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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.

EHR Interoperability Breakthrough Powers Referrals, Care Coordination and Clinically Integrated Networks

Infina Connect announces universal electronic exchange of clinical documents, greatly reducing the need for costly interfaces and private HIE’s to support value based care.

CARY, NC, November 19, 2015 – Infina Connect, the leading provider of SaaS referral coordination solutions, today announced the release of ICC Direct, a significant breakthrough in standards-based interoperability and care coordination that lets a patient’s healthcare providers easily share clinical records with other providers and team members, no matter where they work or which electronic health record (EHR) they use.

ICC Direct – a new capability built into Infina Connect’s Intelligent Care Coordinator (ICC) – leverages the secure messaging capability built into all 2014 edition Certified EHRs, access to the Surescripts Clinical Direct Messaging solution via the nation’s largest health information network, and universal delivery capability to accomplish this breakthrough.  With ICC Direct, healthcare providers are able to automate the creation of new ICC referrals from any certified EHR and electronically exchange documents with any provider anywhere, including Meaningful Use Stage Two- compliant exchange of Consolidated CDA (C-CDA) documents such as Continuity of Care Documents (CCD’s).  More importantly, ICC Direct connects the relevant clinical information from the EHR directly to the referral workflow in ICC, making it easier for providers using ICC to provide effective closed loop care coordination.

“We’ve been using ICC for many years to close the loop on patient care,” said Kelly Crisp, Director of Health Information & Technology, Raleigh Medical Group, a 29-provider internal medicine and gastroenterology group with 4 main and 11 satellite locations in the Raleigh, NC area.  “Now with ICC Direct, our referral process is even more efficient with little to no workflow integration changes, and we can easily meet the 10 percent electronic transmission requirement for Meaningful Use Stage Two.”

In addition to gaining the visibility into patient information that is necessary to effectively manage populations, ICC Direct’s simplified access to contextually relevant clinical information represents a key differentiator for health systems and ACO’s interested in improving outcomes and expanding their provider networks.

Providers nationwide have been struggling to share information electronically due to technology systems that are unable to easily communicate with each other, with the top barriers cited as cost, vendor support and technical difficulty.  The transition to value-based contracts has led healthcare organizations to invest in expensive interfaces, integrations, and private HIE’s to exchange information as patients transition across care settings and providers.  ICC Direct greatly reduces the need for these costly and time-consuming investments, enabling all providers to share information electronically and seamlessly coordinate care across care settings for about what it costs to fax.  As a result, ICC Direct eliminates the top interoperability barriers to population health management and the success of value-based healthcare.

“The primary reason providers need to communicate with each other is because they have a patient in common,” said Mark Hefner, CEO of Infina Connect.  “We set out to enable providers to coordinate referrals and transitions of care in a highly effective and efficient manner.  Along the way, it became clear that solving the interoperability problem was the next logical step, and that’s what ICC Direct does – more effectively and affordably than any other solution on the market today.”

Referring providers using ICC Direct can also easily meet the “10 percent electronic transmission” requirement of Meaningful Use Stage Two, Objective 15, Measure 2, even if the consulting provider is unable to receive Direct messages.  Many providers have had difficulty meeting this requirement.  Adherence to Meaningful Use is required for providers to receive incentives, participate in population health contracts, and avoid payment penalties.

About Infina Connect

Infina Connect is the leading provider of SaaS referral coordination solutions, and the first to be adopted by a majority of providers across a major metropolitan area.  Infina Connect enables providers to optimize placement of referrals within high value networks and electronically perform closed loop referrals to coordinate patient care, improve patient health and maximize revenue.  Infina’s electronic exchange of clinical documents also enables providers to comply with the electronic document exchange requirements of Meaningful Use Stage Two (Objective 15) and the CMS Chronic Care Management program.  For more information, visit www.infinaconnect.com.

November 19, 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 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.

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.

CHIME Statement on the Introduction of the Flexibility in Health IT Reporting (Flex-IT) Act

This afternoon Congresswoman Renee Ellmers (R-NC) and Congressman Jim Matheson (D-UT) introduced the Flexibility in Health IT Reporting (Flex-IT) Act granting the nation’s healthcare providers the additional flexibility in meeting Meaningful Use requirements through a shortened reporting period in 2015.

CHIME commends Congresswoman Ellmers and Congressman Matheson for their immense leadership on this critically important issue following the industry’s joint call to action earlier today. The Flexibility in Health IT Reporting (Flex-IT) Act would negate the latest final rule and adjust the program reporting timeline; giving providers the option to choose any three-month quarter for EHR reporting in 2015.

The misstep by officials 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 intended impact of the program. To date; only 143 hospitals have met Stage 2 to date, representing a very small percentage of the 3,800 hospitals required to be Stage 2-ready within the next 14 days.

With just two weeks remaining in the fiscal year, Congress’ swift passage of the Flexibility in Health IT Reporting (Flex-IT) Act would help hundreds of thousands of providers meet Stage 2 requirements in an effective and safe manner, and ensure long-term vitality of the program itself.

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.

September 16, 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.

Industry Leaders Call for Immediate Action to Amend 2015 EHR Reporting Period

ANN ARBOR, MI, September 16, 2014 – In a letter to HHS Secretary Sylvia M. Burwell, the College of Healthcare Information Management Executives (CHIME), the Association of Medical Directors of Information Systems (AMDIS) and 15 other healthcare organizations issued an immediate call to action to adjust the 2015 EHR reporting period to help hundreds of thousands of providers meet Meaningful Use Stage 2 requirements in an effective and safe manner.

Responding to the Centers for Medicaid and Medicare Services’ (CMS) final rule on Meaningful Use flexibility, the letter states 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.

“We implore you to take immediate action by shortening the 2015 EHR reporting period to 90 days and by adding flexibility in how providers meet the Stage 2 requirements,” the letter states. “The additional time and flexibility afforded by these modifications will help hundreds of thousands of providers meet Stage 2 requirements in an effective and safe manner. This will reinforce investments made to date and it will ensure continued momentum towards the goals of Stage 3, including enhanced care coordination and interoperability.”

While the final rule does provide flexibility in meeting MU requirements for 2014, most hospitals who take advantage of the new pathways will not be in a position to meet Stage 2 requirements beginning October 1, 2014 (FY 2015).

“With just two weeks to go before the start of Fiscal Year 2015, immediate attention to this requirement is essential,” said CHIME President and CEO Russell P. Branzell, FCHIME, CHCIO. “There are thousands of hospitals right now desperately trying to determine how to appropriately install and configure software for Stage 2, and how to start collecting data by the end of this month.”

The letter outlines that to date; only 143 hospitals have met Stage 2, representing a very small percentage of the 3,800 hospitals required to be Stage 2-ready within the next 14 days.

“This additional time is vitally important to ensure that hospitals and physicians continue moving forward with technology to improve patient care,” the letter states. “By making such changes, HHS would improve patient safety, without compromising momentum towards interoperability and care coordination supported by health IT.”

By adjusting the timeline, providers would have the option to choose any three-month quarter for an EHR reporting period in 2015 to qualify for Meaningful Use.

“This sensible change to the 2015 reporting period, from 365 days to 90, will ensure broad program participation and will enable providers to continue their Meaningful Use journey,” said CHIME Board Chair Randy McCleese FCHIME, LCHIME, CHCIO, Vice President of Information Services and CIO at Morehead, Kentucky-based St. Claire Regional Medical Center. “Carrying forward the 2014 policy requiring providers submit data covering one quarter of their choosing in 2015 is the right decision, and it is our hope that officials act quickly.”

CHIME leaders will reiterate this call to action as they meet with officials this week as part of National Health IT Week in Washington, D.C.

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.

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 Statement on Finalization of Meaningful Use ‘Modifications’ Rule

From Russell P. Branzell, FCHIME, CHCIO, President and CEO

This afternoon the Centers for Medicaid and Medicare Services (CMS) and the Office of the National Coordinator for Health IT (ONC) finalized a regulation granting providers additional flexibility in meeting Meaningful Use (MU) requirements in 2014. However, the final rule lacked a key provision that would ensure continued EHR adoption and MU participation

CHIME is deeply disappointed in the decision made by CMS and ONC to require 365-days of EHR reporting in 2015. This single provision has severely muted the positive impacts of this final rule. Further, it has all but ensured that industry struggles will continue well beyond 2014.

Roughly 50% of EHs and CAHs were scheduled to meet Stage 2 requirements this year and nearly 85% of EHs and CAHs will be required to meet Stage 2 requirements in 2015. Most hospitals who take advantage of new pathways made possible through this final rule will not be in a position to meet Stage 2 requirements beginning October 1, 2014. This means that penalties avoided in 2014 will come in 2015, and millions of dollars will be lost due to misguided government timelines.

Nearly every stakeholder group echoed recommendations made by CHIME to give providers the option of reporting any three-month quarter EHR reporting period in 2015. This sensible recommendation, if taken, would have assuaged industry concerns over the pace and trajectory of rulemaking; it would have pushed providers to meet a higher bar, without pushing them off the cliff; and it would have ensured the long-term vitality of the program itself. Now, the very future of Meaningful Use is in question.

August 29, 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.

New CMS rule allows flexibility in certified EHR technology for 2014

Rule will help more providers use electronic health record technology

The Department of Health and Human Services (HHS) published a final rule today that allows health care providers more flexibility in how they use certified electronic health record (EHR) technology (CEHRT) to meet meaningful use for an EHR Incentive Program reporting period for 2014. By providing this flexibility, more providers will be able to participate and meet important meaningful use objectives like drug interaction and drug allergy checks, providing clinical summaries to patients, electronic prescribing, reporting on key public health data and reporting on quality measures.

“We listened to stakeholder feedback and provided CEHRT flexibility for 2014 to help ensure providers can continue to participate in the EHR Incentive Programs forward,” said Marilyn Tavenner, CMS administrator. “We were excited to see that there is overwhelming support for this change.”

Based on public comments and feedback from stakeholders, the Centers for Medicare & Medicaid Services (CMS) identified ways to help eligible professionals, eligible hospitals, and critical access hospitals (CAHs) implement and meaningfully use Certified EHR Technology. Specifically, eligible providers can use the 2011 Edition CEHRT or a combination of 2011 and 2014 Edition CEHRT for an EHR reporting period in 2014 for the Medicare and Medicaid EHR Incentive Programs; All eligible professionals, eligible hospitals, and CAHs are required to use the 2014 Edition CEHRT in 2015.

These updates to the EHR Incentive Programs support HHS’ commitment to implementing an effective health information technology infrastructure that elevates patient-centered care, improves health outcomes, and supports the providers that care for patients.

The rule also finalizes the extension of Stage 2 through 2016 for certain providers and announces the Stage 3 timeline, which will begin in 2017 for providers who first became meaningful EHR users in 2011 or 2012.

An updated meaningful use timeline and a chart with 2011 and 2014 CEHRT Edition options are available at http://cms.gov/Newsroom/MediaReleaseDatabase/Press-releases/2014-Press-releases-items/2014-08-29.html.

For more information about the EHR Incentive Programs, please visithttp://www.cms.gov/EHRIncentivePrograms. For more information about CEHRT, please visit http://www.healthit.gov/certification.

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 Supports New Pathways for Meaningful Use in 2014

Nation’s CIOs ask for swift finalization of proposed rule with ‘common sense’ amendments
ANN ARBOR, MI, June 30, 2014 – In comments submitted Friday, June 27 on proposed “Modifications to the Medicare and Medicaid Electronic Health Record Incentive Programs for 2014,” the College of Healthcare Information Management Executives (CHIME) offered general support of program changes, but requested additional revisions and clarifications to maintain momentum of the federal initiative.

Comments from the professional association of healthcare CIOs and IT leaders said additional flexibility is needed because changes proposed for the Meaningful Use incentive program were only first released in late May, limiting the amount of time providers have to react to changes.

“CHIME supports the new pathways as defined in the proposed rule,” the letter read. “We believe these options will provide needed flexibility for EHR optimization, encourage continued participation in the program and help maintain the upward trajectory of EHR adoption in the US.”

One of CHIME’s primary requests is that the Centers for Medicare & Medicaid Services allow providers to choose any three-month quarter for an EHR reporting period in the next federal fiscal year or calendar year to qualify for Meaningful Use in 2015. As currently structured, the program requires providers to report a full year of data to qualify for incentives.

“We believe this change will have a dramatically positive effect on program participation and policy outcomes sought in 2015,” CHIME’s comments noted. “The additional time afforded by this modification would help hundreds of thousands of providers meet Stage 2 requirements in an effective and safe manner.”

“We are grateful for the agencies’ acknowledgement that 2014 has been an extremely challenging year for the industry,” said CHIME President and CEO Russell P. Branzell, FCHIME, CHCIO.  “The new pathways created by this NPRM will enable many hospitals and physicians to capitalize on progress made to date. However, the benefits of this new flexibility will be immediately lost if 2015 reporting requirements are not tempered.  Carrying forward the 2014 policy requiring providers submit data covering one quarter of their choosing in 2015 is common sense.”

Additional flexibility is needed because of the continued industry-wide strain to implement information technology in time to meet ongoing requirements of the program, CHIME contended. “Because there is such limited capacity for the industry to absorb ongoing technology upgrades and process changes, CHIME implores CMS to allow 3-month quarter EHR reporting options in 2015.”

CHIME’s comments also asked that the agencies delete ambiguous attestation requirements related to the definition of “fully implemented” Certified EHR Technology (CEHRT). “A number of CHIME members have indicated their apprehension to take advantage of the new pathways created by this NPRM (because of) how this proposed rule defines ‘full implementation’ of CEHRT since the examples do not adequately represent their situation,” CHIME stated.

“Given the industry’s experience with Meaningful Use audits, there is a lot of anxiety over how such a requirement would be validated,” said CHIME Board Chair Randy McCleese, FCHIME, LCHIME, CHCIO, Vice President of Information Services and CIO at Moorhead, Kentucky-based St. Claire Regional Medical Center.  “The fear generated by meaningless audits can be crippling for small and rural organizations like ours. Ambiguity in what constitutes ‘full CEHRT implementation’ defeats the primary intent of this NPRM – namely, to encourage continued participation in the program.”

Overall, CHIME believes “these new pathways will provide much-needed relief to hundreds of thousands of providers struggling to meet MU requirements in 2014, due to circumstances beyond their control,” but CHIME is asking agencies to “explicitly state its intentions to let providers meet MU requirements retrospectively in 2014, if they are able.”

Finally, CHIME offered its support of the one-year extension of Stage 2 for providers that first qualified as meaningful users of EHR technology in 2011 and 2012. “This is a necessary extension to give policymakers time to evaluate past experience and incorporate lessons learned into the third Stage of Meaningful Use,” CHIME stated.

“From Day One, CHIME has been an adamant supporter of Meaningful Use, and we remain supporters to this day,” said Branzell. “Our comments and recommendations are pragmatic and meant to ensure that industry, government and taxpayer investments are properly managed.  We are confident that if CMS makes these common sense changes, we can realize the benefits of a modern, connected healthcare system.”

The full text of CHIME’s response to the proposed modifications to the Meaningful Use program can be found at http://www.cio-chime.org/advocacy/resources/download/CHIME_Response_to_Modifications_MU_2014_Final.pdf

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 more than 130 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.

June 30, 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.