GE Healthcare Camden Group Insights Blog

What’s Up with Meaningful Use?

Posted by Matthew Smith on May 6, 2015 10:43:53 AM

By Lucy Zielinski, Vice President, The Camden Group

Stage3.pngYou 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

lucy_zielinski.pngMs. Zielinski is a vice president with The Camden Group, with over 20 years of experience in the healthcare industry. She specializes in helping private and hospital-owned medical practices achieve top financial performance by guiding physicians through practice development, strategic planning, coding and revenue cycle process optimization, and electronic health record system implementation. In her health system leadership roles, she has successfully managed the revenue cycle for over 2,000 physicians. Additionally, Lucy has led engagements with physician billing companies that involved restructuring operations and development of dashboard reports. She may be reached at lzielinski@thecamdengroup.com or 312-775-1700.

Topics: Meaningful Use, Lucy Zielinski, Stage 3 Meaningful Use, MACRA

The Next Phase of the Meaningful Use Journey: Stage 3 is On the Horizon

Posted by Matthew Smith on Apr 3, 2015 1:08:00 PM

By Cindy Barrett, LPN, Senior Consultant, and Leslie Madden, Consultant, The Camden Group

Stage3If achieving Meaningful Use is on your radar, the proposed rule for Stage 3 has been released and is open for public comment. For those who are already in the middle of their Meaningful Use (“MU”) journey, Stage 3 will hold its own share of challenges, as we’ve seen in the transition from Stage 1 to Stage 2. But if you’re looking at working toward attesting for the first time, consider the opportunity to do so sooner rather than later. Stage 3 builds upon the framework established in Stage1 and Stage 2, with further expansion proposed for Stage 3.

The Stage 3 objectives will eliminate some of the more easily attainable measures from Stage 1 and Stage 2, or increase the threshold requirements to meet those measures. Additionally, Stage 3 contains two major proposed reporting changes of note. First, in 2018, all providers must attest to Stage 3 Meaningful Use objectives, regardless of where they are on their MU journey. Secondly, everyone will attest for a 365-day reporting period in 2018, thus eliminating the 90-day reporting periods with which we are familiar for first time adopters. Expanded measure requirements for things such as patient engagement and data reporting will pose challenges for many providers and hospitals to meet all the objectives in Stage 3, and that includes many who have already completed successful attestations to MU Stages 1 and 2. And, if you are just starting on your MU journey, Stage 3 patient engagement, CPOE, and e-prescription requirements will be a drastic shift in process for you and/or your patient population.

The spirit of the proposed rule reportedly demonstrates an intended response to take into consideration the input received during Stages 1 and 2, while maintaining long term goals of the overall EHR incentive program like interoperability and enhanced use of EHR applications. The proposed Stage 3 rule is composed of 8 objectives- fewer in number than previous stages, but increasingly more difficult to achieve. Don’t let the lower number of objectives fool you. It’s a combination of higher thresholds for existing measures, enhanced system requirements, and increasing burdens for providers and hospitals to meet measures for patient engagement, care coordination and health information exchange. Once again, there will be challenges for vendors to meet timelines to comply with these requirements, and increasing costs to providers and hospitals in technology and resources to meet and sustain these objectives in your practice setting. 

While Stage 3 is expected to be the final stage of the Federal EHR Incentive Program, MU is not going away. Currently in an incentive phase, there are penalties phases in the coming years, and the expected standard is that everyone will meet and maintain these objectives to help achieve improved clinical outcomes and efficiencies, as well as cost reductions across the care continuum for years to come.

MU is truly a journey, with winding paths, bumpy roads and a course that promises hurdles and obstacles along the way. Whether the trip will result in the anticipated destination…..we’ll have to wait and see. What we do know is that the expectations for participation are not going away, and those who choose not to take the journey will find the price to pay only getting steeper with each passing year.


CindyBMs. Barrett is a senior consultant with The Camden Group, with over 30 years of clinical experience in the healthcare field. She specializes in collaborating with electronic medical record (“EMR”) implementation support teams to facilitate and build processes, workflows, post-implementation support, and optimization as it applies to EMR solutions. Ms. Barrett is recognized for her expertise in EMR clinical workflow analyses, technical EMR system builds, training oversight, and practice support during pre-implementation, implementation, go-live, and post go-live. Ms. Barrett has helped organizations achieve Meaningful Use and implement processes and care team models to support Patient-Centered Medical Home development. She may be reached at cbarrett@thecamdengroup.com or 512-795-5500.


lmaddenMs. Madden is a consultant with The Camden Group, with over 15 years of experience working with medical groups and physician practices. With strong knowledge of practice operations, Ms. Madden helps practices improve their billing/collections processes, assists with managed care contracting, establishes front office procedures, improves financial performance, and implements overall practice management approaches. She may be reached at lmadden@thecamdengroup.com or 512-795-5500.


Topics: Meaningful Use, CMS, Cindy Barrett, Stage 3 Meaningful Use, Leslie Madden

Subscribe to Email Updates

Value Model, Health Analytics

Posts by Topic

Follow Me