Meaninful Use Stage 3 Final Rules

Now that the ICD-10 panic has subsided the healthcare world is focusing on something new: Meaningful Use. Despite mixed reactions from the public and congress, many of whom expressed concern about the proposed changes and rules, The Centers for Medicare & Medicaid Services (CMS) and Office of the National Coordinator for Health Information Technology (ONC) released the final rules for the changes to Meaningful Use Stage 1 and 2, the Stage 3 requirements and the 2015 Edition Health IT Certification Criteria. The mixed reactions are born out of the reports that many healthcare providers that have yet to successfully achieve Stage 2, with “35 percent of hospitals and a small fraction of physicians” meeting the Stage 2 requirements.” If you haven’t been keeping up with the Meaningful Use news you can read some of our blog explaining meaningful use Stage 2 here.

The statement from the Department of Health and Human Services (HHS) stated that the final rules and changes would hopefully “add new flexibilities for providers to make electronic health information available when and where it matters most and for health care providers and consumers to be able to readily, safely, and securely exchange that information.”

Dr. Patrick Conway, M.D., M.Sc., CMS deputy administrator for innovation and quality and chief medical officer said in a statement:

“We have a shared goal of electronic health records helping physicians, clinicians, and hospitals to deliver better care, smarter spending, and healthier people.  We eliminated unnecessary requirements, simplified and increased flexibility for those that remain, and focused on interoperability, information exchange, and patient engagement. By 2018, these rules move us beyond the staged approach of ‘meaningful use’ and focus on broader delivery system reform. Most importantly we are seeking additional public comments and plan for active engagement of stakeholders so we take time to get broad input on how to improve these programs over time.”

The Centers for Medicare & Medicaid Services (CMS) also announced that it would open a 60-day comment period to “gather additional feedback about the EHR Incentive Programs going forward, in particular with the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), which established the Merit-based Incentive Payment System and consolidates certain aspects of a number of quality measurement and federal incentive programs into one more efficient framework.” They hope to use the feedback to help make future policy decisions.

The final rule for the 2015 Edition Health IT Certification Criteria will focus on increasing interoperability and improving transparency and competition in the Health IT marketplace.

According to the CMA fact-sheet:

The EHR Incentive Programs in 2015 through 2017 major provisions include:

  • 10 objectives for eligible professionals including one public health reporting objective, down from 18 total objectives in prior stages.
  • 9 objectives for eligible hospitals and critical access hospitals (CAHs) including one public health reporting objective, down from 20 total objectives in prior stages.
  • Clinical Quality Measures (CQM) reporting for both eligible professionals (EPs) and eligible hospitals/CAHs remains as previously finalized.

For Stage 3 of the EHR Incentive Programs in 2017 and subsequent years, major provisions include:

  • 8 objectives for eligible professionals, eligible hospitals, and CAHs:  In Stage 3, more than 60 percent of the proposed measures require interoperability, up from 33 percent in Stage 2.
  • Public health reporting with flexible options for measure selection.
  • CQM reporting aligned with the CMS quality reporting programs.
  • Finalize the use of application program interfaces (APIs) that enable the development of new functionalities to build bridges across systems and provide increased data access. This will help patients have unprecedented access to their own health records, empowering individuals to make key health decisions.

“The Stage 3 requirements are optional in 2017. Providers who choose to begin Stage 3 in 2017 will have a 90-day reporting period. All providers will be required to comply with Stage 3 requirements beginning in 2018 using EHR technology certified to the 2015 Edition. Objectives and measures for Stage 3 include increased thresholds, advanced use of health information exchange functionality, and an overall focus on continuous quality improvement.”

You can read more about the rules and final regulations in this CMS factsheet: “Electronic Health Record Incentive Program and Health IT Certification Program Final Rule” and here “CMS FACT SHEET: EHR Incentive Programs in 2015 and Beyond.”

More Resources

Final Rules for Meaningful Use Announced  via Medscape

Meaningful Use Stage 3 – 2015 Certification final rules released via Practice Fusion

Meaningful Use Stage 3, alterations rules in hands of OMB via Fierce EMR