Meaningful Use Changes take effect starting 2015 and continue through 2017.

After ongoing feedback from medical providers, professional medical associations, and Congress, the Centers for Medicare and Medicaid Services (CMS) released changes to the Meaningful Use program on October 16, 2015. These changes take effect starting 2015 and continue through 2017. The intended aim of this Final Rule is to reduce the complexity of the EHR Incentive Program and address the many challenges that prevented providers from meeting Stage 2 Meaningful Use requirements.

Here are the six most important things you need to know about the changes :

1. Every provider will now be completing a 90-day reporting period for the 2015 reporting year.

No matter what stage or year you were previously in, the Final Rule states that all providers will attest for a 90-day reporting period in 2015.

2. All providers are now in Stage 2 of Meaningful Use — with a “Modified Stage 2” for providers that were previously in Stage 1.

CMS has removed Stage 1 from the program in order to simplify the requirements by placing everyone into the same Stage. However, any providers who were previously in Stage 1 for 2015 will now be placed in “Modified Stage 2” which only requires them to meet Stage 1 requirements.

3. The core and menu measures have been simplified into 10 “Objectives.”

Every provider will complete and attest to 10 objectives, with one or several measures per objective. There is no longer a concept of “core” or “menu” measures.

4. The Stage 2 measures that required patient engagement have been greatly reduced.

The threshold for the measure Patient Electronic Access: View Download and Transmit health information dropped from 5% to “at least one patient seen by the EP during the reporting period.” The 5% threshold for Secure Messaging was removed and replaced with “the capability for patients to send and receive a secure electronic message with the EP was fully enabled during the EHR reporting period.” These measures have been adjusted in order to minimize the burden and challenges that providers were experiencing in meeting Meaningful Use Stage 2.

5. Many data-entry measures have been eliminated.

Record Demographics, Record Vital Signs, Record Smoking Status, Clinical Summaries, Structured Lab Results, Patient List, Patient Reminders, Summary of Care Measure 1 – Any Method and Measure 3 – Test, Electronic Notes, Imaging Results, and Family Health History have been removed from the reporting requirements.

6. Attestation will not be available to providers until January 4, 2016. The current attestation deadline is February 29, 2016.

CMS needs time to update the attestation process to support the changes to the Meaningful Use program. We’ll continue to update you with additional information on attestation as we approach the attestation window in 2016.
 

Here at AccuChecker, our Healthcare Consultants are available to assist with multiple issues facing the healthcare industry today:

·         PQRS

·         HEDIS

·         Meaningful Use

·         Practice Management

·         Risk Management

·         ICD-10 

 

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Meaningful Use Attestation

Meaningful Use Attestation

What is attestation?

Attestation is a legal statement that you have met the thresholds and all of the requirements of the Medicare EHR Incentive Program. The process of attestation happens through an internet-based CMS system that allows you to enter information on all of the following:

·                     13 core objectives

·                     5 out of 9 menu objectives

·                     9 measures from 64 approved CQMs

 

Where do you go to attest?

You will attest through the same system where you initially registered.  Go to :  https://ehrincentives.cms.gov, for the CMS EHR Registration and Attestation system now.

During the attestation process, you will enter data and answer yes/no questions on the core objectives, menu objectives, and clinical quality measures. Above is an example of how the core objective for Drug- Drug and Drug-Allergy Checks appears in the attestation system.

How do you attest?

Just as with registration, there is also an attestation guide to help you through the process.

Go to http://www.cms. gov/Regulations-and-Guidance/Legislation/ EHRIncentivePrograms/downloads/EP_Attestation_User_ Guide.pdf, to download an Attestation User Guide that will give you step-by-step directions on how to enter information and attest online.

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Meaningful Use Stage 2

The meaningful use requirements of Stage 2 include measures whose completion depends on other care facilities or individuals being able to connect with eligible professionals and hospitals — health information exchange and patient access to health information as well as the means to communicate directly with their providers.

Meaningful Use Stage 2

Meaningful Use Stage 2 Deadline: Stage 2 attestation can start as early as Jan 1, 2014 for those providers who have already passed Stage 1. In 2014 the attestation period will be 90 days, but a change in requirements for EHR systems will lengthen the attestation to a full year starting in 2015. The shorter period in 2014 will give providers a chance to acquire or upgrade to Stage 2 compliant technology. Medicaid eligible providers can choose any 90 day period to complete the requirements, but Medicare eligible providers must start on either January 1, April 1, July 1, or October 1, 2014.

 Eligible Professional Core Objectives

1)

Use computerized provider order entry (CPOE) for medication, laboratory and radiology orders directly entered by any licensed healthcare professional who can enter orders into the medical record per state, local and professional guidelines.

(2)

Generate and transmit permissible prescriptions electronically (eRx).

(3)

Record the following demographics: preferred language, sex, race, ethnicity, date of birth.

(4)

Record and chart changes in the following vital signs: height/length and weight (no age limit); blood pressure (ages 3 and over); calculate and display body mass index (BMI); and plot and display growth charts for patients 0-20 years, including BMI.

 

(5)

Record smoking status for patients 13 years old or older.

(6)

Use clinical decision support to improve performance on high-priority health conditions.

(7)

Provide patients the ability to view online, download and transmit their health information within four business days of the information being available to the EP.

(8)

Provide clinical summaries for patients for each office visit.

(9)

Protect electronic health information created or maintained by the Certified EHR Technology through the implementation of appropriate technical capabilities.

(10)

Incorporate clinical lab-test results into Certified EHR Technology as structured data.

(11)

Generate lists of patients by specific conditions to use for quality improvement, reduction of disparities, research, or outreach.

(12)

Use clinically relevant information to identify patients who should receive reminders for preventive/follow-up care and send these patients the reminders, per patient preference.

(13)

Use clinically relevant information from Certified EHR Technology to identify patient-specific education resources and provide those resources to the patient.

(14)

The EP who receives a patient from another setting of care or provider of care or believes an encounter is relevant should perform medication reconciliation.

(15)

The EP who transitions their patient to another setting of care or provider of care or refers their patient to another provider of care should provide a summary care record for each transition of care or referral.

(16)

Capability to submit electronic data to immunization registries or immunization information systems except where prohibited, and in accordance with applicable law and practice.

(17)

Use secure electronic messaging to communicate with patients on relevant health information. 

 Eligible Professional Menu Objectives

1)

Capability to submit electronic syndromic surveillance data to public health agencies except where prohibited, and in accordance with applicable law and practice.

(2)

Record electronic notes in patient records.

(3)

Imaging results consisting of the image itself and any explanation or other accompanying information are accessible through CEHRT.

(4)

Record patient family health history as structured data.

(5)

Capability to identify and report cancer cases to a public health central cancer registry, except where prohibited, and in accordance with applicable law and practice.

(6)

Capability to identify and report specific cases to a specialized registry (other than a cancer registry), except where prohibited, and in accordance with applicable law and practice

Meaningful Use Stage 2 EP Core Objectives - Stage 2 EP Menu Objectives

Meaningful Use [MU]

Stage 2 EP Core Objectives – 17 measures and all must be met

Core Objective	Measure
1. CPOE	Use CPOE for more than 60% of medication, 30% of laboratory, and 30% of radiology
2. E-Rx	E-Rx for more than 50%
3. Demographics	Record demographics for more than 80%
4. Vital Signs	Record vital signs for more than 80%
5. Smoking Status	Record smoking status for more than 80%
6. Interventions	Implement 5 clinical decision support interventions + drug/drug and drug/allergy
7. Labs	Incorporate lab results for more than 55%
8. Patient List	Generate patient list by specific condition
9. Preventive Reminders	Use EHR to identify and provide reminders for preventive/follow-up care for more than 10% of patients with two or more office visits in the last 2 years
10. Patient Access	Provide online access to health information for more than 50% with more than 5% actually accessing
11. Visit Summaries	Provide office visit summaries for more than 50% of office visits
12. Education Resources	Use EHR to identify and provide education resources more than 10%
13. Secure Messages	More than 5% of patients send secure messages to their EP
14. Rx Reconciliation	Medication reconciliation at more than 50% of transitions of care
15. Summary of Care	Provide summary of care document for more than 50% of transitions of care and referrals with 10% sent electronically and at least one sent to a recipient with a different EHR vendor or successfully testing with CMS test EHR
16. Immunizations	Successful ongoing transmission of immunization data
17. Security Analysis	Conduct or review security analysis and incorporate in risk management process

 

 

 

Stage 2 EP Menu Objectives – 3 of 6 measures must be met

Menu Objective	Measure
1. Imaging Results	More than 10% of imaging results are accessible through Certified EHR Technology
2. Family History	Record family health history for more than 20%
3. Syndromic Surveillance	Successful ongoing transmission of syndromic surveillance data
4. Cancer	Successful ongoing transmission of cancer case information
5. Specialized Registry	Successful ongoing transmission of data to a specialized registry
6. Progress Notes	Enter an electronic progress note for more than 30% of unique patients

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Payment Changes for FSY 2015

Payment Changes for FSY 2015

 

The Centers for Medicare and Medicaid Services (CMS) is reminding eligible professionals (EPs) participating in the Medicare EHR Incentive Program that they may receive payment changes on January 1, 2015. To avoid payment changes, EPs must demonstrate meaningful use (MU) before 2015.

 

Eligible professionals participating in the Medicare EHR Incentive Program may be subject to payment adjustments beginning on January 1, 2015. CMS will determine the payment adjustment based on meaningful use data submitted prior to the 2015 calendar year. Eligible professionals must demonstrate meaningful use prior to 2015 to avoid payment adjustments.

Determine how your EHR Incentive Program participation start year will affect the 2015 payment adjustments:

 

If you began in 2011 or 2012…
If you first demonstrated meaningful use in 2011 or 2012, you must demonstrate meaningful use for a full year in 2013 to avoid the payment adjustment in 2015. 

If you began in 2013…
If you first demonstrated meaningful use last year, you needed to demonstrate meaningful use for a 90-day reporting period to avoid the payment adjustment in 2015.

If you plan to begin in 2014…
If you first demonstrate meaningful use in 2014, you must demonstrate meaningful use for a 90-day reporting period in 2014 to avoid the payment adjustment in 2015. This reporting period must occur in the first 9 months of calendar year 2014, and eligible professionals must attest to meaningful use no later than October 1, 2014, to avoid the payment adjustment. 

Avoiding Payment Adjustments in the Future
You must continue to demonstrate meaningful use every year to avoid payment adjustments in subsequent years. 

If you are eligible to participate in both the Medicare and Medicaid EHR Incentive Programs, you MUST demonstrate meaningful use to avoid the payment adjustments. You may demonstrate meaningful use under either Medicare or Medicaid. 

If you are only eligible to participate in the Medicaid EHR Incentive Program, you are not subject to these payment adjustments.

Criteria for Reporting Clinical Quality Measures

Criteria for Reporting Clinical Quality Measures 

Beginning in 2014, the reporting of clinical quality measures (CQMs) will change for all providers. EHR technology that has been certified to the 2014 standards and capabilities will contain new CQM criteria, and eligible professionals (EPs), eligible hospitals, and critical access hospitals (CAHs) will report using the new 2014 criteria regardless of whether they are participating in Stage 1 or Stage 2 of the Medicare and Medicaid Electronic Health Record (EHR) Incentive Programs. Although clinical quality measure (CQM) reporting has been removed as a core objective for both EPs and eligible hospitals and CAHs, all providers are required to report on CQMs in order to demonstrate meaningful use.

2013

Eligible Professionals (EPs), will continue to report from the 44 measures finalized for Stage 1 in the same schema laid out for Stage 1 -  3 core/alternate core 3 additional measures for EPs

Eligible hospitals and CAHs will continue to report the 15 measures finalized for Stage 1

Beginning in 2012 and continuing in 2013, there are two reporting methods available for reporting the Stage 1

eReporting Pilots: Physician Quality Reporting System EHR Incentive Program Pilot for EPs

eReporting Pilot for eligible hospitals and CAHs

 

2014 and Beyond  

EPs must report on 9 of the 64 approved CQMs Recommended core CQMs – encouraged but not required 9 CQMs for the adult population 9 CQMs for the pediatric population NQF 0018 strongly encouraged since controlling blood pressure is high priority goal in many national health initiatives, including the Million Hearts campaign  

Selected CQMs must cover at least 3 of the National Quality Strategy domains

Eligible Hospitals and CAHs must report on 16 of the 29 approved CQMs Selected CQMs must cover at least 3 of the National Quality Strategy domains  

Beginning in 2014, all Medicare-eligible providers beyond their first year of demonstrating meaningful use must electronically report their CQM data to CMS. (Medicaid EPs and hospitals that are eligible only for the Medicaid EHR Incentive Program will electronically report their CQM data to their state.)