MU Stage 3- Did the CMS finally get it

right?

CureMD Healthcare

Meaningful Use stage 3 Strategy

Stage 3 ofMeaningful Useis expected to be
the final stage. It incorporates major portions
of the prior stages as well as introduces
many new challenges. What else does this
300-page document entail and its fine print?
CureMD investigates to make it simple for
you
The March 20thannouncement of the
proposed Meaningful Use Stage 3 rule by the
Centers for Medicare & Medicaid Services
(CMS) is still being dissected, analyzed, and
reanalyzed by healthcare experts

Meaningful Use stage 3 Strategy

While we can spend our time going through
300-page long documents, physicians
might not find it the easiest thing to read.
For your convenience, we have compiled a
list of things you should know about
Meaningful Use stage 3. You canalso read
the complete proposed rulehere
Remember
CMS is open to public comments and will
be taking your feedback before finalizing
the rule in the third quarter of this year.
This feedback period will endMay 29, 2015

Meaningful Use stage 3

Strategy
1. Reporting in 2017 isnt compulsory
Phew!
Instead of 2017, the compulsion for all providers
to report for Stage 3 would be 2018
In 2017, providers expected to move from Stage
2 to Stage 3 could choose to stay on Stage 2; and
make the more convenient transition in 2018
To attest to Stage 3, you will require a 2015 ONC
certifiedEHR

Meaningful Use stage 3 Strategy

2. Every provider must attest to Stage
3 in 2018 No training wheels for
New Providers
Irrespective of your first year of reporting, you
will have to attest to MU Stage 3 in
2018.Group practices will benefit from this
change as they will have to focus on a single
set of measures for everyone
However, critics are of the view that startup
practices or people using the EHR technology
for the first time will find it difficult
They will have to adjust their workflows for
such advanced level of reporting from the get
go

Meaningful Use stage 3 Strategy

3. You must report for one whole
calendar year unless you are a
Medicaid EP Unfair much?
Starting from 2017, all providers will report
according to a full calendar year period.
This step is being taken to align MU closer to
other CMS quality-reporting initiatives such as
the Physician Quality Reporting System (PQRS)
In the past CMS has shortened reporting
periods based on provider feedback and would
probably be doing the same this year due to
the poor implementation rates of MU Stage2

Meaningful Use stage 3 Strategy

But beyond that, we highly doubt there would
be any further flexibility. There will not be a 90day reporting period for new providerregistrants of the MU program either
The only exemption, which is garnering a lot of
criticism from some quarters, is that Medicaid
Eligible Professionals (EPs) and hospitals can
report for 90 days in their first year
We agree with this criticism and think that the
playing field should be leveled for all new
entrants into the program. We would definitely
like to get your feedback on this

Meaningful Use stage 3 Strategy

4. Eight specific objectives, but higher
thresholds Interoperability and
Patient Engagement returns with a
bang
The number of specific objectives have been
reduced to eight so that providers maximize
their attention towards the advanced usage
of EHRs
Patient engagement and interoperability are
the areas of maximum focus; Stage 3 will
require an excess of 35 % of patients to be
sent a secure message via the providers EHR,
or in response to a secure message sent by the
former

Meaningful Use stage 3 Strategy

Meaningful Use stage 3 Strategy

More than 25% of patients who visit an EP (or
are discharged by a hospital) must
electronically obtain their health information is
another addition that many will find difficult to
implement, given the low levels of patient
engagement (electronically) at most practices
After this, you might want to readHow to
Succeed with Patient Portals for Meaningful Use
Stage 2
There is some fine-print though. Contained
within many of the objectives are multiple
measures

Meaningful Use stage 3 Strategy

Depending on which option one chooses, and
whether you are a provider or a hospital, the
total number of MU measures could range from
15 to 20, and thats NOT INCLUDING
theclinicalquality measures
Which have always been like a MU menu all of
their own, and which are now going to be
determined through a different process and
wont be defined until later in 2015

Meaningful Use stage 3 Strategy

5. Meaningful Use concludes at Stage
3, but the mission continues
While the MU program will conclude with Stage
3, the CMS expects technology and quality care
to improve with time
So a significant proportion of healthcare
experts including myself are of the view that
CMS will build on the base set by the MU
program through other government-backed
quality and technology programs in the future

Meaningful Use stage 3 Strategy

Our two cents
We think that for a first draft, the CMS is
definitely on the right track. Theyve addressed
and rectified many of the issues that providers
faced in the earlier stages of the program;
however, they might have been too ambitious
in certain areas
A year long reporting period for example, is
asking physicians too much. This data helps to
improve healthcare in US, agreed
But seriously cant a subset of this information
be enough to monitor disease patterns?

Meaningful Use stage 3 Strategy

If a clinician has 12 minutes to see a patient,
be empathetic, document the entire visit with
sufficient granularity to justify an ICD-10 code,
achieve 140 quality measures, never commit
malpractice, and broadly communicate among
the care team,
Its not clear how the provider has time to
perform a clinical information reconciliation
that includes not only medications and
allergies, but also problem lists 80 percent of
the time

Meaningful Use stage 3 Strategy

Maybe we need to reduce patient volumes to
10 per day? Maybe we need more scribes or
team-based care? And who is going to pay for
all that increased effort in an era with declining
reimbursements/payment reform?
Boiling the Frog, each incremental proposal is
tolerable, but the collective burden is making
practice impossible

Read more on blog.curemd.com

To read more on this topic, visit:
http://blog.curemd.com/mu-stage-3-did-the-c
ms-finally-get-it-right/

Thank you!

CureMD Healthcare
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