The Centers for Medicare & Medicaid Services’ (CMS) proposed modifications for Stages 1 and 2 of the meaningful use electronic health record (EHR) program offered some good news for physicians—but CMS should stop there before moving forward with Stage 3, the AMA told the agency this week in a comment letter (log in).

The notoriously burdensome program could undergo changes that will make it easier for physicians to achieve success through 2017. However, it will take time for those changes to take effect, which is one of the reasons the AMA is urging CMS to assess the impact of the proposed changes before implementing Stage 3 in 2018.

About 80 percent of physicians already have incorporated EHRs into their practices, according to the U.S. Department of Health and Human Services Office of the National Coordinator for Health IT (ONC). At the same time, participation remains very low, the AMA said in a statement.

Medicare reform will affect the program

More time also is needed to assess the structure, requirements and impact of the new merit-based incentive payment system. Referred to as “MIPS,” this program will be created as a result of the Medicare Access and CHIP Reauthorization Act of 2015, which repealed the Medicare sustainable growth rate (SGR) formula.

The current web of financial penalties under the Physician Quality Reporting System (PQRS), meaningful use and the value-based payment modifier will expire at the end of 2018 and will be replaced by the MIPS.

Interoperability still a challenge

Many health IT systems obstruct interoperability through excessive vendor fees or technical limitations that hinder physicians’ ability to meet Stage 2 of meaningful use, according to a recent ONC report. Without focusing on the cornerstone issues necessary for interoperability, the meaningful use program can’t be truly meaningful, the letter said.

What to address if Stage 3 is rolled out

If the administration decides to proceed with Stage 3, the AMA’s recommendations include:

  • Making 2017 a transitional year to ease many of the concerns both vendors and physicians have regarding program updates, system changes and reengineering work flows
  • Implementing a reporting period that is less than a full year
  • Consulting physicians and vendors before removing or adding  measures
  • Heavily modifying the proposed objectives to align with the needs of medical specialists
  • Allowing quality measures reported to clinical registries to count for meaningful use quality-reporting requirements

The AMA continues its aggressive push for solutions to the one-size-fits-all meaningful use program, as outlined in a blueprint submitted to CMS in October.

In addition, the AMA is building on a new framework for EHR usability that it recently developed with an external advisory committee of practicing physicians and health IT experts, researchers and executives. More than 30 physician groups also joined the AMA in recommending three changes to improve the EHR certification process to make it easier for physicians to use EHRs and care for patients.

As a founding member of Healtheway and Carequality, two organizations working on factors such as patient matching and information exchange rules, the AMA will continue its work to resolve interoperability issues.

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