Meaningful Use Update: Submit Once, Get Double Credit

Stage 2 Meaningful Use electronic health records incentive program would let providers also get credit toward Medicare's Physician Quality Reporting System.
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Physicians and other individual eligible providers would not need to meet different clinical quality measures to participate in both the Meaningful Use electronic health records (EHR) incentive program and the Medicare Physician Quality Reporting System (PQRS), under newly proposed rules for Meaningful Use Stage 2.

"Submit once and get credit for both," Centers for Medicare and Medicaid Services (CMS) insurance specialist Maria Michaels said Thursday at the 2012 Healthcare Information and Management Systems Society (HIMSS) conference in Las Vegas, to a burst of applause. She was one of a parade of federal officials and technical specialists to speak about Meaningful Use at HIMSS12 after national health IT coordinator Dr. Farzad Mostashari introduced the highly anticipated Stage 2 proposal Wednesday morning.

The idea, according to Michaels and Mostashari, is to offer physicians and hospitals more flexibility in achieving the goals of Meaningful Use, namely producing better, more coordinated care at lower cost, engaging patients, eliminating health disparities between populations, and safeguarding privacy.

To this end, the proposed regulations would give providers more flexibility in choosing which quality measures they meet in order to earn Medicare and/or Medicaid bonus payments for achieving Meaningful Use in Stage 2, starting in 2014 or two years after a provider gets to Stage 1, whichever comes later.

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Eligible providers--physicians, chiropractors, dentists, physical therapists, and other practitioners--would have to achieve 12 clinical quality measures from a list of about 105. They could follow the pattern established in Stage 1 and pick at least one from each of five "domains" of clinical practice, or they could meet 11 "core" quality measures and pick one additional standard from a menu of options.

Alternatively, they would be able to qualify via PQRS. However, Steven Posnack, director of the Office of the National Coordinator for Health Information Technology (ONC)'s Federal Policy Division, noted that providers still would have to make sure their EHR software is both certified for Meaningful Use and qualified for PQRS in order to get dual credit.

"We're also proposing a group reporting option for PQRS," Michaels said, drawing additional praise from the packed meeting room at The Venetian Hotel. CMS, which administers Meaningful Use and PQRS, would allow doctors to submit summary data of groups of patients under either program rather than having to take the time to break quality metrics down by individual patients. CMS had been criticized for making PQRS too complex and expensive in the view of some providers and EHR vendors.

Posnack said ONC, which sets the Meaningful Use EHR certification standards, said that the office paid "lots of attention" to how providers capture data related to clinical quality measures.

Healthcare providers must collect all sorts of performance data to meet emerging standards. The new Pay For Performance issue of InformationWeek Healthcare delves into the huge task ahead. Also in this issue: Why personal health records have flopped. (Free registration required.)