In October, CMS released a final rule detailing the latest requirements for participating in the Medicare and Medicaid Electronic Health Record (EHR) Incentive Programs. According to the agency, since the programs launched in January 2011, more than 475,000 physicians, hospitals and other eligible providers have been on the receiving end of bonuses.
That's the good news.
However, the sobering reality is that way too many physicians -- including plenty of family physicians -- find the requirements for participation in the programs to be exceedingly complex, administratively burdensome and a diversion from patient care. And a good number of them are bailing as a result.
In short, participation in meaningful use has flattened out.
With that in mind, the AAFP -- a long-time supporter of electronic health records and their place in the nation's rapidly evolving health care system -- recently created a "Frequently Asked Questions About Meaningful Use" resource designed to help family physicians participate and succeed in the programs.
Why the Effort?
Erin Solis, an AAFP regulatory compliance strategist and chief author of the frequently asked questions (FAQ) document, discussed with AAFP News the Academy's continuing efforts to help family physicians stay on top of a program that has been fraught with frequent and confusing changes.
- The AAFP recently created a resource for family physicians based on the most pressing questions physicians have about the meaningful use program.
- The final rule implementing the Medicare and Medicaid Electronic Health Record (EHR) Incentive Programs was released in October; it was nearly 800 pages long.
- The resource should help family physicians better understand the rules associated with the programs and allow participating physicians to achieve success.
Q. Why is an FAQ necessary on this topic?
A. Meaningful use has always been a complex and confusing program. The release of the final rule condensed it to two stages, but didn't really remove any of the complexity; if anything, it added to it. For example, they updated or changed some of the measures and are providing both exclusions and alternate exclusions. Physicians can't be expected to wade through all of that information and pick out what's important.
Q. What are some of the most pressing questions you get from members on this topic?
A. Recently, I've gotten a few questions on the Public Health objective. I think members are getting a little panicked about it because it's one that changed and has fairly specific exclusion requirements. Since meaningful use is all or nothing, if they miss this one, they miss the whole thing. That puts a lot of stress on providers and practice administrators.
Q. Would you explain how the document is organized?
A. I organized it by general questions that would apply to providers regardless of which stage they were in and also highlighted some of the changes made in the final rule. I then broke it out by modified stage two and stage three. Within each of those, I just went through each objective in the final rule and picked out questions that were either raised by commenters or that, based on my clinic experience, I thought members would find valuable.
Q. The document is really long. Does that speak to the complexity of this program?
A. Yes. The rule was nearly 800 pages long. There was a lot of discussion and clarification requested from commenters.
The answers to physicians' most important questions about meaningful use most likely are addressed in this member resource.
For instance, the FAQ clarifies particulars regarding
- the reporting period and the difference between 90 continuous days versus a three-month period;
- reporting requirements, including alternate measures and exclusions available after 2015;
- information to be included in a health information exchange (previously referred to as a summary of care);
- a timeframe for providing patient-specific education;
- the definition of medication reconciliation;
- patient electronic access and mandatory information;
- a phased-in approach to secure messaging with patients;
- electronic prescribing and the exclusion of OTC medications;
- coordination of patient care and patient engagement; and
- public health and clinical data registry reporting.
Steven Waldren, M.D., director of the AAFP's Alliance for eHealth Innovation, offered a hint of optimism about the future of a federal program that has seen considerable criticism from the physician community.
"Although the meaningful use program is complex and challenging, the AAFP was encouraged to see CMS make changes to the program in the final rule and leave open the possibility of more improvements in the future," he told AAFP News.
And to be sure, the AAFP has for months been peppering CMS with letters offering suggestions on how to make the programs more palatable and workable for physicians, as well as meeting face-to-face with federal officials and policymakers to air concerns.
Importantly, Waldren noted that CMS recently agreed to roll the meaningful use program into the Merit-based Incentive Payment System. "That move indicates there is a chance for even more streamlining of the meaningful use requirements with other existing regulations," he said.
Related AAFP News Coverage
Meaningful Use a 'Program in Crisis'
AAFP Urges HHS to Pause, Refocus, Streamline MU Program