Those requirements have proven to be a common challenge
to date in stage 1, because few providers had processes or IT
systems that provide patients with copies of their information
promptly, especially in electronic format.
Under other stage 2 objectives EPs would have to provide
more than half of their patients with clinical summaries within
24 hours of each office visit, and EPs and EHs would have to use
EHR technology to identify and provide patient-specific education resources to more than 10 percent of their patients.
Finally, more than 10 percent of an EP’s patients must use the
secure messaging function in the provider’s EHR.
Easing Quality Measures Reporting
Acknowledging the challenges the industry faces in reporting
quality measures, CMS proposes better alignment of stage 2
measures with existing programs, such as the Physician Quality
Reporting System, the Medicare Shared Savings Program, and
Joint Commission accreditation.
Beginning in 2014, EPs would report 12 clinical quality measures, and EHs would report 24.
CMS proposes two reporting options for Medicare and Medicaid EPs, but it intends to select a single method in the final rule.
In one option, EPs would report 12 clinical quality measures,
including at least one measure from each of six domains. In the
other, EPs would report 11 core clinical quality measures plus
one menu measure.
In the Medicaid program, states would continue to determine
how reporting occurs. However, reporting under the Medicare
program would change dramatically.
Beginning with 2014, EPs would have three options that allow
professionals within a single group practice to report on a group
level. All three methods would be available for Medicare EPs,
while only the first one would be possible for Medicaid EPs, at
the state’s discretion.
The first option would allow EPs in a group practice to report
their measures in aggregate as an EHR incentive group.
The other two options would allow EPs to satisfy their meaningful use quality measures requirement if they successfully
meet the quality measures reporting requirements of either
the Medicare Shared Savings Program or the Physician Quality Reporting System. However, the measures would have to be
reported through EHR technology certified for the meaningful
Beginning with FY 2014 EHs would report 24 clinical quality
measures from a menu of 49 clinical quality measures, including at least one clinical quality measure from each of the six domains.
For the remaining clinical quality measures, EHs would select
the measures from table 9 (page 13760) that best apply to their
The 49 clinical quality measures would include the current set
of 15 clinical quality measures that were finalized for FYs 2011
and 2012 in the stage 1 final rule as well as additional pediatric
measures, an obstetric measure, and cardiac measures.
Medicare EHs would submit the measures through a CMS-designated portal or through their EHRs similar to the 2012
Medicare EHR Incentive Program Electronic Reporting Pilot.
Medicaid-only eligible hospitals would report as determined
by their states.
Comments on the rule are due May 7. CMS intends to publish
a final rule this summer. ¢
Centers for Medicare and Medicaid Services. “Medicare and
Medicaid Programs; Electronic Health Record Incentive
Program—Stage 2.” March 7, 2012. www.gpo.gov/fdsys/
Kevin Heubusch ( email@example.com) is editor-in-chief of the Journal of AHIMA.
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