AHA: Halt Stage 3 meaningful use work, until concerns are addressed about the program
January 25, 2013
The federal government should halt adoption of criteria for Stage 3 of the meaningful use program, and the Office of the National Coordinator (ONC) for Health Information Technology (IT) instead should fund an external study of the program’s progress, the AHA said in a recent letter to the Health Information Technology Policy Committee (HITPC).
The association called for an evaluation of why most hospitals and physicians have yet to enter Stage 1 of the meaningful use program and if the incentive payments providers and hospitals can earn through the program are large enough. “We urge the HITPC to refrain from finalizing Stage 3 recommendations until it has reviewed the results of such an evaluation and can develop an implementation plan for Stage 3 that addresses the issues raised in Stage 1,” the AHA wrote in its Jan. 14 letter.
HITPC, a federal advisory committee that makes recommendations to ONC, asked for input on its draft recommendations for Stage 3 meaningful use, which were released last November. The committee is aiming to have final Stage 3 recommendations for the Medicare and Medicaid electronic health record (EHR) incentive programs ready for the Centers for Medicare & Medicaid Services (CMS) and ONC by May. CMS is responsible for the final rulemaking in the meaningful use program.
The AHA also urged the panel to focus on its mandate to make recommendations for a nationwide health IT infrastructure. “Addressing the current limits to interoperability will bring far greater benefits than rushing into a definition for Stage 3 that is not built on lessons learned from Stage 1, let alone Stage 2,” the AHA wrote.
The meaningful use program requires providers to meet certain criteria in order to qualify for financial incentives. The AHA’s letter notes that the costs of EHRs are growing significantly at a time when federal policymakers are cutting Medicare payments.
The AHA estimates the Medicare and Medicaid EHR incentives will offset only 10 to 15% of the total costs of adopting EHRs. “Given these high costs and the looming payment cuts, some hospitals are weighing whether the investment in IT is financially feasible, and many more will face that question in the near future,” the AHA told the advisory panel.
Among other issues, HITPC’s request for comments asked for input on clinical quality measure (CQM) development, such as the challenges created by implementing electronic CQMs in clinical settings. In its comments, the AHA called for “processes that support valid, reliable and feasible data collection and reporting of clinical quality measures.” The association added that a “rushed timeline and insufficient testing of certified EHRs led to an inability to generate useable clinical quality data out of the certified EHRs to meet the Stage 1 regulatory requirement.”