Meaningful Use Stage 2 Timeline

Meaningful Use Stage 2 Timeline

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The idea of Meaningful Use was developed by the National Quality Forum (NQF) in an effort to create a set of national priorities that would help healthcare performance-improvement efforts. In 2008 the NQF released a report which identified the areas they felt needed to be improved. Their ideas included many obvious areas such as: improved population health, coordination of care, improved safety, increased efficiency, reduction of racial disparities, and patient engagement. Privacy and security were later added to this list. These ideals were used as a framework framework to determine the Meaningful Use of EMR/EHRs.

 

In 2009 the American Recovery and Reinvestment Act (ARRA) added to Meaningful Use by focusing on preserving and improving the affordability of health care as well as less medically-relevant provisions such as modernizing the nation's infrastructure, enhancing energy independence, providing tax relief, and expanding educational opportunities. The HITECH Act addressed the ARRA's focus on affordable healthcare, and specifically outlines the promotion of Health Information Technology (HIT), HIT testing, grants and loans funding and demonstration programs, privacy, and provisions for monetary incentives through Medicaid and Medicare.

 

If you are still reading this, chances are you are already familiar with Meaningful Use Stage 1 criteria and timeline as well as the concept of core and menu objectives that the Centers for Medicare & Medicaid Services (CMS) introduced.  Basically Stage 1 objectives require that Eligible Professionals (EPs) 15 core objectives, 5 out of the 10 menu objectives plus a total of 6 Clinical Quality Measures (CQMs).  For Eligible Hospitals (EHs) and Critical Access Hospitals (CAHs) the requirement is 14 core objectives, 5 out of 10 menu objectives and 15 CQMs.

 

This proposed new standards for Stage 2 maintain the existing structure and specifies that  EPs must meet (or qualify for an exclusion to)  17 core objectives and 3 of 6 menu objectives. EHs and CAHs must meet or qualify for an exclusion to 16 core objectives and 3 of 6 menu objectives as summarized here:

 

EPs

 

Stage Two

Stage One

 

Core Objectives

17

15

 

Menu Objectives

3/6

5/10

 

CQM Alternative #1

12, 1 from each domain

core plus 3 additional

 

CQM Alternative #2

Physician Quality Reporting System Program

 

EH/CAH

Core Objectives

16

14

 

Menu Objectives

3/6

5/10

 

CQM Alternative #1

24, 1 from each domain

15 core

 

CQM Alternative #2

Hospital Inpatient Quality Reporting Program

 

 

Nearly every objective considered optional for Stage 1 will  be required in Stage 2 and thresholds and exclusions of all measures have been reevaluated. Specific submission of clinical quality measures (CQMs) that align with pre-existing national quality programs will be required in 2014. New objectives are proposed, some of which are part of the Stage 2 core set and others would make up the Stage 2 menu set.

 

Stage 2 meaningful use requirements include rigorous expectations for health information exchange and more demanding e-prescribing, incorporation of structured laboratory results, and transmission of patient care summaries across unaffiliated providers, settings, and EHR systems. Specifically, Stage 2 meaningful use criteria encourage the use of Healthcare IT for continuous quality improvement at the point of care, exchange of information in structured format, and patient engagement.

 

With this new regulation, CMS has proposed changes to the timeline as well as an extension beyond 2014. Stage 2 requires changes to both technology and workflow that cannot be expected to be completed in the time between publication of the final rule and the start of the EHR reporting periods. Consequently, CMS is proposing a 1 year extension of Stage 1 of meaningful use for providers who successfully demonstrated meaningful use for 2011. The new timeline is reflected in the table below.

 

 

First Payment Year

Stage of Meaningful Use

 

2011

2012

2013

2014

2015

2016

2017

2018

2019

2020

2021

2011

1

1

1

2

2

3

3

TBD

TBD

TBD

TBD

2012

 

1

1

2

2

3

3

TBD

TBD

TBD

TBD

2013

 

 

1

1

2

2

3

3

TBD

TBD

TBD

2014

 

 

 

1

1

2

2

3

3

TBD

TBD

2015

 

 

 

 

1

1

2

2

3

3

TBD

2016

 

 

 

 

 

1

1

2

2

3

3

2017

 

 

 

 

 

 

1

1

2

2

3

 

Just as federal officials have finalized standards for Stage 2 of the Meaningful Use incentive program for adoption of EHRs, an advisory committee is already hard at work planning for the third and final stage of this $27 billion initiative.  The same ideals of increased care and efficiency that were the basis for the development of stages 1 and 2 will also apply to the drafting of the stage 3 criteria for Meaningful Use.  In the months and years ahead there will be much public discussion on this topic and CoreTech will be here to keep you informed of the latest.

 

~ Steve Barnes