Health and Human Services Secretary Kathleen Sebelius today announced
the next steps for providers who are using electronic health record
(EHR) technology and receiving incentive payments from Medicare and
Medicaid. These proposed rules, from the Centers for Medicaid &
Medicaid Services (CMS) and the Office of the National Coordinator for
Health Information Technology (ONC), will govern stage 2 of the Medicare
and Medicaid Electronic Health Record Incentive Programs.
“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 Secretary Sebelius. “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 Health Information Technology
for Economic and Clinical Health (HITECH) Act, part of the American
Recovery and Reinvestment Act of 2009, eligible health care
professionals and hospitals can qualify for Medicare and Medicaid
incentive payments when they adopt certified EHR technology and use it
in a meaningful way. What is considered “meaningful use” is evolving in
three stages:
- Stage 1 (which began in 2011 and remains the starting point for all providers):
“meaningful use” consists of transferring data to EHRs and being able
to share information, including electronic copies and visit summaries
for patients.
- Stage 2 (to be implemented in 2014 under the proposed rule):
“meaningful use” includes new standards such as online access for
patients to their health information, and electronic health information
exchange between providers.
- Stage 3 (expected to be implemented in 2016): “meaningful use” includes demonstrating that the quality of health care has been improved.
CMS’
proposed rule specifies the stage 2 criteria that eligible providers
must meet in order to qualify for Medicare and/or Medicaid EHR incentive
payments. It also specifies Medicare payment adjustments that,
beginning in 2015, providers will face if they fail to demonstrate
meaningful use of certified EHR technology and fail to meet other
program participation requirements. In a November 2011 “We Can’t Wait”
announcement (http://www.hhs.gov/news/press/2011pres/11/20111130a.html),
the Department outlined plans to provide an additional year for
providers who attested to meaningful use in 2011. Under today’s
proposed rule, stage 1 has been extended an additional year, allowing
providers to attest to stage 2 in 2014, instead of in 2013. The proposed
rule announced by ONC identifies standards and criteria for the
certification of EHR technology, so eligible professionals and hospitals
can be sure that the systems they adopt are capable of performing the
required functions to demonstrate either stage of meaningful use that
would be in effect starting in 2014.
“Through the Medicare and
Medicaid EHR Incentive Programs, we’ve seen incredible progress as over
43,000 providers have received $3.1 billion to help make the transition
to electronic health records,” said CMS Acting Administrator Marilyn
Tavenner. “There is great momentum as the number of providers adopting
this technology grows every month. Today’s announcement will help
ensure broad participation and success of the program, as we move toward
full adoption of this money-saving and life-saving technology.”
“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, MD, ScM, National Coordinator for Health Information
Technology. “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.”
The number of hospitals
using EHRs has more than doubled in the last two years from 16 to 35
percent between 2009 and 2011. Eighty-five percent of hospitals now
report that by 2015 they intend to take advantage of the incentive
payments.
A technical fact sheet on CMS’s proposed rule is available at http://www.cms.gov/apps/media/fact_sheets.asp.
A technical fact sheet on ONC’s standards and certification criteria proposed rule is available at http://www.healthit.gov/policy-research.
The proposed rules announced today may be viewed at www.ofr.gov/inspection.aspx. Comments are due 60 days after publication in the Federal Register.
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