Meaningful Use Prepares to Take a Bow… and Then an Encore
The Centers for Medicare and Medicaid Services (CMS) gives the Electronic Health Record (EHR) Incentive Program (also known as "Meaningful Use") a facelift in anticipation of its starring role in the Merit-Based Incentive Pay System (MIPS), which imposes performance measures on Part B providers that affect their eligible reimbursements. CMS released its Final Rule for Stages 2 and 3 of the Meaningful Use Program on October 16, 2015. Providers and Health IT developers should be aware of the changes to the Meaningful Use Program, because although its role as a stand-alone program ends on December 31, 2018, the Stage 3 requirements will comprise 25% of the composite performance score for MIPS eligible professionals (EPs) which can increase or decrease Medicare and Medicaid payment by up to 4% in 2019 and 9% by 2022. Providers seeking to invest in EHRs to satisfy MIPs requirements may scrutinize Stage 3 compatibility in potential EHR systems and solutions.
The final rules for Stages 2 and 3 significantly streamline the program by removing "topped-out" measures (e.g., those measures that achieved such widespread performance that it is no longer necessary to include them as a requirement) and replacing the menu set and core set structure with a single set of required objectives and measures. Starting on January 1, 2015, EPs who do not successfully attest to meaningful use of certified EHR technology (CEHRT) receive a payment adjustment. Under the Final Rule, EPs attesting for the first time in 2015 or 2016 may use a 90-day reporting period (rather than the otherwise full calendar year reporting period) to attest to the modified Stage 2 requirements. Beginning in 2018, all EPs will be required to attest to Stage 3 requirements, regardless of prior participation. However, CMS is allowing EPs who voluntarily attest to Stage 3 requirements in 2017 to have a reduced 90-day reporting period that year as well.
Adding to the list of issues that providers and developers must consider, the Office of the National Coordinator (ONC) also released its final rule for 2015 Edition Health IT Certification Criteria on October 16, 2015. ONC's new rule departs from the previous rule by including a broader definition of CEHRT than the definition contained in CMS's Stage 2 and Stage 3 rules. This change introduces potentially greater complexity because it applies to a broader subset of health IT technologies, not only EHRs to which the Meaningful Use certification process applies.
Providers and Health IT developers should be aware of the changes to the Meaningful Use Program and ONC's 2015 Health IT Certification criteria both to avoid payment adjustments in 2015 through 2018, and to prepare for the new physician payment system beginning in 2019. Read this Advisory for more detailed analysis of the EHR Incentive Program Final Rule.