Meaningful Use Proposed Changes Offer Physicians More Time, Flexibility

CMS has offered a bit of a reprieve to eligible providers struggling to meet the meaningful use guidelines for Stage 2.

According to rule changes proposed on May 20, eligible providers will have an additional year to upgrade their EHRs and meet the reporting requirements for the Stage 2 rules of meaningful use.

This would mean, for example, that a practice which attested to the Stage 1 rules in 2011 can attest to the Stage 2 rules for the next three years starting in 2014, rather than worrying about preparing for Stage 3 in 2016 - that is now delayed until 2017.

CMS also provided the following chart:

In addition to extending Stage 2 until 2016 and delaying the start of Stage 3 until 2017, the new rules will also allow participants to use either 2011-version EHR technology or a combination of 2011 and 2014 versions to attest for meaningful use. CMS previously announced a hardship exemption for physicians and practices in the event of "2014 vendor issues."  Physicians must apply for the hardship by July 1, 2014.

Under the proposed rule change, the requirements for reporting clinical quality measures have also changed, allowing providers to attest in 2014 under the 2013 definition.

"This will definitely help some people," said health IT expert Robert Wah, chief medical officer for Computer Sciences Corporation, "and with more than just added flexibility. There were clearly some issues about software delivery, but it also gives more space to qualify and meet the requirements."

The rule changes are, at least in part, a response to the difficulties many providers were having acquiring the necessary EHR software, but are also a response to concerns about the program expressed by many participants. In February 2014, a group of physician organizations sent a letter to HHS Secretary Kathleen Sebelius, supporting the program, but writing, "We fear the success of the program is in jeopardy, however, if steps are not taken now to address our shared concerns." Those concerns included difficulties obtaining software editions in compliance with 2014 standards as well as having adequate time to implement and learn the software when it is available.

And it appears the concerns were taken seriously. In announcing the rule changes, CMS administrator Marilyn Tavenner stated, "By extending Stage 2, we are being receptive to stakeholder feedback to ensure providers can continue to meet meaningful use and keep momentum moving forward."

In addition to the extra time and flexibility, the extension might also provide time to evaluate the program's progress. "This is an opportunity to do a vector check, to make sure we are doing what we set out to do," said Wah. "We don't want to get caught up in the idea that this is some checklist we have to tick off. We should all be focused on the same goal: Improving the quality of care for patients. Anything that can be done to keep us working toward that goal is a good thing."

Wah was also recently elected president of the AMA, but spoke to Physicians Practice prior to assuming that new role.

On whether the timeline changes are an indicator that CMS' EHR Incentive Programs for Medicare and Medicaid are in trouble, Wah said, "I am an optimist. I think it is a good sign. [CMS and HHS] are listening and being responsive."