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Few Hospitals Attesting to Stage 2 Of Meaningful Use Program, CMS Says

Wednesday, May 7, 2014

By Alex Ruoff  

May 6 — Just four hospitals and 50 health-care providers had attested to meeting Stage 2 requirements for meaningful use of electronic health records by May 1, according to the Centers for Medicare & Medicaid Services.

More hospitals have applied for hardship exceptions from the meaningful use program this year than attested to meeting either Stage 1 or Stage 2 program requirements, the CMS reported, raising questions about the success of the program. The CMS presented the data during a May 6 meeting of the Health Information Technology Policy Committee, a federal advisory body for the Office of the National Coordinator for Health IT.

Elisabeth Myers, a program analyst for the CMS Office of eHealth Standards and Services, said her agency doesn't have enough data to determine how many more hospitals are likely to attest to Stage 2 in the coming months. Hospitals that have participated in the meaningful use program for at least two years must attest to meeting Stage 2 requirements by July or face a Medicare reimbursement penalty.

“We have a slim amount of data,” Myers said.

The number of eligible professionals enrolling to participate in the meaningful use program increased slightly in March over February, but the number of hospitals enrolling continued to decline in the month-over-month comparisons, the CMS reported in April.

The Medicare and Medicaid EHR Incentive Programs provide financial incentives for the meaningful use of certified EHR technology to improve patient care. Hospitals and providers must adopt EHR systems certified for use in Stage 2 and attest to meeting the program's 16 core objectives and half of its six menu objectives in order to qualify for an incentive payment.

Stage 2 began for hospitals in October and providers in January.

Between October 2013 and May 1, 30 hospitals attested to meeting either Stage 1 or Stage 2 requirements, significantly lower than how many attested to meeting Stage 1 during the same time a year before. Of those 30 hospitals, just eight were attesting for the first time.

More than 8,300 providers enrolled to participate in the Medicare EHR incentive program in March, and 4,100 providers enrolled to participate in the Medicaid incentive program.

Three hospitals enrolled in March, compared with nine in both January and February. Those are the lowest enrollment numbers for hospitals since the start of the program. As of 2012, there were about 5,700 hospitals in the U.S., according to American Hospital Association data.

Hardship Exceptions

As of March, the CMS has paid nearly $23 billion in incentive payments to providers and hospitals participating in the meaningful use program, according to the CMS. The largest share of the incentive money for electronic health record adoption—$14.3 billion—has gone to hospitals, 4,532 in total, according to the new data.

To date, 72 hospitals have applied for a hardship exception to the meaningful use program, Myers said. Of those, 66 exceptions have been granted and six hardship exceptions were dismissed as unwarranted, she said.

In addition, 600 providers have applied for a hardship exception, Myers said. The CMS is currently reviewing the provider exception applications, she said.

Meaningful use program hardship exceptions exempt providers and hospitals from payment adjustments for failure to meet requirements of the program during the previous year, Myers said. Hardship exceptions granted this year exempt those providers and hospitals from payment adjustments for failure to report during the 2013 reporting year, she said.

Time Left to Attest

Paul Egerman, a software entrepreneur and member of the Health IT Policy Committee, asked Myers during the meeting whether it was “too early to make changes” to Stage 2 requirements or deadlines to help more hospitals meet them.

Myers said hospitals have until July to attest and many are expected to attest soon.

According to CMS data, more than 3,000 hospitals participated in the meaningful use program during its first year, 2011. If all of these hospitals continued to participate in the program, all would be required to meet Stage 2 this year.  

According to a survey of hospitals conducted by the ONC and the American Hospital Association, only 6 percent of hospitals in 2013 were using an electronic health record capable of meeting all 16 core requirements of Stage 2. More than 70 percent were using an EHR capable of meeting at least 12 core requirements of Stage 2, according to the survey.

Jennifer King, a data analyst for the ONC, said the survey data were encouraging as hospitals are close to being capable of meeting the requirements of Stage 2.

“The data suggest that the majority of hospitals need to adopt just a few functionalities,” King said.

To contact the reporter on this story: Alex Ruoff in Washington at aruoff@bna.com

To contact the editor responsible for this story: Kendra Casey Plank at kcasey@bna.com

The CMS data is at http://op.bna.com/mdw.nsf/r?Open=plon-9jumhh.

The ONC survey is at http://op.bna.com/mdw.nsf/r?Open=plon-9jumg8.

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