Where Are We in 2014
The Sustainable Growth Rate (SGR) Repeal Act consolidated three existing programs, the Physician Quality Reporting System (PQRS), the Value‐Based Modifier (VBM), which adjusts payment based on quality and resource use; and Meaningful Use of Electronic Health Records (EHR) into its merit-based incentive payment system (MIPS). The MIPS program will assess the performance of eligible professionals in four performance categories: quality; resource use; meaningful use of EHRs; and clinical practice improvement activities. The penalties associated with the current programs are sunset at the end of 2017, including the 2 percent penalty for failure to report PQRS quality measures and the 3 percent penalty (increasing to 5 percent in 2019) for failure to meet EHR meaningful use requirements. However, if the SGR Repeal Act is not enacted, the existing programs and associated penalties remain in effect.
ACS Cohosts Discussion on HIT and the Effects on Providers
The American College of Surgeons (ACS) Division of Advocacy and Health Policy (DAHP) and the National Coalition of Healthcare Providers (NCHP) held a leaders meeting with individuals from other provider groups on health information technology (HIT) on April 18. This meeting was a follow-up to the March 13 HIT roundtable discussion cohosted by the College and NCHP. Some of the targeted issues during the March 13 meeting included meaningful use requirements, compliance with the 10th edition of the International Classification of Diseases, workforce issues, e-prescribing, and the Capitol Hill Steering Committee on Telehealth and Healthcare Informatics’ impact on the legislative agenda. Don E. Detmer, MD, FACS, Medical Director, DAHP, spoke at both meetings and highlighted some of the current barriers to and benefits of implementing the electronic health record and its impact on the surgical community.
ACS Represented at Capitol Hill Discussion on HIT
The U.S. Capitol Hill Steering Committee on Telehealth and Healthcare Informatics hosted a panel discussion on May 9, 2012, entitled “Saving Lives: Advancing Health Information Technology Towards Improved Patient Safety and Quality.” Since 1993 this bipartisan steering committee has convened more than 170 widely attended educational sessions and health care technology demonstrations for members of Congress, congressional staff, key federal agency officials, industry professionals, and the general public. The program focused on potential benefits of implementing HIT as a means of measuring quality improvements, the various approaches to IT-enabled quality programs, and the risks potentially defective or poorly implemented systems pose. Panelists included Sen. Sheldon Whitehouse (D-RI); Rep. Erik Paulsen (R-MN); and Kevin Larsen, MD, FACP, Medical Director, Meaningful Use, U.S. Department of Health and Human Services' Office of the National Coordinator for Health Information Technology. Don Detmer, MD, FACS, Medical Director, ACS Division of Advocacy and Health Policy, moderated this important discussion.
ACS Comments on Stage 2 Meaningful Use Proposed Rule
ACS and several other organizations responded to a request for comments from the Centers for Medicare and Medicaid Services (CMS) concerning the Stage 2 meaningful use proposed rule, “Medicare and Medicaid Programs; Electronic Health Record Incentive Program—Stage 2.” Stage 2 meaningful use defines what eligible professionals (EPs) will be required to do in order to demonstrate meaningful use of electronic health records (EHRs) in the second part of the program, which is proposed to begin in 2014. Physicians who have not demonstrated that they are meaningful users of EHRs by 2015 will face penalties, starting at 1 percent, to their Medicare payments.
The letter expresses support for general EHR implementation but clearly articulates the challenges the organizations foresee with compliance in the program. For example, in order to be considered a meaningful user CMS proposes the following:
- EPs must have a threshold level of 50 percent or more outpatient encounters during the EHR reporting period at a practice or location equipped with certified EHR technology.
- EPs must provide a patient with clinical summaries within 24 hours.
- EPs who are eligible for a Medicaid EHR incentive payment in a given year and who have “adopted, implemented, or upgraded” certified electronic health records technology (CEHRT) would not be considered meaningful users and could still be subject to a penalty under the Medicare side of the program.
Other areas of concern include the time frame for patient reminder requirements, the number of ordered clinical lab test results, medication reconciliation transitions, and the methodology for recording immunization data.
Contact: Heather Smith