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Washington Debrief: CMS Signals Additional Changes to MU

February 2, 2015
by Jeff Smith, Senior Vice President of Public Policy at CHIME
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CMS to Grant Providers Shortened Reporting Period in 2015, Signals Additional Changes to MU
Key Takeaway:  The Centers for Medicare and Medicaid Services (CMS) will begin a regulatory process to change the 2015 EHR reporting period to 90-days and make additional changes to the design of meaningful use, chief medical officer Patrick Conway, M.D. announced last week.
Why it Matters:  A shortened reporting period will enable hundreds of thousands of providers to continue participating in meaningful use in 2015, thus maintaining momentum towards interoperability and improved care coordination.  
In a blog posting released last week, CMS announced its intent to give providers much-needed relief in the form of a 90-day reporting period in 2015.  The decision was long coming and a result of congressional and provider pressure.  However, the more direct reason for change can be tied to the long-term sustainability of meaningful use, which will enable improved patient-centered care and health outcomes, the agency said.
Specifically, CMS CMO Patrick Conway, M.D. said the agency is considering proposals to:
Realign hospital EHR reporting periods to the calendar year to allow eligible hospitals more time to incorporate 2014 Edition software into their workflows and to better align with other CMS quality programs.
Modify other aspects of the program to match long-term goals, reduce complexity, and lessen providers’ reporting burdens.
Shorten the EHR reporting period in 2015 to 90 days to accommodate these changes.
The reaction from healthcare providers was immediate.  “CHIME applauds CMS for recognizing the pressing need to bring immediate flexibility to the meaningful use program in 2015.  We are pleased that CMS has announced their intent to make a number of changes to the program – in addition to a shortened reporting period – to reduce complexity and lessen providers’ reporting burden.  Meaningful use has the potential be a transformative program for the nation’s healthcare delivery system and we commend CMS for recognizing the need for a course-correction.”
Details concerning the timing of the announced changes are still unknown, but CMS indicated that these changes would be proposed following release of the Stage 3 notice of proposed rule making (NPRM) due by March.
ONC Unveils Interoperability Roadmap, Standards Advisory
Key Takeaway: The Office of the National Coordinator for Health IT (ONC) released the much-anticipated Interoperability Roadmap last week, which received broad support across the industry.  Also released was the “2015 Interoperability Standards Advisory,” a document meant to identify, assess, and determine the “best available interoperability standards and implementation specifications for industry use toward specific health care purposes.”
Why it Matters: ONC’s Interoperability Roadmap will be used to guide multiple Department of Health and Human Services (HHS) programs and address congressional criticism over the issue of interoperability.  The Standards Advisory is hoped to be updated annually to reflect industry adoption of key clinical standards.  In combination, these documents are hoped to drive consensus on a strategy to achieve functional interoperability in the next three years.
ONC last week released a pair of documents detailing how the National Coordinator hopes to address the multi-faceted issue of interoperability.  For months, the Office has received criticism from Congress and healthcare providers that meaningful use, EHR Certification and other programs have failed to deliver systems that demonstrate functional interoperability.  According to the 166-page document, the “Roadmap focuses on actions that will enable a majority of individuals and providers across the care continuum to send, receive, find and use a common set of electronic clinical information at the nationwide level by the end of 2017.”  While the details of the Roadmap are still under review, CHIME President and CEO Russell P. Branzell said, “This Roadmap incorporates a tremendous amount of stakeholder input and articulates a clear path towards interoperability. It is a cornerstone in the continuing evolution of federal health IT policymaking.”
Joining the release of the Roadmap was the 2015 Interoperability Standards Advisory – a non-binding, non-regulatory document meant to help facilitate discussion and debate on clinical standards currently used in healthcare and referenced in regulation. The Advisory identifies specific standards and references implementation guidelines across four areas of standards, including content, vocabulary, transport and services.
“This is a much-needed playbook for each and every health IT professional,” Branzell said. “Now, healthcare providers and health IT developers have a single source of truth, with an extensible process to align clinical standards towards improved interoperability, efficiency and patient safety.