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No Time For Debbie Downers: Latest MU Results Offer Something to Ponder

January 16, 2015
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Some good news on Stage 2 meaningful use attestation has come at a time when good news around meaningful use has been at a premium

When is a surprise not a surprise? That might be a question to ask some of the Doubting Thomases in healthcare and healthcare IT these days. Because, honestly, when the initial meaningful use Stage 2 attestation numbers came out late last fall, the sense of “I told you so” was fairly strong among many in healthcare. As our Senior Editor, David Raths, reported in November, a number of healthcare association leaders noted that the fact that only 840 hospitals had attested to Stage 2 at that point, and many were ready to declare the entire meaningful use process a failure.

And many had very legitimate concerns, given the level of challenges providers have been facing going into and through Stage 2. But I will say that I, for one, had always trusted the industry observers who had expected most attestations to come at the very last moment. And that is exactly what’s happened.

As David Raths reported on Jan. 14, “With one month left in the 2014 reporting period, 77 percent of hospitals eligible to attest to Stage 2 of the meaningful use program have already done so, according to figures presented at the Jan. 13, 2015, HIT Policy Committee meeting.” As he further reported, “Concerns about low attestation rates earlier in 2014 may have been mitigated by two factors, explained Elisabeth Myers from the Office of E-Health Standards and Services at the Centers for Medicare & Medicaid. First, most eligible hospitals tend to attest after their fiscal report year closes, and that held true this year… Second is the fact not all hospitals and providers are eligible for Stage 2 in 2014.” And as Paul Tang, M.D., the committee’s co-chair, noted, the phenomenon of hospitals waiting until the end of the fiscal year is tracking with a pattern from previous years.

So the plain fact is that more than three-quarters of the hospitals eligible to attest in 2014 have now done so. And that’s a good thing. Are they facing an uphill battle going into 2015? Absolutely. Will some fail to make it successfully to and through Stage 3? Quite possibly.

But it’s important to consider that, in the context of this arduous journey of meaningful use, this 77 percent statistic is significant, and should not be minimized.

Meanwhile, it is interesting to note that only 200 hospitals will see payment adjustments as of this moment, and the number set to get adjustments of more than $5,000 is going to be quite small.

So as challenging as everything looks right now, there is definitely reason for a very cautious flavor of optimism. While this is no time for early victory laps, perhaps things in MU Land are not as dire as some of the Debbie Downers might have led us to believe, either.

And then of course, Stage 3 is now very much on the horizon. As Jeff Smith of CHIME noted earlier this week, “Stage 3 proposed rules are currently under review at the Office of Management and Budget (OMB)—the last step before being released for public comment.” And, Smith noted, “The Stage 3 Notice for Proposed Rulemaking (PRM) process is the most likely vehicle CMS and the Office of the national Coordinator for Health IT (ONC) could use to make changes that CHIME and other stakeholders have been advocating. This is the best chance,” he added, “to make substantive changes to meaningful use and revive an ailing program.”

So we’ll see what happens. Doubtless, the next several months will be pivotal for the meaningful use program going forward. So stay tuned. And keep your powder dry.