By Alex Ruoff
March 16 — Participation in the Medicare EHR incentive program dropped slightly in 2015 despite the federal government's repeated efforts to make it easier for providers to participate.
The number of health-care providers that successfully attested to the CMS to meeting the requirements of the Medicare meaningful use program dropped from 228,662 in 2014 to 226,514 in 2015, a CMS spokesman told Bloomberg BNA March 15.
The final figure for 2015 could change by 150 or more once CMS accounts for those providers who have been granted extensions.
Hospital participation in the meaningful use program also fell slightly, from 4,177 in 2014 to 4,071 in 2015, according to the CMS. However, this change is likely due to hospital mergers.
Industry group representatives said the drop in participation comes as a surprise because the CMS published several rules in 2015 to ease the program's requirements.
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The Centers for Medicare & Medicaid Services has repeatedly pointed to widespread participation in the program as a sign of its success and progress toward the Obama administration's goal of digitizing health records so they can be more easily used for research.
“It’s my personal feeling that CMS gave away the store in 2015, so any hospital or physician who receives a penalty for their performance in 2015 was asleep at the wheel,” Jeff Smith, vice president of public policy at the American Medical Informatics Association, told Bloomberg BNA.
The CMS in October 2015 published a final rule (80 Fed. Reg. 62,762, Oct. 16, 2015) that shortened the meaningful use program's reporting period that year from a full year to 90 days and significantly reduced the program's requirement for giving patients electronic access to their health records, which doctors complained was too difficult .
The rule also made it easier for providers and hospitals to obtain a hardship exception in order to avoid a Medicare penalty for failing to participate, which could explain the slight drop in participation, Smith said.
As of January, 464,727 health-care providers and 4,885 hospitals had received nearly $32 billion in Medicare and Medicaid incentive payments through the meaningful use program since 2011. The program offers incentive payments to providers and hospitals that adopt an electronic health record and meet certain requirements.
Hospital administrators are frustrated with the CMS's history of changing the meaningful use program's requirements late in the year, Chantal Worzala, vice president for health information and policy operations for the American Hospital Association, told Bloomberg BNA.
The CMS's final rule altering meaningful use program requirements was published weeks after the latest date a provider could have started meeting requirements of the program under the CMS’s original reporting time line, she said.
Worzala said the CMS should stop changing the program to allow hospitals and providers to more easily understand the program and meet its requirements. Consistent rules for the program would allow hospitals and providers to go beyond just meeting the program's requirements to using their EHR systems to improve the quality of care they provide their patients, she said.
As of January, 464,727 health-care providers and 4,885 hospitals had received nearly $32 billion in Medicare and Medicaid incentive payments through the meaningful use program since 2011.
“We would like to see stability in the program, for the rules to be stable through the year,” Worzala said. “That would mean I could pivot from just meeting meaningful use to leveraging my EHR to improve the health of my patients.”
While the AHA is calling for stability in the program, 34 health-care organizations—including the College of Healthcare Information Management Executives and the Medical Group Management Association—sent a letter to the head of the CMS March 15 asking the agency to shorten the reporting period of the meaningful use program to 90 days in 2016.
The data from the CMS also revealed that the majority of hospitals and health-care providers in the meaningful use program are now in the program's second stage.
Of the 226,514 providers that attested to meeting meaningful use program requirements in 2015, 167,731 were scheduled to be in Stage 2, according to the CMS.
Of the 4,071 hospitals that attested to meeting meaningful use program requirements in 2015, 3,601 were scheduled to be in Stage 2, according to the CMS.
The requirements of stage 2 of the meaningful use program were significantly more difficult than those of Stage 1, industry groups said last year. Many have said there's little evidence that providers and hospitals will be better prepared to tackle the challenges of Stage 2 of the meaningful use program.
An estimated 4,792 hospitals and 595,100 health-care providers were eligible to participate in the meaningful use program, meaning they could receive an incentive payment for successfully meeting the program's requirements or potentially face a reduction in Medicare reimbursements for failing to meet program requirements.
The total number of eligible providers includes those in the state-administered Medicaid meaningful use programs, which haven't yet reported participation numbers.
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