The Centers for Medicare and Medicaid Services (CMS) and the Office of the National Coordinator for Health Information Technology (ONC) on Oct. 6 released two final rules that align all three stages of the Electronic Health Record (EHR) Incentive Program (also known as “Meaningful Use”). In addition to finalizing program requirements for the 2015-2017 reporting periods, the rules combine Meaningful Use into one single stage. According to the agencies, the alignment aims “to advance electronic health records with added simplicity and flexibility.”

The agencies highlighted the following provisions:

2015-2017 Meaningful Use Modifications Rule

• Ten reporting objectives for eligible professionals, including one public health objective, which is down from 18 objectives.
• Nine reporting objectives for eligible hospitals and critical access hospitals (CAH), including one public health reporting objective, which is down from 20 objectives.
• There are no further changes to the Clinical Quality Measures reporting for eligible professionals or eligible hospitals/CAHs.

Meaningful Use Stage 3 Rule

• Eight objectives for eligible professionals, eligible hospitals and CAHs. More than 60 percent of Stage 3 proposed measures require interoperability versus 33 percent in Stage 2.
• Public health reporting includes flexible options for measure selection.
• Clinical quality measure reporting and CMS quality reporting programs are aligned.
• Application program interfaces will be finalized to enable patients to have access to their health data.

While the ACC is a longtime advocate of EHRs as a way to improve the quality of patient care, the College has voiced its concerns with moving too quickly with Meaningful Use implementation. “Many of the requirements for Stage 2 proved unattainable,” said ACC President Kim Allan Williams, Sr., MD, FACC, in response to the rules. “Large numbers of providers either haven’t met them or, after trying and failing, have given up. That is why it is vital that CMS consider participation data from the current stage to see what is working and what isn’t before outlining an upcoming stage. We cannot establish a long-term health care program that does not take into account what we can feasibly attain in the short-term, transitional period.”

The ACC will continue to work with CMS to determine how Meaningful Use will align with the new Merit-Based Incentive Payment System which will go into effect in 2017. Although CMS and ONC released final rules, they are open to a 60-day comment period. The ACC is currently reviewing the rules and will submit comments by their respective deadlines.

Keywords: Centers for Medicare and Medicaid Services, U.S., Electronic Health Records, Meaningful Use, Medicaid, Medical Informatics, Medicare, Patient Care, Public Health, United States

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