On the afternoon of Aug. 23, the federal Centers for Medicare & Medicaid Services (CMS) issued the final rule for Stage 2 meaningful use under the American Recovery and Reinvestment Act/Health Information Technology for Economic and Clinical Health (ARRA-HITECH) Act. One day later the first reactions have begun to come in from various provider-based organizations, and the reaction to the Stage 2 final rule appears to be mostly positive.
Blair Childs, senior vice president of public affairs at the Charlotte, N.C.-based Premier healthcare alliance, epitomized many of the reactions, by expressing his support for the CMS’ decision to extend the implementation of the onset of Stage 2 criteria.
“In implementing the final meaningful use rule, the Premier healthcare alliance believes CMS has made some extremely important changes that will help facilitate the rapid adoption of health information technologies, including electronic health records (EHRs),” Childs said in a statement. “[It] strongly supports CMS’ decision to give providers until 2014 to attest to Stage 2 meaningful use, giving providers the necessary time to prepare and implement the new requirements.
Childs was also pleased CMS eased the proposed rule’s reporting requirements. He says by “taking a more manageable approach, hospitals will have additional flexibility, ensuring that a greater number of facilities will take steps to implement EHRs and improve patient care.”
There were similar feelings from the Medical Group Management Association (MGMA). Susan Turney, M.D., president and CEO of MGMA, said the association is pleased with CMS’ final rule, especially the start extension.
"MGMA is pleased that the CMS responded to our concerns regarding several of the proposed Stage 2 meaningful use requirements,” Turney said in a statement. “Extending the start for stage 2 until 2014 was a necessary step to permit medical groups sufficient time to implement new software. Permitting group reporting will reduce administrative burden, as will lowering the thresholds for achieving certain measures such as mandatory online access and electronic exchange of summary of care documents. MGMA supports the rule’s expanded list of exclusions and believes it will allow physicians to achieve meaningful use with fewer hurdles."
Richard A. Correll, president and CEO of the Ann Arbor, Mich.-based College of Healthcare Information Management Executives (CHIME), said in a statement: "By allowing providers to demonstrate Meaningful Use through a 90-day EHR reporting period for 2014, government rule-makers have ensured greater levels of program success. And by including additional measures to the menu set, providers have a better chance of receiving funds for meeting Stage 2."
Although Correl noted, “however, we also recognize that these points are conciliatory and that many details may need further clarification. The final rule still puts providers at risk of not demonstrating meaningful use based on measures that are outside their control, such as requiring 5 percent of patients to view, download or transmit their health information during a 3-month period. Some areas of clarification include some of the exclusionary language as well as nuances around health information exchange provisions, clinical quality measures and accessing images through a certified EHR."
Allison Viola, MBA, RHIA, senior director of federal relations at the Chicago-based American Health Information Management Association (AHIMA), was positive for other reasons than just the extension. “We are pleased to see that CMS has heard our calls for increased alignment of quality reporting programs and acknowledgement of making an effort to reduce the reporting burden and duplication of reporting,” she said in a statement.
Not all reaction was universally positive. Linda Fishman, senior vice president of public policy analysis & development at the Chicago- and Washington, D.C.-based American Hospital Association (AHA), said that while the organization appreciates that CMS has allowed for a shorter meaningful use reporting period for 2014, it is disappointed that this rule sets an “unrealistic date by which hospitals must achieve the initial meaningful use requirements to avoid penalties.”
Fishman also said that CMS had complicated the reporting of clinical quality measures and added to the meaningful use objectives, creating significant new burdens.
As more reactions come in, Healthcare Informatics will continue to update this developing story.