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GE Healthcare Camden Group Insights Blog

What’s Up with Meaningful Use?

Posted by Matthew Smith on May 6, 2015 10:43:00 AM

You have not escaped attesting for Meaningful Use. Even after 2018, Meaningful Use will be one of the categories used to award incentives starting in 2019 under the just-passed Medicare Access and CHIP Reauthorization Act, H.R. 2, now known as “MACRA.” Unless you are leaving practice in the next two years, and/or Medicare is not a big portion of your practice, you should move forward with electronic health record (“EHR”) implementation and Meaningful Use attestation to avoid a three percent penalty in 2017.  

The good news is that attesting for Stage 2 Meaningful Use just got easier with new rules proposed by the Centers for Medicare and Medicaid Services (“CMS”) and the Office for the National Coordinator for Health Information Technology. Proposed changes include:

  • Reduces the Stage 2 objectives, and measures are scaled back; those scheduled for Stage 1 can attest to a “modified” Stage 2.
  • Attestation period reduced to 90 days from a full year.
  • Removes measures that have become redundant, duplicative, or have reached widespread adoption
  • Reduces the view-download-transmit requirement to one patient
  • Reduces the secure messaging requirement from five percent to solely having the capability

Stage 3 Meaningful Use

The current requirement to be at Stage 3 by 2018 or face up to a three percent penalty also has not disappeared. The key requirements are:

  • Eight objectives with 21 measures including e-prescribing, clinical decision support, computerized physician order entry, and health information exchange
  • Incorporate either an online patient portal or application-program interface to provide patients with electronic access to their medical record (used by 25 percent of patients)
  • Use secure messaging with 25 percent of patients
  • Report meaningful use measures for a full year

Meaningful Use Audits

CMS has already started meaningful use audits, and the Office of Inspector General will also begin audits.

What Should You Be Doing?

  • If you haven’t moved to an EHR, start now and attest in 2015. Not only does attestation prevent penalties, but it creates the foundation for the data infrastructure required for the Medicare Merit-Based Incentive Payment System (“MIPS”) in 2019
  • Prepare for audits now: review your documentation for each measure, and ensure that it adequately documents your process, your measure calculation reporting, and dated screen shots that demonstrate meeting the measure
  • Begin moving to Stage 3 requirements

Topics: Meaningful Use, Stage 3 Meaningful Use, MACRA

Infographic: Is Meaningful Use Helping or Hurting EHR Adoption?

Posted by Matthew Smith on Dec 3, 2014 11:14:00 AM

Infographic, Meaningful Use, EHR, EMRWhen the Centers for Medicare and Medicaid Services (CMS) launched their EHR Incentive Programs back in January 2011, the main goal was to reward healthcare practitioners for adopting electronic health records and increasing efficiency within their practice. But one question everyone still finds themselves asking is whether or not the incentives have actually encouraged EHR adoption?

NueMD compiled research from the Department of Health and Human Services (HHS), CMS, and the American College of Physicians (ACP) looking to identify adoption trends and determine potential obstacles to successful implementation. Check out the findings below.

To view a larger version of the infographic, please click here and click on the image once it opens in your browser.

MU, Meaningful Use, Infographic, EHR, EMR, Electronic Health Record

 Infographic provided courtesy of NueMD. 

Topics: EHR, EMR, Meaningful Use, CMS, Infographic, Electronic Health Record, Electronic Medical Record, MU

New EHR Attestation Deadline for Eligible Hospitals: 12/31/14

Posted by Matthew Smith on Nov 24, 2014 3:01:00 PM
Courtesy of Centers for Medicare & Medicaid Services 

CMS, EHR, Meaningful UseCMS is extending the deadline for eligible hospitals and Critical Access Hospitals (CAHs) to attest to meaningful use for the Medicare Electronic Health Record (EHR) Incentive Program 2014 reporting year from 11:59 pm EST on November 30, 2014 to 11:59 pm EST on December 31, 2014.

This extension will allow more time for hospitals to submit their meaningful use data and receive an incentive payment for the 2014 program year, as well as avoid the 2016 Medicare payment adjustment.

CMS is also extending the deadline for eligible hospitals and CAHs that are electronically submitting clinical quality measures (CQMs) to meet that requirement of meaningful use and the Hospital Inpatient Quality Reporting (IQR) program. Hospitals now have until December 31, 2014 to submit their eCQM data via Quality Net.

Note: This extension does not impact the deadlines for the Medicaid EHR Incentive Program.

How to attest?
Medicare eligible hospitals and CAHs will use the Registration and Attestation System to submit their attestation for meaningful use for the 2014 reporting year. The system is open and fully operational, and includes the 2014 Certified EHR Technology (CEHRT) Flexibility Rule options. Medicare eligible hospitals and CAHs can attest any time to 2014 data until 11:59 pm EST on December 31, 2014 to meet the new 2014 program deadline.

Attestation Tips
Here are some steps to help make the attestation process easier:

  • Consider logging on to use the attestation system during non-peak hours, such as evenings and weekends
  • Log on to the registration and attestation system now and ensure that your information is up to date and begin entering your 2014 data  
  • If you experience attestation problems, call the EHR Incentive Program Help Desk and report the problem

Reminder: Medicare eligible hospitals must attest to demonstrating meaningful use every year to receive an incentive and avoid a payment adjustment.

2016 Payment Adjustments
Payment adjustments will be applied at the beginning of FY 2016 (October 1, 2015) for Medicare eligible hospitals that have not successfully demonstrated meaningful use in 2014. Read the eligible hospital payment adjustment tipsheet to learn more.

Note:  CAHs have a different payment adjustment schedule than Medicare eligible hospitals. Review the CAH Payment Adjustment and Hardship Exception Tipsheet.

Resources
The EHR Information Center is open to assist you with all of your registration and attestation system inquiries. Please call, 1-888-734-6433 (primary number) or 888-734-6563 (TTY number). The EHR Information Center is open Monday through Friday from 7:30 a.m. – 6:30 p.m. (Central Time), except federal holidays.

Attestation resources are available on the Educational Resources webpage of the EHR Incentives Programs website.

Topics: EHR, EMR, Meaningful Use, Medicare, CMS, Medicaid, Attestation

Summary of Care Meaningful Use Requirements in Stage 2

Posted by Matthew Smith on Nov 18, 2014 10:42:00 AM

EHR, EMR, Electronic Medical Records, Meaningful UseIf you are an eligible provider participating in the EHR Incentive Programs, you will have the option of reporting the Summary of Care menu objective in Stage 1, but will be required to meet the core objective in Stage 2.

CMS wants to ensure providers are able to meet Measure #2 of the Summary of Care objective in Stage 2. Below is some additional guidance to help you meet the measure.

Guidance for Meeting Measure #2

For Measure #2 of the Stage 2 Summary of Care objective, an eligible professional, eligible hospital or critical access hospital (CAH) may count a transition of care or referral in its numerator for the measure if they electronically create and send a summary of care document when a third party organization is involved so long as:

  • The summary of care document is created using certified EHR technology (CEHRT);
  • The summary of care document electronically transmitted by the eligible professional, eligible hospital, or CAH to the third party organization is done so using EITHER:
    1. their CEHRT’s transport standard capability; or
    2. an exchange facilitated by an organization that is an eHealth Exchange participant.
  • The third party organization can confirm for the sending provider that the summary of care document was ultimately received by the next provider of care.

In instances where a “third party organization that plays a role in determining the next provider of care and ultimately delivers the summary of care document” is involved, the service the third party provides does not have to be certified for the transmission to be counted in the numerator for Measure #2. Nor are there any specific requirements around the technical standards or methods by which the third party delivers the summary of care document to the receiving provider (e.g., SOAP, secure email, fax).

For More Information

For more information, read the updated FAQ. For additional Stage 2 resources, visit the Stage 2 webpage of the EHR Incentive Programs website.

Topics: EHR, EMR, Meaningful Use, CMS, CEHRT, CAH, Critical Access Hospitals, Summary of Care

Hardship Exception Applications to Avoid the 2015 Medicare Payment Adjustment Due 11/30/14

Posted by Matthew Smith on Oct 7, 2014 3:46:00 PM

CMS, Meaningful UseCMS is announcing its intent to reopen the submission period for hardship exception applications for eligible professionals and eligible hospitals to avoid the 2015 Medicare payment adjustments for not demonstrating meaningful use of Certified Electronic Health Record Technology (CEHRT). The new deadline will be November 30, 2014. Previously, the hardship exception application deadline was April 1, 2014 for eligible hospitals and July 1, 2014 for eligible professionals.

As part of the American Recovery and Reinvestment Act of 2009 (Recovery Act), Congress mandated payment adjustments under Medicare for eligible hospitals, critical access hospitals, and eligible professionals that are not meaningful users of CEHRT. The Recovery Act allows the Secretary to consider, on a case-by-case basis, hardship exceptions for eligible hospitals, critical access hospitals, and eligible professionals to avoid the payment adjustments.

This reopened hardship exception application submission period is for eligible professionals and eligible hospitals that:

  • Have been unable to fully implement 2014 Edition CEHRT due to delays in 2014 Edition CEHRT availability; AND
  • Eligible professionals who were unable to attest by October 1, 2014 and eligible hospitals that were unable to attest by July 1, 2014 using the flexibility options provided in the CMS 2014 CEHRT Flexibility Rule.  

These are the only circumstances that will be considered for this reopened hardship exception application submission period. Applications must be submitted by 11:59 PM EST November 30, 2014.

More Information
More information about the application process will be shared soon. We intend to address this issue in upcoming rulemaking. Visit the Payment Adjustments and Hardship Exceptions webpage for more information about Medicare EHR Incentive Program payment adjustments.

Topics: Meaningful Use, Medicare, CMS, CEHRT

FREE CMS Webinar on CEHRT for Small Practices

Posted by Matthew Smith on Oct 6, 2014 4:58:00 PM

CMS, EHREvent: 

CMS 2014 Certified EHR Technology (CEHRT) Flexibility Rule Overview

 

Date: 

Wednesday, October 15, 2014
Time: 1:00 PM-2:00 PM Eastern Time

Registration:

https://attendee.gotowebinar.com/register/5020894920993673730

Agenda:

  • CMS 2014 CEHRT Flexibility Rule overview
  • Stage 2 extension
  • 2014 flexibility options
  • Attestation System updates
  • CMS responses to public comments
  • Resources
  • Q&A

Description:

This webinar provides PAHCOM members with an overview of the 2014 Certified EHR Technology (CEHRT) Flexibility Rule that went into effect on October 1, 2014. While directed at PAHCOM members, all are welcome and anyone focused on medical office management will benefit.

This presentation will cover guidance and instructions on how eligible professionals who have been unable to fully implement 2014 Edition CEHRT for an EHR reporting period in 2014 due to delays in 2014 Edition CEHRT availability can use the rule’s flexibility to report for 2014. The presentation also provides information about the extension of Stage 2 through 2016. A question and answer session will follow the presentation.

Speaker:

Vidya Sellappan, HIT Initiatives Group, Office of E-Health Standards and Services

Register now as space is limited - https://attendee.gotowebinar.com/register/5020894920993673730

Topics: Meaningful Use, CMS, CEHRT, PAHCOM, Stage 2

CMS Releases New and Updated FAQs for the EHR Incentive Programs

Posted by Matthew Smith on Sep 24, 2014 11:10:00 AM

EHR, EMR, CMS, Meaningful UseTo keep you updated with information on the Medicare and Medicaid EHR Incentive Programs, CMS recently added one new FAQ and updated seven FAQs to the CMS FAQ system. We encourage you to stay informed by taking a few minutes to review the new information below.

 

New FAQ:

  1. For Measure 2 of the Stage 2 Summary of Care objective for the EHR Incentive Programs, may an eligible professional,  eligible hospital, or critical access hospital count a transition of care or referral in its numerator for the measure if they electronically create and send a summary of care document using their CEHRT to a third party organization that plays a role in determining the next provider of care and ultimately delivers the summary of care document? Read the answer.

Updated FAQs:

  1. If my practice does not typically collect information on any of the core, alternate core, and additional clinical quality measures (CQMs) listed in the Final Rule on the Medicare and Medicaid EHR Incentive Programs, do I need to report on CQMs for which I do not have any data? Read the answer.
  2. Can eligible professionals use CQMs from the alternate core set to meet the requirement of reporting three additional measures for the Medicare and Medicaid EHR Incentive Programs? Read the answer.
  3. If one of the measures for the core set of CQMs for eligible professionals is not applicable for my patient population, am I excluded from reporting that measure for the Medicare or Medicaid EHR Incentive Programs? Read the answer.
  4. If none of the core, alternate core, or additional clinical quality measures adopted for the Medicare and Medicaid EHR incentive programs apply, am I exempt from reporting on all CQMs? Read the answer.
  5. If the denominators for all three of the core CQM are zero, do I have to report on the additional CQMs for eligible professionals under the Medicare and Medicaid EHR Incentive Programs? Read the answer.
  6. For the Medicare and Medicaid EHR Incentive Programs, if the certified EHR technology possessed by an eligible professional generates zero denominators for all CQMs in the additional set that it can calculate, is the eligible professional responsible for determining whether they have zero denominators or data for any remaining CQMs in the additional set that their certified EHR technology is not capable of calculating? Read the answer.
  7. I am an eligible professional who has successfully attested for the Medicare EHR Incentive Program, so why haven't I received my incentive payment yet? Read the answer.
Want more information about the EHR Incentive Programs?
Make sure to visit the Medicare and Medicaid EHR Incentive Programs website for the latest news and updates on the EHR Incentive Programs.

Topics: EHR, EMR, Meaningful Use, Electronic Health Records, CMS, HIT, Health IT

Health IT News: EMR Overhaul, Meaningful Use Reporting, & Patient EMR Access

Posted by Matthew Smith on Sep 18, 2014 9:08:00 AM

AMA Speaks Out In Favor of EMR Overhaul.

Health IT, HIT, EHR, EMR, Meaningful UseThe Wall Street Journal (9/16, Beck, Subscription Publication) reports, under the headline “AMA Urges Overhaul Of Electronic Medical Records,” that the AMA is backing physicians’ concerns that the current electronic medical records options are not user friendly and get in the way of patient care. AMA president-elect Steven J. Stack, MD, told the Journal that current EMR technology “is not supporting the quality of care we need it to.”

Dr. Stack criticized the Federal Meaningful User program, managed by HHS, and its requirements for the issues doctors have with EMR technology. Dr. Jacob Reider, currently the deputy national coordinator for health IT at HHS, said the agency welcomes the AMA’s feedback and noted that the agency is prioritizing usability. Dr. Reider was joined by other industry representatives in telling the Journal that usability was a priority for them but that improvement would be gradual and take a few years. 

Health IT Stakeholders Lobby for 90-day Meaningful Use Reporting Period in 2015

When CMS issued a final rule in early September granting providers the flexibility in meaningful use attestation the agency had originally proposed back in May and finalizing the extension of stage 2 through 2016 for providers that started attesting in 2011 or 2012.

The rule finalizes the proposed attestation flexibility for providers that were unable to implement 2014 CEHRT in time to successfully attest due to vendor delays. These providers will be able to use 2011 Edition CEHRT or a combination of 2011 and 2014 Edition to attest to either stage 1 or stage 2. They will also be able to attest to meaningful use under the 2013 reporting year definition and use 2013's clinical quality measures.

The rule was generally welcomed by provider organizations and other stakeholders, with one notable point of contention — the final rule keeps the 2015 reporting period at a full 365 days rather than the 90-day period industry members had urged.

This week, 17 industry organizations wrote a letter to HHS Secretary Sylvia Burwell to again request the reporting period be shortened to 90 days. The organizations' main concern is that many of the providers who weren't able to implement 2014 Edition CEHRT in time to attest this year won't be ready to do so in the next 15 days, when the 2015 reporting period starts.

"For roughly 3,800 hospitals, the final rule requires implementation of 2014 Edition CEHRT configured for stage 2 measures and objectives by Oct. 1, 2014," according to the letter. "More than 237,000 eligible professionals will need to be similarly positioned by Jan. 1, 2015. This is in addition to the 1,200 hospitals and 290,000 EPs who also must have 2014 Edition CEHRT implemented before the beginning of their reporting year at stage 1."

However, current meaningful use attestation numbers suggest the vast majority of these providers will not be ready. Just 143 hospitals have met stage 2 thus far, or about 4 percent of the hospitals that will be required to begin stage 2 reporting next month, according to the letter.

Reducing the attestation period to 90 days, and thereby giving hospitals until July 1, 2015 (and eligible professionals until Oct. 1, 2015) to start the reporting period, would "help hundreds of thousands of providers meet stage 2 requirements in an effective and safe manner," according to the letter. "This will reinforce investments made to date and it will ensure continued momentum towards the goals of stage 3, including enhanced care coordination and interoperability."

The letter's 17 signatory organizations include the American Academy of Family Physicians, American College of Physicians, the American College of Physician Executives, America's Essential Hospitals, American Hospital Association, American Medical Association, Association of American Medical Colleges, Association of Medical Directors of Information Systems, Catholic Health Association of the U.S., Children's Hospital Association, College of Healthcare Information Management Executives, Federation of American Hospitals, HIMSS, Medical Group Management Association, National Rural Health Association and Premier healthcare alliance.

ONC: Half of Patients Given Online EMR Access Use It

In 2013, about three in 10 patients were offered online access to their medical record. About half of those patients offered access logged on at least once, according to a news brief from the ONC.

The ONC surveyed 661 patients with online EMR access. Of those patients, 21 percent viewed their record once or twice, 15 percent viewed it three to five times and 10 percent viewed it more than six times. Fifty-four percent did not access their record at all.

Of those who accessed their medical record online, 60 percent said it was "very useful."

The brief comes at a time when hospitals and health systems are struggling to meet the view/download/transmit requirement of meaningful use stage 2, many worrying about low participation among their patient populations. This brief indicates patients may be more receptive to accessing their records online than providers think, according to an ONC blog post.

Topics: EHR, EMR, Meaningful Use, Health IT, AMA, Patient Access

CMS Releases Final Rule for Participants in EHR Incentive Programs

Posted by Matthew Smith on Sep 2, 2014 2:16:00 PM

EHR Incentive Program, Meaningful UseOn Friday, August 29, CMS released a final rule that allows providers participating in the EHR Incentive Programs to use the 2011 Edition of certified electronic health record technology (CEHRT) for calendar and fiscal year 2014. 

The rule grants flexibility to providers who are unable to fully implement 2014 Edition CEHRT for an EHR reporting period in 2014 due to delays in 2014 CEHRT availability. Providers may now use EHRs that have been certified under the 2011 Edition, a combination of the 2011 and 2014 Editions, or the 2014 Edition for 2014 participation.

Under the modified attestation schedule, providers that were not able to fully implement 2014 Edition certified EHR technology in time to successfully attest to meaningful use due to vendor delays will be able to use 2011 Edition CEHRT or a combination of 2011 and 2014 Edition to attest to either stage 1 or stage 2. Providers will also be able to attest to meaningful use under the 2013 reporting year definition and use 2013's clinical quality measures.

The College of Healthcare Information Management Executives has supported giving providers more options for attesting in what has been a challenging year for CIOs. However, the organization was disappointed the rule will still require a full year of attestation in 2015.

"Roughly 50 percent of eligible hospitals and critical access hospitals were scheduled to meet stage 2 requirements this year and nearly 85 percent of EHs and CAHs will be required to meet stage 2 requirements in 2015,” said CHIME CEO Russ Branzell in a statement. “Most hospitals that take advantage of new pathways made possible through this final rule will not be in a position to meet stage 2 requirements beginning Oct. 1, 2014. This means that penalties avoided in 2014 will come in 2015, and millions of dollars will be lost due to misguided government timelines.”

Beginning in 2015, all eligible providers will be required to report using 2014 Edition CEHRT.

2014 Participation Options

Under the rule, providers are able to use 2011 Edition CEHRT, and have the option to attest to the 2013 Stage 1 meaningful use objectives and the 2013 definition CQMs.

2011 CEHRT

Providers scheduled to meet Stage 1 or Stage 2:

Combination of 2011 & 2014 CEHRT

Providers scheduled to meet Stage 1:

Providers scheduled to meet Stage 2:

  • 2013 Stage 1 objectives and 2013 CQMs; or
  • 2014 Stage 1 objectives and 2014 CQMs; or
  • 2014 Stage 2 objectives and 2014 CQMs

2014 CEHRT

Providers scheduled to meet Stage 1:

  • 2014 Stage 1 objectives and 2014 CQMs

Providers scheduled to meet Stage 2:

  • 2014 Stage 1 objectives and 2014 CQMs; or
  • 2014 Stage 2 objectives and 2014 CQMs

CEHRT Flexibility Resources

To help the public understand the final rule’s changes to 2014 participation, CMS has developed the following resources:

  • CEHRT Interactive Decision Tool – providers answer a few questions about their current stage of meaningful use and Edition of EHR certification, and the tool displays the corresponding 2014 options.
  • 2014 CEHRT Flexibility Chart – chart provides a visual overview of CEHRT participation options for 2014.
  • 2014 CEHRT Rule Quick Guide – guide provides corresponding resources based on the option a provider chooses to participate in the EHR Incentive Programs in 2014.

Extending Stage 2

The rule also finalizes CMS and ONC’s recommended timeline to extend Stage 2 through 2016. The earliest a provider can participate in Stage 3 of meaningful use is now 2017.

For More Information

Visit the CMS Newsroom to read the press release about the final rule. For more EHR Incentive Programs resources, visit the CMS EHR website.

 

Topics: EHR, EMR, Meaningful Use, Electronic Health Records, CMS, HIT, Health IT, Provider, Final Rule

Infographic: A Look at the Emerging Nashville EHR Market

Posted by Matthew Smith on Aug 12, 2014 2:47:00 PM

Nashville, EHR, EMR, Meaningful Use, HCAAs one of the fastest growing healthcare markets in the United States, Nashville is home to the Hospital Corporation of America (HCA) with has 194,000 global employees and $34 billion in annual revenue. Technology Advice surveyed over 250 Nashville practices to look for EHR trends in this emerging market.

Some of the most interesting findings iinclude:

  • Epic, the number one national electronic health record vendor, does not rank among the top five vendors in Nashville
  • Nashville healthcare providers are significantly more satisfied with their EHR programs than providers nationwide
  • 16% of providers in Nashville have already switched EHRs
  • Adoption rate among certain specialties is significantly higher than national averages
  • Cost appears to be the number one consideration for Nashville EHR buyers

They also put out the Nashville EHR market infographic below. Most interesting is the percentages and how the EHR market is still very diverse. 

Nashville EHR Market Infographic resized 600

 

Topics: EHR, EMR, Meaningful Use, Electronic Health Records, Medicare, CMS, Nashville

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