The start date for Stage 2 of the meaningful use incentive program, expected to begin Oct. 1, 2013 for hospitals and Jan. 1, 2014 for eligible providers is once again up for discussion. This is not the first time that lawmakers have called for a delay. This July, at a Senate Finance Committee meeting, the debate was rekindled to no avail.
Though federal leaders have not indicated they will bend toward a new start date, 17 GOP senators on Tuesday tried to sway the status quo. In a letter, the Senators asked the Department of Health and Human Services to extend the meaningful use program’s attestation deadline by one year, relaying a message from some of their provider constituents.
Sen. John Thune, a South Dakota Republican and chair of the Senate Republican Conference, and Lamar Alexander, a Republican from Tennesee and a ranking member of the Health, Education, Labor and Pensions Committee, led the charge. They argue there are “several key problems with the current timeline.
“First, we are concerned the regulatory structure of the program has created significant time pressure in 2014, and progressing to Stage 2 may not be feasible for all participants,” they wrote. That in turn could “further widen the digital divide for small and rural providers who lack the resources of large practices and may not be vendors’ top priorities.”
The senators were also concerned that “an artificially aggressive Stage 2 timeline may stifling innovation and increase medical errors.”
HIMSS has urged HHS to keep the Stage 2 start dates as is, yet with a more nuanced approach. In an Aug. 15 letter, HIMSS asked federal officials to launch Stage 2 on schedule but extend year one of the attestation period.
Drawing on data from the HIMSS Analytics database, the HIMSS Board of Directors argues that the timeline and certification challenges faced by eligible hospitals, eligible professionals and technology vendors do indeed necessitate a longer attestation window.
That period should extend through April 2015 and June 2015 for EHs and EPs, respectively, they say. This would encompass 18 months in which those groups can attest to meaningful use requirements for one quarter.
[See also: Keep stage 2 start as is, says HIMSS.]
On Tuesday, the College of Healthcare Information Management Executives praised the senators for their request to delay Stage 2.
CHIME believes the extension of Stage 2 will give providers sufficient time to meet new program requirements, while maintaining software development and deployment deadlines, and it will better enable patients to receive the benefits of an e-enabled U.S. healthcare system.
“We strongly believe that EHR incentive payments under the policy of Meaningful Use have been essential in moving the nation’s healthcare system into the 21st Century,” said CHIME president and CEO Russell P. Branzell in a news release. “Since we began this conversation last May, our belief was the industry would best be served by maximizing the opportunity of program success, which means maximizing participation in Meaningful Use. This letter is an important step towards seeing that opportunity seized.”
In May, CHIME responded to a senate report entitled, “REBOOT: Re-examining the Strategies Needed to Successfully Adopt Health IT,” by outlining the numerous ways hospitals and clinicians are making great strides in EHR adoption with the help of federal incentive payments. “The work accomplished through Meaningful Use to reach consensus on transport, vocabulary and content standards is foundational to advancing interoperability and exchange,” CHIME wrote. “Additionally, we know that many U.S. hospitals and physicians rely on the expectation of incentive monies in executing their business plans for EHRs and interoperability solutions.”
But CHIME also acknowledged a need to evaluate program results and monitor timelines to ensure program success in subsequent Stages. For example, CMS had spent over $15.1billion through May 2013, with more than 50 percent of eligible hospitals (EHs) and over 30 percent of eligible professionals (EPs) having achieved Stage 1 Meaningful Use. Currently, 70 percent of hospitals and 46 percent of EPs have achieved Stage 1 Meaningful Use, or approximately 240,500 hospitals and physicians.
“With this great success comes an obligation to ensure that those who have started down the path do not miss the end goal,” said Sharon F. Canner, senior director of CHIME Public Policy. “Some 500,000 providers will be required to use new technology in 2014, regardless of Stage, and many providers simply will not have the time to upgrade software in a safe, responsible manner to meet Meaningful Use criteria.”
In its May letter, CHIME formally and strongly recommended a one year extension to the Meaningful Use Program reporting requirements in 2014, arguing that providers need more time to optimize EHR technology and flexibility to achieve the benefits of 2014 Edition EHRs and Stage 2 requirements. CHIME has developed a number of policy recommendations and educational resources, available here.
By the end of August, several provider associations echoed CHIME’s call for an extension, including a joint letter from the American Hospital Association and American Medical Association, and letters from the American College of Physicians, the American Academy of Family Physicians, the Health Information Management Systems Society, the National Rural Health Association and the Medical Group Management Association.
“These 17 Senators have evaluated program data, heard from constituents and acted in a responsible manner by issuing their request to HHS Secretary [Kathleen] Sebelius,” said Branzell. “The tenor of Senate’s letter echoes that of CHIME and others who desperately want this program to succeed, but also know that some changes are needed.”
