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GE Healthcare Camden Group Insights Blog

Meaningful Use Stage 2 Attestations May Drastically Drop in 2015

Posted by Matthew Smith on Jan 8, 2015 4:39:00 PM

Meaningful Use, MU, Attestation, Medical Practice Insider polled nearly 2,000 physicians to reveal that 55% do not plan to attest for meaningful use Stage 2 in 2015.

The questioning was simple yes/no question: Do you plan to attest for Stage 2 in 2015?

The answer? Doctors are planning to forego Stage 2 by a margin of 994 to 822 participants.

Status check: MU participants
About 75% of office-based primary care physicians had some form of EHR system in 2012, according to the National Ambulatory Medical Care Survey, conducted by the National Center for Health Statistics.

Since the 2009 enactment of the HITECH Act, which established the Medicare and Medicaid EHR Incentive Programs for eligible professionals (EPs) and hospitals, nearly two-thirds of physicians who implemented health IT tools said financial incentives and penalties were a major influence to adopt such systems.

EPs have been paid nearly $10 billion by the Centers for Medicare and Medicaid Services under the meaningful use program to date. Only 3,655 unique Medicare EPs had received payments for Stage 2 attestation as of early December, however, compared to 268,686 EPs for Stage 1.

Individual comments from surveyed providers show a variety of reasons — some financially motivated, others not — for physicians deciding that they've had enough with the meaningful use program and will go no further.

"I did Stage 1 in years one and two, but it is almost impossible to do Stage 2. It requires patients to have emails and engage my EHR,” one cardiologist explained. “Well, I have a lot of patients in their 80s and 90s, and they don’t have computers, let alone email."

A family practitioner who CMS said was in the top 3 percent in terms of readiness and reporting is now at a crossroads.

"I’ve done Stage 1 three times now. I have the option to do either Stage 2 or Stage 1 for the fourth time. I would rather stay with Stage 1 for now because my patients are reluctant to use messaging and I personally do not like the interface for my portal,” the family practitioner noted. “I do not have too many Medicare patients even though I am participating in an ACO, so I am not concerned much about a penalty. I just want the software to be perfected and be more usable."

An internist echoed that last point about usability: "Every night there’s more chart work. I can’t find things in the patient chart easily, and it's hard to compare current and old EKS’s, current and old labs."

A rheumatologist, meanwhile, said that the administrative costs exceed any financial gains, meaningful use incentives and otherwise. “I am re-examining getting on an MU-certified EMR in 2015 as interoperability and eRx systems tend to mature and become more prevalent."

And then there’s the old-fashioned preference for paper.

"Because I don’t use an EMR, my work is easier, profits are better,” a gastroenterologist commented, “and I get my work done in 30 percent of the time it takes EMR-equipped hospital doctors."

It’s important to point out that the above comments are from specialists, a collective that often faces unique meaningful use challenges — particularly when it comes to core, menu and clinical quality measures engineered for providers with a broader swath of patients and services, making it easier to fulfill those requirements.

Topics: EHR, EMR, Meaningful Use, Electronic Health Records, Electronic Medical Records, Stage 2

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

CHIME Weighs in on Proposed Meaningful Use Changes in 2014

Posted by Matthew Smith on Jul 2, 2014 4:29:00 PM

CHIME, Meaningful Use,The College of Healthcare Information Management Executives (CHIME) has a handful of recommendations for the two federal agencies within the Department of Health & Human Services (HHS) responsible for the proposed changes to meaningful use in 2014.

In late May, the Centers for Medicare & Medicaid Services (CMS) and the Office of the National Coordinator for Health Information Technology (ONC) notified eligible providers in the EHR Incentive Programs that modifications to meaningful use 2014 were on the way with the purpose of providing greater flexibility to participating hospitals and physicians.

At the time, the leaders of CHIME made clear its concerns about the timing of the propose rule modifying meaningful use in 2014 — that is, if eligible hospitals (EHs) would be able to benefit from the rule. The association has now reiterated those concerns, urging CMS and ONC to move swiftly in finalizing the rule along with incorporating certain changes.

First, CHIME is recommending that CMS explicitly state whether eligible providers will be covered retroactively in 2014 and especially significant concern for EPs and critical access hospitals (CAHs) for which July 1 represents the start of the last available reporting period in 2014, a date that will come well before the proposed rule is finalized. Additionally, providers should have the option to report clinical quality measures of their choosing no matter the stage of meaningful use they are in.

Second, the association wants to see the 3-month quarterly periods be used as part of meaningful use in reporting year 2015. “Most providers who take advantage of the flexibilities proposed in this NPRM will need to report on Stage 2 measures and objectives in 2015, and most of these providers will not be in a position to report a full year of data, beginning October 1, 2014,” CHIME states.

Third, CHIME is seeking clarification around the implementation of 2014 Edition certified EHR technology (CEHRT):

There is widespread concern among CIOs that program auditors will be overly zealous in determining what implementation and workflow changes merit the ability to take advantage of the new flexibility. We appreciate the examples listed in this proposed rule and would urge CMS to give EHs and CAHs additional confidence by expanding those examples to include scenarios “outside the provider’s control” such as an underdeveloped ecosystem of exchange participants to receive summaries of care for transitions of care.

Lastly, CHIME is throwing its support behind the proposed one-year extension of Stage 2 Meaningful Use for providers who demonstrated meaningful use successfully in 2011 and 2012.

The comment period for the proposed rule closes on July 21, 2014 at 11:59PM ET. So far more than 400 comments have been received.

Meaningful Use, Stage 1, Stage 2, EHR, EMR

Topics: EHR, EMR, Meaningful Use, Stage 2, CHIME

Don’t Miss the Chance to Earn EHR Incentive Payments

Posted by Matthew Smith on Apr 16, 2014 11:46:00 AM
EHR, EMR, Electronic Health Record, Meaningful UseEligible Professionals Must Start Medicare EHR Participation in 2014 to Earn Incentives

If you are an eligible professional for the Medicare EHR Incentive Program, 2014 is the last year you can start participation in the Medicare EHR Incentive Program in order to receive incentive payments.

Eligible professionals who begin participation in the Medicare EHR Incentive Program after 2014 will not be able to earn an incentive payment for that year or any subsequent year of participation.

If you choose to participate in the Medicare EHR Incentive Program for the first time in 2014, you should begin your 90-day reporting period no later than July 1, 2014 and submit attestation by October 1, 2014 in order to avoid the payment adjustment in 2015.

Note: October 1 is the attestation deadline for eligible professionals in their first year of participation to avoid the payment adjustment. However, eligible professionals who miss this deadline can still demonstrate meaningful use during the last 90-day reporting period of the year (October - December 2014) and earn an incentive payment for 2014.

Providers Who First Begin Participation in 2014 must:

To Earn Your Maximum Medicare Incentive

  • Demonstrate 90 days of Stage 1 of meaningful use in 2014 to earn up to $11,760.
  • Demonstrate a full year of Stage 1 of meaningful use in 2015 to earn up to $7,840.
  • Demonstrate a full year of Stage 2 of meaningful use in 2016 to earn up to $3,920.

If you successfully demonstrate meaningful use each year beginning in 2014, your total payment amount could be as much as $23,520.

Additional Resources

The EHR Incentive Program website offers several helpful tools and resources so you can successfully begin participation:

Meaningful Use, Stage 1, Stage 2, EHR, EMR

Topics: EHR, EMR, Meaningful Use, CMS, Electronic Health Record, Stage 1, Patient Engagement, Stage 2

New Download: Meaningful Use In 2014--Changes to Stage 1 & Challenges for Stage 2

Posted by Matthew Smith on Mar 19, 2014 11:45:00 AM

Download, Meaningful Use, EHR, Stage 1, Stage 2CMS published a final rule that specifies the Stage 2 criteria that eligible professionals (EPs), eligible hospitals, and critical access hospitals (CAHs) must meet in order to continue to participate in the Medicare and Medicaid Electronic Health Record (EHR) Incentive Programs. All providers must achieve meaningful use under the Stage 1 criteria before moving to Stage 2.

This new download from Health Directions will help readers learn about the changes to Stage 1 in 2014 and understand the challenges confronting providers in Stage 2.

Specific content includes:

  • Updated stateus of CMS EHR Incentive Program
  • Financial Impact of Non-Participation in the EHR Incentive Program
  • Changes to EMR Technology Certification
  • Stage 1 Changes
  • Stage 2 Overview
  • Core Measures: Stage 1 vs. Stage 2
  • Clinical Quality Measures (CQMs)
  • CQM Reporting Period
  • Reporting Options for Providers
  • Stage 2 Challenges and Solutions
  • Implementing a Patient Portal
  • Engaging Your Patients
  • Changing Behavior
  • Program Audits

Simply click the button, below, to access the download.

Meaningful Use, Stage 1, Stage 2, EHR, EMR

Topics: EHR, EMR, Meaningful Use, CMS, Stage 1, Patient Engagement, CQM, Stage 2

What CMS is Saying About Stage 2 Meaningful Use at HIMSS14

Posted by Matthew Smith on Feb 25, 2014 12:56:00 PM

Stage 2, Meaningful Use, EHR, Health DirectionsAt HIMSS14, the message from healthcare organizations and professionals about the EHR Incentive Programs is clear and consistent: those working to implement all the changes required of federal health IT initiatives want more time to complete their tasks.

From ICD-10 to Stage 2 Meaningful Use, they are petitioning the Centers for Medicare & Medicaid Services (CMS) and the Office of the National Coordinator for Health Information Technology (ONC) to provide flexibility. Although these calls for action may not lead to the desired end, CMS and other agencies are listening.

“We have definitely heard that and are implementing more flexibility,” Elizabeth Holland, Director of the HIT Initiative Group in the Office of E- Health Standards and Services at CMS, told EHRIntelligence.com about the feedback the federal agency has received from providers about the EHR Incentive Program for Medicare, particularly Stage 2 Meaningful Use. “We are looking at flexibility options. We’re working very closely with our lawyers to see how much flexibility we have. We’re really looking to see what we can possibly do.”

It is not just the interactions with attendees at HIMSS14 or the public advocacy on the part of healthcare associations that have caught the attention of CMS. There are also the results of Stage 1 Meaningful Use. Trends in attestation show just how ready eligible professionals (EPs) and hospitals (EHs) are for the next phase of meaningful use.

“For me, the most interesting part is that we have had a whole lot of people coming in for the first time,” Holland explains. “It’s well over 20,000 and I wouldn’t have thought that so many people would have waited until the very end to attest for the first time with all these returning people coming in as well. We’re happy with the volume. But how high is it going to go; how many people are going to come in?”

With so many eligible providers coming in at the end, how likely are they to be ready for Stage 2 Meaningful Use? The answer is not very. But it’s not entirely the fault of providers. Without EHR technology certified for Stage 2, EPs and EHs cannot achieve meaningful use.

“One of the things we were worried about is the deployment of the 2014 products,” continues Holland. “We’ve looked to see if people are attesting for 2014 yet, and we’ve had some hospitals that have attested for 2014 but for Stage 1 — so new hospitals coming on. We haven’t had people come in for Stage 2 yet.”

If 2014 Edition certified EHR technology is not available to providers, how can that be held against them? According to Holland, a plan is in the works for these EPs and EHs to claim a hardship exemption. “We just had a change to our hardship exception form — that we explicitly added that to the form. Before it was hard to understand that you could fit into a category so it’s much more clearly spelled out on the form,” she reveals.

And that flexibility shouldn’t be limited to this next phase of meaningful use. It will influence Stage 3 Meaningful Use as well.

“At this point, Stage 3 has been pushed out, but that’s really from the practical point,” says Holland. “People are still doing Stage 2 certification and if we all of a sudden start pushing too hard on Stage 3, people are really going to be pushed. We don’t have any experience yet from Stage 2 to know and inform our development of Stage 3.”

While the legislation is expected to appear in the fall, its importance pales in comparison to the emphasis being placed on the health IT initiatives bearing down on health systems, hospitals, and physician practices right now. Perhaps the good news is that federal agencies are listening and looking to assist them.

EHR, Meaningful Use, Electronic Health System

Topics: Meaningful Use, CMS, ICD-10, Stage 2

New Download: Optimizing Your EMR & Engaging Your Patients

Posted by Matthew Smith on Feb 3, 2014 10:29:00 AM

EHR, Meaningful UseIf You’re Not Meeting Meaningful Use, You May Be Leaving Money on the Table

Eligible providers who meet Meaningful Use criteria may receive up to $24,000 (Medicare) or may receive up to $63,750 (Medicaid). That’s a lot of incentive dollars to leave behind—especially if you’re already operating on an Electronic Health Records (EHR) system.

This complimentary download from Health Directions will help you to:

  • Learn how to optimize your EMR and successfully participate in the CMS EHR Incentive Program
  • Understand the differences between Stage 1 and Stage 2 requirements
  • Prepare for the 2014 changes, including how to engage your patients
To download the guide, click the button, below, share some general information, and you will be directed to the presentation that you may view or download by right-clicking and saving to your computer.
EHR, Meaningful Use, Electronic Health System

Topics: EHR, EMR, Meaningful Use, Electronic Health Record, Electronic Medical Record, Patient Engagement, Stage 2

Free EHR Breakfast Seminar for Independent Physicians & Staff: Jan. 23rd | Suburban Chicago

Posted by Matthew Smith on Jan 17, 2014 4:14:00 PM

Independent Physician Advisors, EHRJoin the Independent Physician Advisors on Thursday, January 23rd at 7:30 am in Oakbrook Terrace for a complimentary breakfast and seminar: Optimizing Your EHR & Engaging Your Patients--Preparing for Stage 2 Meaningful Use.

If You’re Not Meeting Meaningful Use, You May Be Leaving Money on the Table

Eligible providers who meet Meaningful Use criteria may receive up to $24,000 (Medicare) or may receive up to $63,750 (Medicaid). That’s a lot of incentive dollars to leave behind—especially if you’re already operating on an Electronic Health Records (EHR) system.

Learning Objectives:

  • Learn how to optimize your EMR and successfully participate in the CMS EHR Incentive Program
  • Understand the differences between Stage 1 and Stage 2 requirements
  • Prepare for the 2014 changes, including how to engage your patients

Presented by:

Carmina Nitzki
Managing Associate
Health Directions

Lori Miller
President 
Tooty, Inc.

Schedule:

7:30am    Hot Breakfast & Networking
8:00am    Presentation 
9:30am    Q&A and open networking

Location:

Redstone American Grill
13 Lincoln Center
Oakbrook Terrace, IL 60181
(630) 268-0313

Sponsor:

Athena Health

Registration:

This event is complimentary, however advanced registration is required. We ask that attendance be limited to independent physicians and their office staff.

To register for this event, please click the button, below:

 

Topics: EHR, Meaningful Use, Electronic Health Records, Independent Physician Advisors, Patient Engagement, Stage 2

Industry Stakeholders Weigh in on Adjusted Meaningful Use Timeline

Posted by Matthew Smith on Dec 10, 2013 1:20:00 PM

Meaningful UseIndustry stakeholders have begun to comment on CMS' decision to adjust the timeline of the meaningful use program.

Under the 2009 federal economic stimulus package, health care providers who demonstrate meaningful use of certified electronic health record systems can qualify for Medicaid and Medicare incentive payments.

Background

On Friday, federal officials announced that CMS has proposed delaying the start of Stage 3 of the meaningful use program, while the Office of the National Coordinator for Health IT has proposed adjustments to its certification process.

Under CMS' revised meaningful use timeline:

  • Stage 2 would be extended through 2016; and
  • Stage 3 would begin in 2017 for health care providers who have completed at least two years in Stage 2 of the program.

Notices of proposed rulemaking expected to be released by CMS and ONC in the fall of 2014 will offer additional details on the new proposed timeline.

The final rule on Stage 3 of the meaningful use program is expected to be released in the first half of 2015 (iHealthBeat, 12/6).

CHIME's Reaction

Russell Branzell, CEO of the College of Healthcare Information Management Executives, said the group is "pleased that ONC and CMS in particular have provided some flexibility for Stage 3 and back-end Stage 2 deployment of software" (Hagland, Healthcare Informatics, 12/6).

However, CHIME confirmed with CMS that the announcement will not delay the start date for Stage 2 of the meaningful use program (Goedert, Health Data Management, 12/7).

In a release, CHIME stated that the proposed Stage 2 extension and Stage 3 delay "does not change front-end requirements for meaningful use in 2014 and does not afford much needed flexibility to providers working to install and upgrade new technology" (CHIME release, 12/6).

"We still believe there's going to be a pressure point in 2014 for ICD-10 and Stage 2," Branzell said, adding, "CHIME still wants to ensure that those eligible hospitals and providers that need flexible timing to meet the requirements of ICD-10 and Stage 2 can do it in a reasonable sequencing" (Healthcare Informatics, 12/6).

Branzell said that CHIME will continue to work with CMS and lawmakers in hopes to shift reporting periods and increase flexibility for providers trying to comply with meaningful use and ICD-10 requirements (Health Data Management, 12/7).

HIMSS' Reaction

In a statement, Thomas Leary -- vice president for government relations at the Healthcare Information and Management Systems Society -- said that group was "gratified" by the decision to extend Stage 2 of the meaningful use program by one year.

However, HIMSS soon amended its statement to note that, "After further analysis of the government's decision to extend meaningful use Stage 2 through 2016, we believe our call for action to extend year 1 of the meaningful use Stage 2 attestation period still needs to be addressed." 

The group said it will "call on the government to address the timeline and allow at least 18 months in which eligible hospitals and eligible providers can attest to meaningful use requirements for one quarter" (McCann, Healthcare IT News, 12/6).

Topics: EHR, Meaningful Use, CMS, Stage 2

Stage 2 Guide for the EHR Incentive Programs Now Available

Posted by Matthew Smith on Oct 3, 2013 1:04:00 PM

CMS, EHR, Stage 2CMS has released a new resource, An Eligible Professional’s Guide to Stage 2 of the EHR Incentive Programs, which provides a comprehensive overview of Stage 2 of the EHR Incentive Programs to eligible professionals. The guide outlines criteria for Stage 2 meaningful use, 2014 clinical quality measure reporting, and 2014 EHR certification.

The guide is intended to provide eligible professionals (EPs) with an overview of Stage 2 of meaningful use. The guide discusses changes to meaningful use objectives and to Clinical Quality Measures (CQMs), and the overall goals of Stage 2 including:

  • Measures focused on more rigorous health information exchange (HIE)
  • Additional requirements for e-prescribing and incorporating lab results
  • Electronic transmission of patient care summaries across multiple settings
  • Increased patient and family engagement

As Stage 2 starts in January, 2014, CMS includes an important reminder – all providers must upgrade or adopt newly certified EHRs in 2014 and regardless of their stage of meaningful use,  are only required to demonstrate meaningful use for a three-month (or 90-day) EHR reporting period in 2014

View or download a PDF of the guide here.

Topics: EHR, Meaningful Use, CMS, HIT, Health IT, HITECH, Stage 2

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