2015, mirroring the policy of 2014.

“The low number of EP attestations to date is clear evidence that physician practices and their vendor partners have faced significant challenges in meeting the more onerous Stage 2 requirements of meaningful use,” said Anders M. Gilberg, Senior Vice President, government affairs, MGMA. “Shortening the reporting period in 2015 is a much needed change if the program is to remain viable and is a critical step if the nation is to continue making progress toward the goal of interoperability.”

“We’re focused on transforming health and healthcare,” said Carla Smith, MA, CNM, FHIMSS, Executive Vice President of HIMSS.  “Meaningful Use Stage 2 and 2014 certified EHR technology are important drivers toward that outcome.  If CMS continues to require a full-year of Meaningful Use reporting for 2015, we anticipate that large segments of providers will no longer be able to participate in the program-which hinders our nation’s ability to improve the quality, safety, cost-effectiveness, and access to care.”

A coalition of national provider groups have repeatedly told CMS that a shortened reporting period will have a dramatically positive effect on program participation and policy outcomes sought in 2015.  Additionally, allowing flexibility in how providers meet the Stage 2 requirements, particularly related to Transitions of Care and View, Download, Transmit measures would also improve program participation.

“In addition to a shortened reporting period, CMS must end its one-size-fits all approach to achieve the goals of the Meaningful Use program, which are to create a secure and interoperable infrastructure,” said AMA President Elect Steven J. Stack, MD. “The AMA recently released a blueprint to outline ways to improve the Meaningful Use program, as well as a framework outlining eight priorities for more usable EHRs. We believe the stringent pass fail requirements for meeting Meaningful Use, combined with a tsunami of other overlapping regulations, are keeping physicians from participating in the Meaningful Use program.”

In response to a CMS final rule issued in September, provider groups sent a letter to Health and Human Service Secretary Burwell saying additional time would help hundreds of thousands of providers meet Stage 2 requirements in an effective and safe manner.  Further, the group of nearly twenty national provider organizations said a shortened reporting period and flexibility on the Transitions of Care and View, Download, Transmit measures would serve as positive incentive for those who must seek alternative paths to MU in 2014 to continue their work in 2015.

“The agency’s decision to require a full-year of reporting using 2014 Edition certified EHR technology (CEHRT) in 2015 puts many eligible hospitals and physicians at risk of not meeting Meaningful Use next year and hinders the forward trajectory of the program,” the letter states.

November 4, 2014 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.