Healthcare News & Insights

How will Stage 3 change the meaningful use program?

The feds just proposed rules for the next stage of the meaningful use program. But does Stage 3 address or just add to providers’ attestation problems? 

ThinkstockPhotos-149402573Earlier this year, the Department of Health and Human Services (HHS) promised that Stage 3 would be more flexible and address the barriers many providers ran into trying to meet Stage 2’s criteria.

Now, the Centers for Medicare & Medicaid Services (CMS) has proposed the new Stage 3 rules and is asking for providers to weigh in on the new provisions.

Providers can expect several big changes to the meaningful use program in Stage 3, according to the proposed rule. But not all them fulfill HHS’ promise of flexibility.

Less-than-flexible changes

For one, regardless of providers’ participation in past stages, all eligible professionals will be required to report on Stage 3 criteria in 2018 or see their Medicare pay lowered. However, if leaders feel their facilities are in a strong position to meet meaningful use criteria, they have the option of beginning Stage 3 in 2017.

Similarly, Stage 3 will align with CMS’ current quality reporting programs, like the physician quality reporting system and hospital inpatient quality reporting program.

For example: Stage 3 encourages hospitals to electronically submit data on clinical quality measures in 2017, if possible, and will require all providers to electronically submit this information in 2018.

The proposed rules raise the bar on several program requirements, which may make it difficult for providers to avoid pay adjustment. Stage 3 will require:

  • 80% of prescriptions to be sent electronically
  • 60% of lab and imaging requests to be sent electronically
  • 25% of patients to have access to their medical records
  • 25% of patients to use secure messaging with a physician, and
  • 15% of patients to generate health data using mHealth devices or applications.

Bending on some criteria

Although Stage 3 lacks flexibility in some provisions, the new rules give providers more wiggle room in other areas.

For example, the proposed rules also include changes to the electronic health record (EHR) reporting period for attestation.

Providers attesting to meaningful use for the first time won’t be required to meet the current 90-day reporting period. And eligible professionals who’ve attested to past stages will have a full year to report attestation under Stage 3.

Additionally, although Stage 3 raises the bar in terms of how much patients need to be engaged, the proposed rule also gives hospitals more leeway in regards to what methods they use to engage them. Under Stage 3, providers can report two of three engagement options, such as:

  • giving patients electronic access to medical records
  • collecting patient-generated data, and
  • providing the option for secure messaging between patients and clinicians.

Although it’s likely that CMS will adjust some of Stage 3’s criteria, the proposed rules give providers some idea of where to focus their efforts to meet the new program requirements.

For example, if patient engagement was your biggest issue for meeting Stage 2 criteria, you may want to survey patients to see what tools they’re most interested in using to manage their own care.

Likewise, if your facility has held off on leveraging mHealth in its operations, now may be the time to reevaluate how those devices or mobile apps can be effectively implemented by your physicians.

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