Meaningful Use Requirements

AAFP, Others Urge Timeline Tweaks, Flexibility in EHR Incentive Programs

September 23, 2014 02:16 pm News Staff

Message to HHS Secretary Sylvia Burwell: Increase the flexibility in the Medicare and Medicaid Electronic Health Record (EHR) Incentive programs or risk an escalating dropout rate by America's physicians and hospitals.

[3d illustration of digital year display with 2014 in Red]

That was the gist of a Sept. 15 letter(3 page PDF) addressed to Burwell and signed by the AAFP, the AMA, the American Hospital Association and 14 other stakeholder organizations.

The letter highlights the organizations' "immediate concerns" with their members' ability to successfully participate in the programs in 2015.

"We are convinced that program success hinges on addressing the 2015 reporting period requirements," says the letter. "Specifically, we request HHS provide for a shortened, 90-day EHR reporting period in 2015, which would give time for (health care) providers to continue their transition without having to drop out of the program."

The letter reminds Burwell that in February, many organizations vested in the programs' success had communicated their concerns "that the pace and scope of (program) change had outstripped our collective capacity to comply with meaningful use requirements."

Story Highlights
  • The AAFP joined 16 other organizations in signing on to a letter asking HHS Secretary Sylvia Burwell to enhance the flexibility of the Medicare and Medicaid Electronic Health Record Incentive programs.
  • The organizations stated concerns with their members' ability to successfully participate in the programs in 2015.
  • Tweaking timelines and adding some flexibility will help hospitals and physicians continue their transition to meaningful use stage two.

It was obvious to those stakeholders that the proposed rule fell short of addressing some of the most pressing issues voiced by physicians and hospitals, says the letter, but most organizations assumed regulators would act quickly and make appropriate changes to the final rule.

However, when that final rule was published in the Sept. 4 Federal Register, the stakeholders found that it still contained a provision that would require providers to perform a full year of EHR reporting in 2015.

"We were surprised to learn that flexibilities meant to mitigate 2014 challenges did not also address program misalignment in 2015 and beyond," say the organizations, adding that they remain "incredibly concerned that a full-year reporting period will diminish the benefits of the rule HHS proposed in May and complicate the forward trajectory of meaningful use."

The final rule -- which covers implementation of 2014 edition certified EHR technology and stage one and stage two of meaningful use -- impacts thousands of hospitals and hundreds of thousands of physicians and other eligible health professionals.

Many hospitals must comply with stage two requirements using 2014 edition technology by Oct. 1, 2014, but currently, less than 4 percent of U.S. hospitals will be stage two-ready by that date, notes the letter.

"And while eligible professional have more time, they are in comparatively worse shape, with only 1.3 percent of their cohort having met the stage two bar thus far," the letter continues.

Only two weeks remain in the federal 2014 fiscal year, the organizations point out.

"We urge 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 two requirements," particularly those sections related to transitions of care and view, download and transmit measures, says the letter.

"By making such changes, HHS would improve patient safety without compromising momentum towards interoperability and care coordination supported by health IT."

The organizations conclude by pledging a strong, continuing commitment to the success of the EHR incentive programs and again encouraging Burwell to add flexibility, saying that giving physicians and other health care professionals a little extra time to complete the transition to meaningful use stage two "is the right policy to keep the program on track."

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