Health System Reform Insight - June 29, 2012
The AMA has developed Health System Reform Insight to help you better understand new physician payment and care delivery models, and improve patient care.
While widespread use of health information technology (IT) holds the promise of aiding physicians in their efforts to enhance care quality, patient safety and practice efficiency, barriers holding physicians back must first be addressed. This is the message the AMA is emphasizing to the Centers for Medicare & Medicaid Services (CMS).
Nearly 100 state and specialty medical associations joined the AMA in sending a detailed comment letter to acting CMS Administrator Marilyn Tavenner on May 7, recommending significant changes to the proposed Stage 2 requirements for CMS's electronic health record (EHR) "meaningful use" program, which is scheduled to begin in 2014.
Billions of dollars to help physicians and hospitals incorporate and "meaningfully use" EHRs were included in the 2009 economic stimulus law, but receiving this financial aid is dependant upon physicians' ability to meet rigid program requirements.
Stage 1 assessment and Stage 2 measures
The AMA is urging CMS to fully evaluate Stage 1 of its EHR program to determine what is working and what can be improved prior to moving to Stage 2. Specifically, the AMA has asked CMS to survey both physicians who elected to participate in Stage 1 and those who did not to identify important barriers that keep physicians from participating.
In the comment letter, the AMA explains that an evaluation of Stage 1 may reveal that physicians did not participate last year because they could not meet certain requirements, known as "core" measures. CMS needs to develop adequate exclusions for measures that are challenging for physicians to meet, or it should make these measures optional, transferring them to the Stage 2 "menu" set.
Specific changes to Stage 2
Additional changes the AMA and other medical associations recommended include:
- Reducing the number of measures in the required core set and increasing the menu set so physicians have more optional measures from which they can choose.
- Establishing a certain number of measures from which physicians can opt out. This option would be particularly important when a measure has little relevance to a physician's specialty.
- Adding more exemptions from the penalty program. The AMA also has recommended a broad category that lets physicians apply for an exemption based on their individual circumstances.
- Counting good faith efforts to meet measures in Stage 2 toward earning incentives and avoiding penalties.
The comment letter also outlined ways to streamline the EHR program and other overlapping federal health IT and quality programs. The AMA is committed to fostering advances in health IT that can help make physician practices more efficient and enhance the quality of care they provide. The AMA will continue to work with CMS to develop solutions that enable physicians to participate in these programs.
Health IT physician resources
Physicians can prepare to select, implement and maintain EHR technology that meets the unique needs of their practice with help from numerous AMA resources. A series of six short video modules walks through methodologies for successful adoption, and a collection of archived podcasts and other resources cover a variety of considerations related to CMS's EHR incentive program.
CMS will begin enforcing the version 5010 Health Insurance Portability and Accountability Act electronic transactions on this date. Failure to use the new transactions will result in claim rejections and disruptions in cash flow. Learn more.
Physicians have until Monday to file a hardship exemption to avoid a 1.5 percent reduction in Medicare Part B payments in 2013 if they have not reported on at least 10 electronic scripts already this year. View an AMA tip sheet to learn more.
"Safely referring: Stark law ‘rules of the road' for physicians," an hourlong webinar hosted by the AMA, will take place at 1 p.m. Eastern time on this date. Sign up today.