Meaningful Use

U.S. Senators and Representatives introduced a bill on Wednesday that would reduce the meaningful use reporting period from a full year to 90 days – and do so in 2016, a move pressed by healthcare organizations across the country. Sens. Rob Portman and Michael Bennet and Reps. Renee Ellmers, Tom Price, Bobby Rush and Ron Kind introduced bipartisan legislation. CHIME, the Medical Group Management Association, the National Rural Health Association, the Federation of American Hospitals and physician groups, not only support the bill, but have also pressed lawmakers for it. Many of the organizations wrote CMS on March 15, asking for a 90-day reporting period for 2016. [Also: Healthcare providers press CMS for 90-day meaningful use reporting] “A preliminary yet critical step to facilitate increased provider success, we respectfully request CMS adopt for the 2016 reporting year the same 90-day reporting period policy for participants in the Meaningful Use program that was offered in 2015,” they wrote to CMS Acting Administrator Andy Slavitt. CMS required a full year reporting period last year, but later reduced the requirement to 90 days in a rule that also reduced the number of meaningful use, Stage 2 requirements. Twitter: @Bernie_HITN Email the writer: bernie.monegain@himssmedia.com Like Healthcare IT News on Facebook and LinkedIn

National Coordinator Karen DeSalvo, MD, is stepping away from the co-chair role on the ONC Health IT Policy Committee. Kathleen Blake, MD, vice president of performance improvement at the American Medical Association, will replace DeSalvo, according to Politico, which reported the announcement was made Tuesday at the joint meeting of the Health IT Policy and Standards Committees. Blake will serve alongside DeSalvo's current co-chair, Paul Tang, MD, chief innovation and technology officer at the Palo Alto Medical Foundation. Tang is also the head of ONC's meaningful use workgroup.  [Also: How satisfied are you with your EHR? Satisfaction Survey results]  DeSalvo currently serves as both National Coordinator for Health IT and Acting Assistant Secretary of Health and Human Services. She's been with ONC since January 2014. Health and Human Services Secretary Sylvia Burwell brought DeSalvo to HHS in October 2014 to help coordinate the federal government respond to the Ebola outbreak – touting her public health qualifications after having served as New Orleans Health Commissioner in the wake of Hurricane Katrina. In May 2015, President Barack Obama appointed DeSalvo HHS Acting Assistant Secretary for Health. If she gets a Senate confirmation hearing and is approved, she would step down from the National Coordinator post at ONC.   Twitter: SullyHIT Email the writer: tom.sullivan@himssmedia.com Like Healthcare IT News on Facebook and LinkedIn

Starting in 2019, Centers for Medicare & Medicaid Services, will change how they pay physicians in a profound way. Unfortunately, the details are complicated and confusing, and many of the particulars have yet to be worked out, which has led many healthcare leaders to glaze over the details and focus on more immediate concerns.

Company executives say that joining Cerner, Epic, Meditech and others in promising to use agreed upon standard and not block data is merely formalizing what they already practice.  

Remember ONC Regional Extension Centers? There were 62 of those federally-funded organizations, better known as RECs, created nationwide in 2009 with a mission of helping primary care physicians move from paper to digital systems. In 2009, Morehouse School of Medicine was awarded a $21 million from the Office of the National Coordinator for Health Information Technology to become the only REC in Georgia to provide on-the-ground technical assistance for individual and small medical practices. News out of Atlanta today is that the Georgia center, GA-HITEC, part of the National Center for Primary Care at Morehouse School of Medicine, is closing in on getting the job done. The Georgia REC has reached 100 percent of the eligible primary care providers in the state and 89 percent of its eligible critical access and rural hospitals have achieved Stage 1 meaningful use. [Also: Most RECs plan to stay open for business] Through the program, it has reached more than 4,000 eligible primary care physicians and 56 critical access and rural hospitals by employing a 10-Step Roadmap to meaningful use. Also, it has assisted members in receiving more than $80 million in incentive payments through the federal EHR incentive programs. "Through our quest for Health IT interoperability we have provided the Georgia medical community increased patient engagement and improved quality health care through the use of technology," said Dominic Mack, MD, GA-HITEC's principal investigator and newly named director of the National Center for Primary Care at Morehouse School of Medicine, in a news release. He added that the work of the team would result in both better clinical outcomes and improved population health outcomes. As the national REC program is slated to sunset in late 2016, GA-HITEC continues to develop activities in support of CMS' HIT initiatives, including Stage 2 and Stage 3 meaningful use, health information exchange, clinical practice transformation, along with other value-based reporting efforts. And, GA-HITEC is not alone. Most RECs plan to stay open, according to the 2014 HIMSS Regional Extension Center Survey. Twitter: @Bernie_HITN Email the writer: bernie.monegain@himssmedia.com Like Healthcare IT News on Facebook and LinkedIn

Looking into its crystal ball – or perhaps digital spreadsheets – PiperJaffray analysts see big plays in the RCM market. That potential is so large, in fact, that Cerner alone has a $40 billion opportunity, and it ranks fifth in market share.

Arguing that too many well-meaning providers are facing financial penalties from meaningful use, the American Hospital Association called on the Centers for Medicare and Medicaid Services this week to offer more flexibility. Specifically, AHA says hospitals that meet 70 percent of meaningful use requirements should be deemed as having complied with the program. With the current "all-or-nothing approach," writes Ashley Thompson, AHA's senior vice president of public policy analysis and development, "failure to meet any one of the requirements under the Medicare and Medicaid EHR Incentive Programs has meant a provider would not receive an incentive payment; more recently, it has meant a provider would be penalized." [Also: Hospitals press HHS on meaningful use] Given the huge complexity and high hurdles of meaningful use, the fact that a hospital missing a given threshold by small amount leads to overall failure is "unfair to providers that make good faith efforts to comply," according the March 22 letter to CMS Acting Principal Deputy Administrator Patrick Conway, MD. CMS has told AHA that it doesn't have the statutory authority to offer anything less than that absolutist approach, according to the letter. But AHA offers a legal analysis that suggests that's not true: "We believe that CMS possesses the authority to eliminate the all-or-nothing approach to meaningful use and that the agency should do so." Among the arguments put forth by CMS for the necessity of an all-in requirement: The law requires more stringent MU measures to improve quality over time; certain measures capture policies, such as health information exchange, that are specifically required by statute; use of a "qualified EHR" must meet all the requirements, not some, in order to meet the law's objectives. The agency has also argued that a more flexible framework wouldn't reduce providers' reporting burden anyway – a contention with which AHA "respectfully disagrees" but points out isn't statutorily binding anyway. "We strongly believe that CMS is not legally required to maintain its  all-or-nothing approach to meaningful use," AHA argues, but instead has "ample legal authority" to adopt a more forgiving approach like the 70 percent threshold it suggests. "This flexibility would support providers who have implemented IT functionality but may not have optimized each function sufficiently to meet the full set of requirements in the EHR Incentive Program in order to avoid a payment adjustment." Twitter: @MikeMiliardHITN Email the writer: mike.miliard@himssmedia.com Like Healthcare IT News on Facebook and LinkedIn

More than 30 healthcare provider organizations have banded together to urge the Centers for Medicare and Medicaid Services to adopt a 90-day reporting period for meaningful use measures in 2016, rather than full-year reporting as CMS has proposed. Providers proved successful when they rallied for 90-day reporting for 2015. [Also: Meaningful use will still be part of MIPS reimbursement] In a March 15 letter to CMS Acting Administrator Andy Slavitt, the groups said the changes CMS made in the Modified Stage 2 final rule for 2015 provided welcomed relief to the provider community. As they see it, full-year reporting in 2016 would demand complex system changes: "For many providers, these system changes will impact their ability to comply with the full-year reporting period," they wrote. CHIME, which represents more than 1,800 healthcare chief information officers, is leading the call for 90-day reporting. [Also: Healthcare industry cheers meaningful use modifications] "Healthcare providers are firmly committed to using information technology to transform the delivery system," CHIME Board Chair Marc Probst, CIO at Intermountain Healthcare, and CHIME President and CEO Russell Branzell, said in a joint statement. "Changes made to the meaningful use program last year provided welcomed relief from burdensome regulatory requirements.” "Providers now are awaiting further changes to the program spurred by the Medicare Access and CHIP Reauthorization Act of 2015. However, the current regulatory scheme still calls for a 365-day reporting period. Until the final MACRA rules are issued, providers will be greatly challenged to meet the reporting requirements,” they said. [Like Healthcare IT News on Facebook] "Maintaining 365-day reporting period also will force providers to pull resources away from using health IT to innovate care processes and workflows. Additionally, it will limit the amount of time providers and vendors could spend on improving interoperability and information exchange." Organizations supporting the change are: American Academy of Dermatology Association American Academy of Family Physicians American Academy of Neurology American Academy of Ophthalmology American Association of Clinical Endocrinologists American Association of Neurological Surgeons American Association of Orthopaedic Surgeons American College of Cardiology American College of Mohs Surgery American College of Physicians American College of Rheumatology American College of Surgeons American Gastroenterological Association American Society for Dermatologic Surgery American Society for Gastrointestinal Endoscopy American Society of Nuclear Cardiology American Society of Plastic Surgeons American Urological Association America’s Essential Hospitals Association of Medical Directors of Information Systems Cardiology Advocacy Alliance Coalition of State Rheumatology Organizations College of Healthcare Information Management Executives Congress of Neurological Surgeons Federation of American Hospitals Heart Rhythm Society Infectious Diseases Society of America Medical Group Management Association National Association of Spine Specialists National Rural Health Association Oncology Nursing Society Premier healthcare alliance Society for Cardiovascular Angiography and Interventions United Surgical Partners International Twitter: @Bernie_HITN

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Value-based program will score physicians on quality, resource use, practice improvement and certified technology.