Skip to content Skip to navigation

Will Public Comments Impact Meaningful Use Rules?

January 7, 2010
by David Raths
| Reprints

Because they had already expressed concern about the meaningful use matrix outlined last summer, the immediate negative reaction of some large provider organizations such as the American Hospital Association to the interim final rules published Dec. 30 was not surprising.

A statement from the AHA noted that the rules “create a stringent definition of ‘meaningful use’ that … would unfairly penalize many hospitals.”

AHA also believes the eligibility requirements for incentives are too restrictive, excluding doctors who practice in outpatient centers and clinics owned by a hospital. The College of Healthcare Information Management Executives echoed this complaint about hospital-based physicians being barred from receiving incentive payments.

Among other things, the Medical Group Management Association bemoaned the requirement that physician offices provide patients and others with electronic copies of medical records.

I have written before about how different rules apply to critical access hospitals, which are small, rural acute-care hospitals. One of the best sources of information on this topic I have found is a blog called Rural Health IT published by the Wisconsin Office of Rural Health (www.worh.org/hit/).

Louis Wenzlow, director of health information technology and CIO of the Rural Wisconsin Health Cooperative, wrote on Jan. 6 that most small and rural providers would find meeting Stage 1 meaningful use requirements by the end of 2012 unachievable.

He noted that the CMS decision to allow providers to meet Stage 1 requirements by 2014 (if 2014 is their first payment year) is critically important. But he added that many providers who meet Stage 1 requirements in later years would likely find meeting Stage 2 and 3 requirements unachievable within the time frames allowed. “These providers will therefore receive reduced incentives and eventually be subjected to penalties,” Wenzlow added.

Will CMS really follow through and penalize these small, rural hospitals? Wenzlow finished his blog post with this analogy: “This is like starting a 40-yard dash with some runners at the starting line, others at the twenty, and still others standing past the finish line, and only those that finish in 4 seconds get a prize.”

It will be interesting to see how much impact these public comments have on the final shape of the CMS rules. We’ll know in a few months.

Topics

Comments

David,
Have you seen or heard any discussion about "unfairly rewarding" hospitals who had made multi-year investments around clinically meaningful HCIT ? I am familiar with a hospital consortium survey whose members felt that they were entitled to fair and meaningful recognition of their prior investment and risks in HCIT.

Although they didn't spend the money banking on a financial return, they do feel that, if they are at the 40-yard line, financial recognition shouldn't be with held because others didn't make those investments, and cannot foresee an affordable, achievable path to MU on the given timelines.

I have addressed the gap to meeting Meaningful Use in my HCI blog post and presentation last May using the HIMSS EHR adoption model, there's a double digit percentage of hospitals ill-positioned to get to stage 7 using traditional implementation models.

That entire argument is, of course, moot for the Rural and CAH hospitals who didn't have the luxury of a margin to make such investments.

David Raths

Contributing Editor

David Raths

@DavidRaths

www.linkedin.com/in/davidraths

David Raths’ blog focuses on health IT policy issues ranging from patient privacy to health...