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CHIME Calls for Extended MU Stage 3 Timeframe

December 14, 2015
by Rajiv Leventhal
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A “laser-like focus on interoperability” is needed, CHIME says

The Ann Arbor, Mich.-based College of Healthcare Information Management Executives (CHIME) is urging the federal government to give providers more time to adjust to recent changes to the meaningful use program before “mandating new and burdensome Stage 3 requirements.”

According to a statement CHIME released on Dec. 14, “extending the timeframe for Stage 3 no sooner than 2019 would allow all stakeholders—policymakers, providers and vendors—to fully implement modifications made in October to Stage 2, and to focus energies on the critical issue of interoperability.” This is in line with what CHIME said when the meaningful use Stage 3 final rule, as well as the Stage 2 modifications final rule, were released in October by the Centers for Medicare & Medicaid Services (CMS): “Unfortunately, the agency decided to move forward with Stage 3 rulemaking. CHIME, other healthcare associations and members of Congress had urged CMS to hold off on issuing a final rule in order to ensure that it is in sync with new payment models being advanced by Medicare. Delaying rulemaking would also give stakeholders time to address such key issues as interoperability before moving forward.”

In today’s press release statement, CHIME Board of Trustees Chair Charles E. Christian, said, “CHIME members are committed to the goals of the meaningful use program. We have made significant progress in implementing information technology systems to improve patient care and reduce costs. However, we do not believe that the course laid out by the Centers for Medicare & Medicaid Services for Stage 3 will help us achieve some important goals, including better alignment of quality improvement efforts and widespread health information exchange. We need to let providers and vendors continue down the adoption curve and perfect systems that many are still putting in place.”

With stakeholder comments for the Stage 3 final rule due on Dec. 15, there has been a recent push to make changes to the meaningful use program. Last week, various healthcare stakeholders—including the Health IT Now Coalition and certain health IT vendorswrote a letter to members of Congress urging them to oppose any delays to meaningful use Stage 3 that do not include changes to interoperability standards. In late October, more than 100 medical associations sent letters to members of the Senate and the House urging lawmakers to intervene with Stage 3 of the meaningful use program.

Nonetheless, despite the fact that CMS is accepting comments for the regulations until Dec. 15, the agency has said that all comments will be considered for future rulemaking, such as the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) that requires the establishment of a Merit-based Incentive Payment System (MIPS)—not Stage 3 of meaningful use.

What’s needed now, CHIME’s Christian added, is “a laser-like focus on interoperability.” Central to that is finding a safe, secure and accurate methodology for patient identification, he said. Also, Christian said, there needs to be a concerted effort to protect patients’ health information from cyber threats and data breaches. Christian also noted concerns among CIOs and IT vendors that the Stage 3 timeline is unrealistic for ensuring that certified products are available in the marketplace.

In written comments to CMS on Stage 3 regulations, CHIME specifically called for:

  • Starting Stage 3 no earlier than 2019 and only after 75 percent of all eligible providers have met Stage 2
  • Removing the 2017 transitional year for meeting meaningful use Stage 3 and require 2015 Edition certified electronic health record technology (CEHRT) no earlier than 2018
  • Creating a 90-day reporting period for every year of the program, including the first year at Stage 3, to allow providers adequate time for upgrades, planned downtime, fixes related to technology or optimizing the use of new technology within workflows
  •  Creating parity for both eligible providers (EPs) and eligible hospitals (EHs) by removing the existing pass/fail approach for meaningful use
  •  Reducing the burden for providers by streamlining reporting redundancies and refraining from requiring data collection and submission on measures that do not advance patient care

In these written comments, CHIME also gives specific recommendations for all eight of the program’s objectives for Stage 3. “CHIME appreciates the increased flexibility CMS created in Stage 2 and the agency’s willingness to receive comments on Stage 3 regulations,” Christian said. “We are all striving to create a more efficient delivery system; one that improves patient care and lowers costs. CHIME looks forward to working with its partners in the federal government and other stakeholders as we drive towards those goals.”

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