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Calls for Stage 3 Meaningful Use Delay Intensify with New Bill

By Jennifer Bresnick

- Congress is doubling down on its calls to pull the emergency brake on Stage 3 meaningful use with a new piece of legislation that would delay rulemaking for the third segment of the EHR Incentive Programs until at least 2017. 

Stage 3 meaningful use delay

This week, Representative Renee Ellmers (R-NC), introduced the Further Flexibility in HIT Reporting and Advancing Interoperability Act, otherwise known as the Flex-IT 2 Act, to provide some relief for healthcare organizations currently feeling overwhelmed with the EHR adoption, interoperability, HIE, and clinical quality reporting requirements of Stage 2.

The bill is a follow-up to the original Flex-IT Act, introduced in late 2014, which aimed to reduce the burden of a full-year reporting period for Stage 2 meaningful use.  CMS later did cut the full-year reporting requirements down to 90 days, due to intense industry pressure, but the change hasn’t turned Stage 2 into the major success that federal regulators hoped it would be.

“Only 19 percent of providers have met Stage 2 attestation requirements—a clear sign that physicians, hospitals and healthcare providers are challenged in meeting CMS’ onerous requirements,” Ellmers said in a public statement. Close to half of eligible hospitals have also successfully attested to Stage 2.   “Given this basic fact, I’m uncertain why CMS would continue to push forward with a Stage 3 rule. From my conversations with doctors back home, it is clear they are eager for relief.”

“Today’s legislation is key to supplying healthcare providers with flexibility and certainty, as they struggle yet again to meet the Centers for Medicare & Medicaid Services’ (CMS) stringent requirements pertaining to Meaningful Use,” she added. “This legislation supplies relief by delaying Stage 3 rulemaking until at least 2017 in order to give providers time to breathe and a reprieve from the unfair penalties.”

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“As a nurse, I can speak to the fact that a patients’ health and safety must be put first,” Ellmers stated. “This legislation will ensure that hospitals and providers can effectively share information so they can continue to focus their time and attention to caring for patients.”      

Stage 3 of the EHR Incentive Programs drastically increases expectations for the healthcare industry, particularly around health data interoperability, advanced EHR use, and population health management.  In conjunction with recent legislation repealing the Medicare Sustainable Growth Rate (SGR) and rolling CMS’ three major quality reporting systems into the MIPS program, Ellmers and other healthcare stakeholders believe that the burden is simply too great for the beleaguered industry.

In addition to confusion surrounding the future implementation of MIPS and patient engagement expectations deemed unrealistic for providers who continue to struggle to secure portal sign-ups, Stage 3 critics say that the proposed criteria do not reflect the realities of the health data interoperability landscape.  The requirements ask providers to engage in increased levels of health information exchange, yet their EHR systems are just not up to the task.

“We heard loud and clear from physicians at the AMA’s first-ever town hall meeting on EHRs and the Meaningful Use program that the systems they use are cumbersome, poorly designed and unable to ‘talk’ to each other thereby preventing necessary transmission of patient medical information,” said American Medical Association President Steven J. Stack, MD, in a statement emailed to journalists.

Last week, during testimony in front of the Senate Committee on Health, Education, Labor, and Pensions, DirectTrust President and CEO David Kibbe, MD, MBA, noted that the industry’s lingering negative attitudes towards data sharing and interoperability continue to make it incredibly difficult to develop a cooperative, coordinated care continuum.  

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“Healthcare provider organizations must come to realize that acting in the best interest of patients is to assure that health information follows the patient and consumer to whatever setting will provide treatment, even if that means in a competitor’s hospital or medical practice,” Kibbe said.  “And they must demand collaborative and interoperable health IT tools from their EHR vendors to make this routine and ubiquitous as a practice in every community in the United States.”

CMS must also play a role in helping health data interoperability progress in a meaningful way by establishing a more reasonable pace for Stage 3 meaningful use and its other reporting requirements, the AMA believes. 

"The AMA thanks Rep. Ellmers for sharing our deep concern with a Meaningful Use program that continues to move ahead without first fixing barriers faced by physicians, hospitals, vendors and patients," Stack said. The AMA has been hugely influential in the process of digitizing the healthcare industry, lobbying continually for a slower, less expensive, and less onerous approach to EHR adoption and other mandates such as ICD-10

"Under Rep. Ellmers’ leadership, federal regulations would be revised to provide greater flexibility for physicians to meet the Meaningful Use requirements and ensure that Stage 3 of the program is developed in step with other efforts to modernize our nation’s health care system,” Stack added.


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