subject: Are Cms Meaningful Use Regulations Reasonable? [print this page] With billions of dollars in stimulus money hanging in the balance, debate rages over the recently released "meaningful use" rules. Providers using certified EMRs are eligible for substantial financial incentives for meeting meaningful use, but some experts feel the proposed objectives are unrealistic.
Meaningful Use and Certified EMR
Included in the American Recovery and Reinvestment Act of 2009 (ARRA) is a provision to pay financial incentives to medical providers who aggressively pursue implementation of electronic medical record systems. Qualification for these incentives hinges on satisfying something the Act called "meaningful use."
In February 2010, the Centers for Medicare & Medicaid Services (CMS) released an initial draft of the definition of meaningful use. It requires offices to satisfy 25 measures of use across five healthcare categories: care coordination, patient engagement, privacy & security, public health, and quality & safety. ARRA-certified EMR that meets these goals will be eligible for incentives starting in 2011.
Are The Current Rules Too Harsh?
Under the proposed system, providers are either eligible or not and falling even a tiny amount short completely disqualifies a facility from receiving incentive money. Some analyst feel this will discourage providers from making the transition to certified EMR or will penalize those who make good faith efforts but fail to meet the goals.
It is important to ensure ARRA incentives are given only to providers that make real efforts to adopt Electronic Medical Record systems, but the technology is new and changing a current practice management system to embrace new methods is a difficult project. This is true even on the level of a single physician practice, and even more so in a major hospital system. Some experts feel a graduated system of goals will lead to more widespread EMR use, and that is the ultimate goal of the incentive program.
New Recommendations From HHS
A Health and Human Services advisory group has released some proposed changes they feel better embodies the intent of ARRA-certified EMR than the current rules.
Under the HHS guidelines, providers would be allowed to defer up to five of the twenty-five measures until 2013, allowing each provider to focus on current strengths to create a strong EMR foundation. Six specific goals, including e-prescriptions and patient access to records, would not be eligible for deferral and at least one measure in each of the five healthcare categories would have to be achieved.
The HHS recommendations include other provisions designed to allow the program to meet its intent. They feel any provider fined for significant HIPAA violations should not be eligible for ARRA incentives regardless of performance. They also recommend CMS release more detailed guidelines on how to calculate usage percentages so all providers are measuring to the same standard.
CMS is accepting public comment until March 15. They will review the suggestions and plan to release a finalized version of meaningful use guidelines in late spring.
