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Washington Debrief: CMS MU Data Indicates Strong Finish for Hospitals

December 15, 2014
by Jeff Smith, Vice President of Public Policy at CHIME
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Jeff Smith, Vice President of Public Policy at CHIME

Top News

CMS MU Data Indicates Strong Finish for Hospitals; Worries Over 2015 Persist

Key Takeaway: More than 3,690 hospitals participated in meaningful use in 2014, setting a new program year high. However, fewer than 35 percent of the nation’s hospitals have met Stage 2 meaningful use requirements, and only four percent of eligible professionals (EPs) have demonstrated achievement of Stage 2 objectives.

Why it Matters: Centers for Medicare and Medicaid Services (CMS) data indicates that one in three hospitals that should have demonstrated Stage 2 in 2014 chose to use one of the new pathways created by the “flexibility rule,” finalized in September. With a full-year reporting policy in place for 2015, fewer than half of the hospitals expected to be at Stage 2 in 2015 are poised to do so.

CMS data released last week provides a clearer picture of how hospitals participated in meaningful use during 2014. Nearly 4,000 hospitals demonstrated compliance with either Stage 1 or Stage 2 in 2014, which is the largest rate of participation among hospitals during any program year. CMS says 1,681 hospitals demonstrated Stage 2 capabilities in 2014, about 900 fewer hospitals than were scheduled to meet Stage 2 in 2014. “Despite policy efforts to mitigate a disastrous program year, today’s release of participation data confirms widespread challenges with Stage 2 Meaningful Use,” said CHIME President and CEO Russell P. Branzell, FCHIME, CHCIO.

Approximately 1 in 3 hospitals scheduled to meet Stage 2 in 2014 had to use alternative pathways to meet MU, administrative data current through December 1 indicate. “This trend demonstrates how vital new flexibilities were in 2014 and again, underscores the need for the same flexibility in 2015,” Branzell said. “It is imperative officials take immediate action to put this critical transformation program back on track. Shortening the time frame for MU reporting in 2015 will help to ensure the program delivers on its promise to advance the transformation of healthcare in this country.”

Eligible professionals have until February to attest to MU in 2014, but with less than a month left in the program year, fewer than four percent of physicians have demonstrated compliance with Stage 2 objectives.

Legislation & Politics

Government Funding Legislation Doesn’t Include MU, ICD-10 Delays

Key Takeaway: The government funding package introduced this past week came with wins and losses for the healthcare industry. While it did not include flexibility for meaningful use participants was, neither did it include language mandating another ICD-10 delay.

Why It Matters: In another heated battle over federal government spending, the healthcare industry eagerly awaited the final “Cromnibus” text to see what other health IT policy issues would be addressed. Among the possibilities were another ICD-10 delay or the inclusion of the Flex-IT Act language concerning Meaningful Use Program flexibility.

Congress used its funding powers to shine a spotlight on the Office of the National Coordinator for Health IT’s (ONC) certification program, information blocking and interoperability. Language in the spending package requires ONC to devise a strategy to combat information blocking. It also tasks the federal Health IT Policy Committee with submitting a report to Congress within a year on the challenges to nationwide interoperability, including technical, operational and financial barriers.

The omnibus spending package was without any language to further delay ICD-10 beyond the current implementation deadline of Oct. 1, 2015. Further, last week the leadership of the House Energy and Commerce Committee and the Committee on Rules stated the Congress’ intention to work with CMS to ensure the nation is ready for the scheduled ICD-10 implementation deadline to conduct hearings on the nation’s readiness when Congress returns to session in 2015.

The controversial spending package, like many others before it, maintained the language to prohibit the use of government funds for the development of a standard patient identifier.

The $1.1 trillion spending package to fund the government through Sept. 30, 2015, passed the House late Thursday night by a vote of 219-206 and was passed by the Senate Saturday.


ONC Released Next 5-Year Federal Health IT Strategic Plan

Key Takeaway: ONC collaborated with 35 federal departments on the Federal Health IT Strategic Plan 2015-2020, which hopes to improve interoperability, increase the use of telehealth, continue the use of new payment models, and increase broadband in rural areas, among other initiatives to reduce healthcare costs and improve outcomes.

Why It Matters: ONC plans to leverage the meaningful use program to achieve many of the goals of the strategic plan. However, it remains to be seen what else can be added to meaningful use regulations, because the Stage 3 NPRM is expected in the next few months; this is particularly unclear at a time when ONC FACA committees and other stakeholders are calling for a less prescriptive rule that focuses on a few things, like interoperability.

The healthcare industry is still struggling with interoperability, telehealth and clarity around medical device regulation. If the strategic plan leads to new policies, the industry will need to work together to create and adopt common standards for health information exchange. Regulatory clarity around remote monitoring technologies and other devices will enable innovation and will likely improve access to care and overall outcomes.

The comment deadline is Feb. 6, 2015. If you would like to help CHIME comment on the Federal Health IT Strategic plan, please contact Angela Morris for more information. The workgroup will meet three times in January (January 8 or 9, January 15 or 16 and January 22 or 23) and communicate via email between meetings.

HHS Rewards Quality Measure Improvements

Key Takeaway: Last week, the Department of Health and Human Services (HHS) awarded $36.3 million to more than 1,100 health centers for quality measure improvement. The awards were designated for those that had a 10 percent improvement on measures in 2012 and 2013, the top 30 percent in clinical outcomes, for those that used EHRs to report clinical quality improvements, and those that exceeded the national benchmark set for managing chronic diseases and other designated healthcare situations, such as preventative care and prenatal care.

Why It Matters: Almost $5 million (about 13 percent) of the awards went to 332 facilities for using EHRs to report clinical quality improvements on all patients, indicating that healthcare centers are interested in using EHRs to report CQMs, but more work needs to be done to improve eCQM reporting to make it even more prevalent.

An HHS announcement last week detailed a new set of grants sent to healthcare providers for quality improvement efforts. HHS Secretary Burwell said, “With these funds, health centers in all 50 states will continue to provide access to high quality, comprehensive primary and preventive health care to the patients that need it the most.” Click here for a list of awards.

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