Big Changes to Meaningful Use

Proposed changes to Meaningful Use for 2015-2017 could make the incentive program much more attainable for eligible professionals and hospitals.

Amid the chatter about the proposed rule for stage 3 of Meaningful Use, another important proposed ruling came out from the Centers for Medicare & Medicaid Services (CMS). In April, CMS issued a new proposed rule for Meaningful Use and the EHR Incentive Programs. The proposed rule includes some significant changes to Meaningful Use, including a major simplification of the program, which could make the program much more attainable for eligible professionals and hospitals.

REDUCED COMPLEXITY – the proposed rule reduces the number of overall objectives and lowers the thresholds on some measures -- in particular, the patient engagement measures in stage 2 are significantly reduced. The public health reporting objectives are combined into a single objective and electronic messaging for eligible professionals would change to a simple yes/no measure. Overall, there are no more Menu objectives, all objectives are required in the proposed rule.

The proposed rule also removes reporting requirements on measures that have “topped out” such as smoking status and vital signs. The intent is to help participants focus on the more complex measures, which are more meaningful uses of electronic health record systems.

SHORTENED REPORTING PERIOD – the proposed rule would change the reporting period in 2015 from one year to a 90-day period aligned with the calendar year (a significant change for hospitals).

ALIGNS ALL THREE STAGES – the proposed rule seeks to make changes to the requirements for Meaningful Use for 2015 through 2017 to align with stage 3 in 2017 and subsequent years. In addition to timing alignment, the objectives for hospitals and professionals are generally the same in the proposed rule.

QUALITY IMPROVEMENT FOCUS – the proposed rule simplifies reporting requirements in an effort to help participants report on quality and outcomes measures.

Mixed Reviews So Far

Some critics of the proposed ruling are concerned the program is being reduced so much that it now lacks meaning. Former ONC Coordinator Farzad Mostashari commented: “If this proposed rule stands, it would roll back a lot of progress that's been made incorporating patient engagement into workflows.”

The American Hospital Association commented: “The shortened reporting period that the Centers for Medicare and Medicaid Services proposes gives hospitals more time to transition to Stage 2 and increases the likelihood they will meet CMS’s timetable. However, the inclusion of numerous additional program changes at this late date risks causing confusion and added burden for hospitals on top of the elements proposed in the Stage 3 rule.”

“The elimination of redundant objectives and focus on patient engagement, interoperability and the alignment of quality initiatives are the largest changes we’ve seen to Meaningful Use since it was first introduced,” says Tracy McDonald, Medicaid EHR Incentive Program Coordinator in Colorado. “The proposed changes simplify the program and level the playing field starting in 2016. After the initial shock, it’s easy to get excited about a smarter, better-defined Meaningful Use program.”

CORHIO Gathering Feedback

CMS has asked for feedback on the proposed rule by June 15th. CORHIO is gathering community feedback and will submit comments to CMS in one document. You can give us your feedback by taking the online survey at https://www.surveymonkey.com/s/R83DPTG. Or attend a webinar to learn more about the proposed changes and provide your feedback: https://www.surveymonkey.com/s/QSHKDPD

For more information on the proposed rule:

See the CMS fact sheet: http://www.cms.gov/Newsroom/MediaReleaseDatabase/Fact-sheets/2015-Fact-sheets-items/2015-04-10.html

View a recorded webinar from CORHIO detailing the changes: https://youtu.be/aBozwiZ7NuM