What the Stage 2 Meaningful Use Extension Means to Physicians

The extension of the Stage 2 deadline for meeting CMS' meaningful-use requirements means physicians have a little more time before they have to worry about Stage 3. What it doesn't mean is that they should slow down their plans for attesting for Stage 2.

"If you're struggling to meet Stage 2, this doesn't in any way solve that immediate problem," Jason Fortin, a senior advisor with Impact Advisors, told Physicians Practice. "Stage 2 is still on for 2014, it's just been extended from two years to three years."

On Friday, CMS proposed a new timeline for the implementation of meaningful use for the Medicare and Medicaid EHR Incentive programs. Under the revised timeline, Stage 2 will be extended through 2016 and Stage 3 will begin in 2017 for those providers who have completed at least two years in Stage 2.

The goal of this change is two-fold; first, to allow CMS and the Office of the National Coordinator for Health Information Technology (ONC) to focus efforts on the successful implementation of the enhanced patient engagement, interoperability, and health information exchange requirements in Stage 2; and second, to utilize data from Stage 2 participation to inform policy decisions for Stage 3.

The phased approach to program participation helps providers move from creating information in Stage 1, to exchanging health information in Stage 2, to focusing on improved outcomes in Stage 3, according to CMS.

Under the proposal, eligible providers who have completed at least two years of Stage 2 would begin Stage 3 in 2017. "We currently anticipate that eligible professionals would begin in January 2017, at the start of the calendar year, and eligible hospitals and critical access hospitals would begin in October 2016, at the start of the federal fiscal year," CMS said in a statement.

For the most part, physicians and organizations representing them, such as the Healthcare Information and Management Systems Society (HIMSS), cheered the news.

"HIMSS is gratified that the U.S. Department of Health and Human Services, the Centers for Medicare and Medicaid Services, and the Office of the National Coordinator for Health IT have heard concerns from health stakeholders and extended meaningful use Stage 2 by one year," said HIMSS in a statement. "This additional time to attest offers an opportunity for increased feedback and analysis on technology implementation, eClinical Quality Measure reporting, and progress toward interoperability that will enhance the ability of eligible hospitals and eligible professionals to meaningfully use health IT, and thus improve the quality and cost-effectiveness of patient care."

Healthcare technology consultant Rosemarie Nelson said the extension "will allow practices to continually evolve their EHR implementation and more fully utilize functions like clinical-decision support to improve and monitor treatment plans." 

But Robert Tennant, a senior policy adviser for the Medical Group Management Association, noted that the proposal does not address the growing concern that many EHR vendors have not yet produced software certified under "the revised and more onerous 2014 criteria."

Meanwhile, many healthcare consultants and physicians believe that meeting Stage 2 requirements, such as proving five percent of their patients are engaged in their own care, will present an ongoing challenge.

"A large bulk of the work that we've done have been related to transitions of care and patient engagements," said Fortin, who consults with physician practices on technology and other issues. "The requirements are very complicated, especially if you have a lot of systems involved in the work flow. Like the patient engagement one, providers are responsible for patients taking action."

For the Stage 2 patient-engagement requirements, education and outreach is essential for patients and staff, said Fortin.

"Patients will need to understand how they can log on and what information is available," said Fortin. "Staff will need to understand changes in work flow. For example, are patients encouraged to sign up for [a patient] portal when they check in at the front desk?"