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Six Key Highlights: Final Rules for Stage 2 Meaningful Use

September 5, 2012

Rules Emphasize Health Information Sharing and Patient Engagement; CMS Takes Provider Concerns Into Account and Reduces Some Thresholds

Less than two weeks ago, the Centers for Medicare and Medicaid Services (CMS) released the final rules and requirements for Stage 2 of the Electronic Health Record (EHR) Incentive Program. The program provides incentive payments to eligible professionals and hospitals that adopt and successfully demonstrate meaningful use of certified EHR technology.

According to the U.S. Department of Health and Human Services (HHS), over 120,000 health care professionals and at least 3,300 hospitals have qualified to receive Meaningful Use incentives since the start of the program in January 2011.

A copy for the CMS rule is available here (PDF).

Six Key Highlights from Stage 2 Final Rules

Overall, the final rules for Stage 2 of Meaningful Use are consistent with what CMS proposed six months ago. However, CMS did incorporate revisions on the proposed rules based on feedback it received from thousands of health care stakeholders. Below, we’ve listed key highlights from final rules for Stage 2.

  1. Timing – CMS has adjusted the timeline so that providers who attested to Stage 1 of Meaningful Use in 2011 will not need to attest to Stage 2 until 2014.

  2. Patient Engagement – Consistent with the proposed regulation, Stage 2 measures require patients online access to health information and secure messaging between patients and providers. The threshold was initially proposed at 10 percent for both objectives, but has been changed to five percent based on provider concerns about being held accountable for patient use.

  3. Meaning Use Objectives Changes – The core-menu structure of Stage 2 is similar to that of Stage 1, but with some notable key changes including two new core objectives, including 1.) Eligible providers will use electronic messaging to communicate with patients on relevant health information. 2.) Eligible hospital and critical access hospitals (CAHs) will automatically track medications from order to administration using assistive technologies in conjunction with an electronic medication administration record.

  4. Electronic Exchange of Summary Care Documents – There are two measures to spur commitment to electronic exchange for Stage 2 Meaningful Use to improve care coordination for patients. 1.) Providers are required to send a summary of care record for more than 50 percent of transitions of care and referrals (down from 65 percent in the proposed rules). 2.) For more than 10 percent of transitions and referrals, eligible providers that transition or refer their patient to another setting of care or provider of care must provide a summary of care record electronically. The intent of this measure is to foster electronic exchange outside established vendor and organization networks. However, CMS is eliminating the organizational and vendor limitations. Instead, CMS is requiring at least one instance of exchange with a provider using EHR technology designed by a different EHR vendor.

  5. Clinical Quality Measures – CMS continues to acknowledge and align clinical quality measures with other reporting programs to reduce burden and duplication of efforts. Eligible hospitals and CAHs must report on 16 out of 29 clinical quality measures, and eligible professionals must report on 9 out of the 64 total clinical quality measures. In addition, all providers must select clinical quality measures from at least 3 of the 6 key healthcare policy domains from the HHS' National Quality Strategy.

  6. Payment Adjustments – Medicare payment adjustments are required by statute to take effect in 2015. In the final rule, CMS maintained its proposal that any Medicare eligible professional or hospital that demonstrates meaningful use in 2013 will avoid payment adjustment in 2015. Also, any Medicare provider that first demonstrates meaningful use in 2014 will now avoid the penalty if they meet the attestation requirement by July 3, 2014 for eligible hospitals or Oct. 3, 2014 for eligible professionals.

Using Health Information Exchange (HIE) to Meet Meaningful Use Objectives

Eligible professionals and hospitals can leverage HIEs, like CORHIO, to effectively meet Meaningful Use Stage 2 Criteria and support better patient care. For example, CORHIO can help deliver laboratory data from multiple sources in a structured format helping providers to meet the objective of incorporating more than 55 percent of all clinical lab results ordered into certified EHR technology.

In addition, HIE allows eligible professionals to meet the requirement to electronically submit summary care records between providers at transitions in care 10 percent of the time. HIE also allows providers to submit electronic data to immunization registries or systems, as well the as ability to submit syndromic surveillance data (such as info on infectious diseases) to public health agencies.

Have Questions?

Through the Colorado Regional Extension Center (CO-REC), CORHIO is hosting a free, half-day educational event called Meaningful Use Boot Camp on September 27th. All Colorado health care providers and medical office staff are welcome to attend. Click here for more information and to register.

You may also submit your question through CORHIO's contact us form.

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