Stage 2: EHR Incentives Available If You're Schooled

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  • September 12, 2012
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Stage 2 Meaningful Use guidelines become effective November 5. To take full advantage of financial incentives available to your practice, knowing what is expected will help.
The Centers for Medicare & Medicaid Services (CMS) announced a final rule after Labor Day specifying the Stage 2 criteria set for eligible professionals, eligible hospitals, and critical access hospitals (CAH) to quality for Medicare and Medicaid electronic health record (EHR) incentive payments. The rule also outlines payment adjustments made if program participants fail to meaningfully use EHR technology. However, the new rules provide a flexible reporting period for 2014 so providers will have sufficient time to adopt or upgrade to the latest technology available in 2014.
CMS said Meaningful Use, which is divided into three stages, affects one out of every five eligible health care professionals.

  • Stage 1 sets the basic functionalities electronic health records must include, such as capturing data electronically and providing patients with electronic copies of health information.
  • Stage 2 (which will begin as early as 2014) increases health information exchange between providers and promotes patient engagement by giving patients secure online access to their health information.
  • Stage 3 will continue to expand meaningful use objectives to improve health care outcomes.

Remember that if your practice is not a facility, you must meet the measurements or quality for exclusion to 17 core objectives and three to six menu objectives. (If you are a hospital or critical access hospital (CAH), you must meet 16, with three to six menu items.) However, if you are using “2011 Edition Certified EHR Technology,”  you may use it until 2014.  Some new criteria include:

  • Patient Engagement. CMS proposed two new core objectives providing patients online access to health information and  secure messaging between patient and provider with measures that require patients to take specific actions  for a provider to achieve meaningful use and receive an EHR incentive payment. For both objectives, the threshold was set at 10 percent of patients. While providers expressed concern, CMS is finalizing the proposed measures with reduced thresholds of 5 percent for both objectives. In addition, CMS introduced exclusions based on availability of broadband in a provider’s practice area.
  • Electronic Exchange of Summary of Care Documents. To spur provider commitment to electronic exchange, CMS had initially proposed two ambitious measures for this objective in Stage 2. The first measure required that a provider send a summary of care record for more than 50 percent of transitions of care and referrals. The second measure required that a provider electronically transmit a summary of care for more than 10 percent of transitions of care and referrals. CMS is requiring at least one instance of exchange with a provider using EHR technology designed by a different EHR vendor or with a CMS-designated test EHR.

Prepare, too, for  clinical quality measure (CQM) guidelines. The rule finalizes that providers must report on nine out of 64 CQMs. All providers must select CQMS from at least three of the six key health care policy domains from the Department of Health & Human Services (HHS) national quality strategy:

  • Patient and family engagement
  • Patient safety
  • Care coordination
  • Population and public health
  • Efficient use of health care resources
  • Clinical processes/effectiveness

For more information about this and hardship exceptions, review the Final Rule, published in the Federal Register Sept. 4.

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