CMS: More Simplification Ahead in Stage 3

CMS, HHS, and the Office of the National Coordinator for Health Information Technology recently released the proposed rule for the third stage of the meaningful use incentive program.

At the Healthcare Information and Management Systems Society Conference (HIMSS) in Chicago, attendees heard directly from CMS regarding what it feels are some of the most significant elements, and changes, included in the proposed rule.

Robert Anthony, deputy director of the quality measurement and health assessment group at CMS, stressed that the rule will include more simplification, making it easier for providers to move forward with the program.

So what exactly did Anthony mean by simplification?

Here are three areas of the proposed rule that he pointed to during his session, "CMS Meaningful Use Stage 3 Requirements," which he co-presented with Elisabeth Myers, the lead for policy and outreach for eHealth initiatives in the division of health information technology at CMS:

1. There will be a single stage for meaningful use after 2018. As proposed, Stage 3 will be the final meaningful use stage, and it will continue as the lone meaningful use regulation in coming years for both physicians previously in the program and new physicians.

We are getting away from a "step process," said Anthony, noting that part of the goal in creation of Stage 3 was to become "simpler" and to create something "sustainable" for the future.

"We heard loud and clear from a number of folks that the framework for meaningful use as we devised it in Stage 1 and Stage 2 had become something that was very complex," he said, adding that it was becoming "burdensome" and causing work flow issues for providers because of the amount of things that needed to be measured and reported. "We very much wanted to focus on simplifying that into something that was going to be more easily understandable as we move forward into the future ..."

2. There will be a single reporting period. The proposed rule specifies that the meaningful use reporting period would be a full year for both physicians and hospitals starting in 2017 and in future years. And, the rule proposes adjusting to the calendar year for hospitals and professionals so that everyone is better aligned, said Anthony.

3. There will be fewer objectives. Stage 3, as proposed, reduces the number of objectives to eight. One reason, Anthony said, is that CMS received feedback from providers that some of the objectives in previous stages were redundant or duplicative.

Anthony acknowledged that many of the objectives have numerous measures associated with them, but he stressed that there is some "internal flexibility" built into them.

CMS heard a lot from providers about the "all-or-nothing concept" of meaningful use: If you miss just one thing then you've missed everything, he said. "What we've tried to do is, we've tried to ... move down to the sort of eight core measures but even within those measures we've tried to preserve a level of flexibility."

Overall, Anthony said, the goals in this third and final stage include stepping up the electronic exchange of information among providers and between patients and providers, ensuring patients have access to their health information, and continuing the push toward "big data" that is standardized and easily shared.