Medical Societies to CMS: Not Ready for Stage 3 Meaningful Use Save

Dozens of medical societies pressed the Centers for Medicare and Medicaid Services (CMS) to temporarily halt implementation of the final stage of Meaningful Use, a program that rewards and penalizes clinicians based on how effectively they use electronic medical records.

Forty-two physician organizations, including the American Medical Association, the American Academy of Family Physicians, and the American Academy of Pediatrics, petitioned Secretary of Health and Human Services Sylvia Burwell and Office of Management and Budget Director Shaun Donovan to delay proposed Stage 3 provisions of the program.

"There is growing bipartisan recognition in Congress that the direction of the Meaningful Use program needs to be reassessed in light of usability and interoperability challenges with electronic health record systems," said AMA President Steven Stack, MD, in a press release.

The physician groups argued that beginning Stage 3 provisions would undercut certain recently enacted Medicare payment reforms, namely the recent Medicare Access and Chip Reauthorization Act (MACRA). That legislation, which was passed in April, was a landmark piece of legislation that repealed the often maligned sustainable growth rate formula for Medicare physician reimbursement. MACRA also includes a rough plan for overhauling several government programs, including Meaningful Use.

"The proposed Stage 3 regulation exacerbates problematic policies of MU Stage 2 by continuing to 'count' physicians' compliance with one-size-fits-all objectives rather than focusing on the clinical activities that should support differences in medical practices and patient care," they wrote in the letter. "We believe Stage 3 takes a drastic step backwards from the proposed improvements of the Modifications Rule. "

Meaningful Use was included in the 2009 Health Information Technology for Economic and Clinical Health (HITECH) Act as a way to reward clinicians and hospitals for using electronic medical records in meaningful ways. The policy also includes significant penalties for failing to meet the requirements.

While the first 2 stages of Meaningful Use focused on acquiring and sharing data, the goal of Stage 3 is to enhance clinical outcomes using electronic medical records.

According to the AMA, while more than 80% of physicians use electronic medical records, less than 10% of physicians "successfully participated" in Stage 2 of Meaningful Use. In December, CMS announced that it would cut Medicare reimbursement by 1% for nearly 300,000 physicians who did not meet Meaningful Use requirements.

In its press release, AMA noted that halting Stage 3 policies would give clinicians time to assess the healthcare landscape and collaborate with the administration on revisions to the Meaningful Use program.

The AMA is urging members to write to members of Congress and request their support for H.R. 3309, a bill that would delay Stage 3 rulemaking until 2017. This would mean the Stage 3 provisions would not be implemented until 2019 or 2020.

A form letter suggested by the AMA states, "We cannot get to a 'learning' health system unless we have the tools to do so. We need state-of-the-art technology that can interoperate with other systems and providers. MU [Meaningful Use] has proven time and again incapable of these needs."

Stack, in the AMA press release, noted that temporarily stopping Meaningful Use would not threaten the advances of electronic medical records. "On the contrary, we firmly believe a temporary period of reevaluation will help move the program forward and drive innovation and adoption," he said.

In February, CMS delayed the deadline for physicians to submit meaningful use data by 3 weeks.