The federal health IT policy committee on July 16 approved long-awaited recommendations from its meaningful use workgroup on how providers can qualify to receive incentives through the new stimulus package. Measuring and improving outcomes is a key component.
As part of a mandated series of steps the federal policy committee accepted its workgroup’s complex matrix of qualifications that will define “meaningful use” of health IT, a pivotal aspect to being a candidate for reimbursement bonuses and avoiding penalties under the American Recovery and Reinvestment Act of 2009 (ARRA). Bonuses will begin in 2011, while penalties will be enacted in 2017.
Paul Tang, MD, chairman of the meaningful use workgroup said the framework of the recommendations is directed toward measuring and continually improving outcomes in stages. “We can’t get from our low adoption rate now to the vision of 2014 widespread adoption in one fell swoop, “ he said. The recommendations focus on data collection in 2011; computerized physician order entry in 2013; and improved outcomes in 2015.
The recommendations also include measures to help providers who are not able to qualify for bonuses under ARRA until after 2012. They will be able to comply with the original first year requirements, but the following year they will be expected to be up to par with the current requirements.
The workgroup’s recommendations will now have to be approved by National Coordinator for Health Information Technology David Blumenthal, MD, before they are delivered to the Centers for Medicare and Medicaid Services (CMS) to be applied as it sees fit in writing a rule expected out for comment in December.
After tabling the workgroup’s recommendations in June, Blumenthal and other members of the committee urged a vote at the July 16 meeting in the interest of progress. “We are in the business of making recommendations, not rulemaking,” Blumenthal said.
Jodi Daniel, director of the Office of the National Coordinator for Health Information Technology (ONC), Office of Policy and Research, said ONC received 790 public comments on meaningful use over a 10-day period in June. Daniel said many who provided comments showed support for the improved health outcomes approach endorsed by ARRA.
Many of those who commented were concerned over the stringent time constraints, which would require providers to establish and meaningfully use health IT by next year if they want to reap the most bonus funding under ARRA.
Specialty physicians were concerned the rules would not be specific to their scope of practice. Physicians were also concerned over liability issues that may arise as electronic health records are shared among various providers.
Blumenthal said the question of liability is not one the policy committee has the authority to address. “If we were to have to think through everything that could cause medical liability, we could be tied in knots.”
With the July16 approval of the new recommendation matrix, “there is going to be some limitation on what we can say and do after today,” Daniel said. ONC and CMS will be working on the rule internally until December.
