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Wait, what? The MU and HIT Tallies from DC

by Lauren H. Fifield, Senior Policy Advisor

As the holidays draw near, I look forward to traditions shared with family and friends. Who doesn’t? There's watching movie classics like Rudolph, eating all of the chocolates in my Advent calendar in one sitting and we can't leave out all the family theatrics around the holiday table...

So it is quite fitting that DC seems to be honoring its own time-honored traditions: 

  • In the wake of the Super Committee failure, we once again look to Congress to address the 27.5% physician reimbursement Medicare cuts —currently effective January 1, 2012—as defined by the Sustainable Growth Rate (SGR)… we need a ‘doc fix.’ I’ll catch you up on that particular topic in a future post.
  • The Department of Health and Human Services (HHS) has started its annual end-of-year final rules and announcements blitz, including the We Can’t Wait campaign, the Meaningful Use (MU) Stage 2 delay announcement and new CMS Meaningful Use performance stats, all of which  I describe below. We also look forward to an announcement about the ACO Pioneer Program participants.

Along with the announcement of the We Can’t Wait campaign to encourage adoption and use of health information technology (HIT), HHS Secretary Kathleen Sebelius released a report from the Centers for Disease Control and Prevention (CDC) showing that adoption rates of HIT have doubled in two years

She also announced the decision to officially delay Stage 2 MU requirements, which the HIT Policy Committee recommended to the Office of the National Coordinator (ONC) this summer. This gives vendors and providers more time to develop and implement Stage 2-certified technology. I understand that timelines became very tight for Stage 2, but I can’t help wondering what a delay does to the EMR market and health care industry. With more than 780 certified solutions in the ambulatory space alone, it seems there is more motivation to create a market in which the most innovative, adaptive solutions survive. I agree with the HHS campaign: We can’t wait. I just wish it didn’t feel like that’s what we’re doing.

Editorializing aside, the delay means that:

  • Providers who began MU in 2011 will demonstrate Stage 1 requirements for an extra year—2011-2013 (Years 1-3)—and perform Stage 2 requirements beginning in 2014 (Year 4). 
  • Providers who begin the program in 2012 must demonstrate Stage 1 requirements in 2012-2013 (Years 1-2), with Stage 2 requirements beginning in 2014 (Year 3).
  • All eligible providers must perform Stage 3 requirements starting in 2015 or incur a fee schedule adjustment of 1% in 2015, followed by a 2% adjustment in 2016, and so on.

The Notice of Proposed Rulemaking (NPRM) for the Stage 2 requirements will be released in early 2012 and we expect the Final Rule to be issued in June.

Aaaaand finally, CMS released new Meaningful Use performance statistics during the HIT Policy Committee meeting on December 7, including the following highlights:

  • Total # of Medicare-eligible professionals (EPs): 382,000
  • Total # of Medicare EPs registered for the MU program YTD: 114,925
  • Total # of Medicare EPs to receive their first MU incentive YTD: 10,155

Meaning?

Approximately 30% of eligible providers in the nation have registered for the program and only about 2.5% have gotten paid.

It is worth noting that 4,255 EPs were paid in November. This accounts for almost half the total payments in 2011, and CMS expects the rate to spike through February. CMS also recognized during the HIT Policy Committee meeting that the number of Medicare EPs is lower than desired. As a result, CMS plans to launch an exploration of barriers to program participation. 

I’ll be in DC this week so stay tuned… and as always, you can follow me on Twitter for constant updates.

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