CMS announces next stage for providers adopting electronic health records

posted 03.06.12

The Centers for Medicaid and Medicare Services announced the proposed rule for the second stage of the federal electronic medical record incentive program, and expects to finalize the rule this summer. Stage two of meaningful use requires those participating in the Medicare and Medicaid EHR Incentive Programs to use their EHR technology to meet tougher quality objectives and coordinate patient care with other physicians and health care providers.

The incentive program was put in place in February 2009 by the multibillion dollar American Recovery and Reinvestment Act. To be eligible for incentive funds—up to $44,000 over five years from Medicare or $63,750 over six years from Medicaid—physicians must show that they are “meaningful users” of EHR technology, beginning with basic criteria and adding capabilities over several years.

Stage one began in 2011 and requires physicians to demonstrate that they can transfer data to EHRs and share information, including electronic copies and visit summaries of patients. According to a CMS release, to date, over 43,000 providers have received $3.1 billion to help make the transition to electronic health records, with additional gains for hospitals.

“We know that broader adoption of electronic health records can save our health care system money, save time for doctors and hospitals, and save lives,” said Health and Human Services Secretary Kathleen Sebelius in a Feb. 24 CMS press release. “We have seen great success and momentum as we’ve taken the first steps toward adoption of this critical technology.  As we move into the next stage, we are encouraging even more providers to participate and support more coordinated, patient-centered care.”

Under the proposed rule, stage two would begin in 2014. It expands meaningful use to include online access for patients to their health information and furthers the exchange of clinically relevant electronic health information between physicians and other providers. It also increases the number of core objectives that must be met. Under stage one, physicians were required to meet all of the core objectives, or qualify for exclusion, and meet five out of the 10 menu measures. Under stage two, physicians must meet 17 core objectives, or qualify for an exclusion, and meet three of five menu objectives.

“The proposed rules for stage 2 for meaningful use and updated certification criteria largely reflect the recommendations from the Health IT Policy and Standards Committees, the federal advisory committees that operate through a transparent process with broad public input from all key stakeholders. Their recommendations emphasized the desire to increase health information exchange, increase patient and family engagement, and better align reporting requirements with other HHS programs,” said Farzad Mostashari, M.D., Sc.M., national coordinator for health information technology, in the CMS release.

“The proposed rules announced today will continue down the path stage 1 established by focusing on value-added ways in which EHR systems can help providers deliver care which is more coordinated, safer, patient-centered, and efficient.”

Stage three is scheduled to be implemented in 2016 and would expand meaningful use further to include demonstrating that quality has been improved. Physicians who fail to adopt EMR systems and demonstrate meaningful use criteria by 2014 may face reduced Medicare payment starting in 2015.

For more information, view the CMS detailed fact sheet on stage two or read the CMS press release.