AMA suggests ways to ease burden of MU requirements
Many practices have experienced difficulty with successfully adhering to meaningful use principles. In response to this issue, the American Medical Association has provided a few recommendations as to how EHR incentive providers can increase flexibility for practices struggling to adhere to the principles, especially as plans for stage 3 of meaningful use are in the works.
As the stages of the EHR Incentive Program increase, the meaningful use requirements become stricter and more complex. Rules such as specific numerator and denominator thresholds are meant to improve patient outcomes and save time and money. However, considering the significant number of recent applications for meaningful use exemption and the Centers for Medicare and Medicaid Services' decision to extend the application deadline, there is a dire need to make the goals and requirements more easily attainable.
The problem
According to the AMA, practices' inability to meet the meaningful use requirements stems from the fact that the requirements must be met with 100 percent compliance at all times or the practice will receive a penalty. The Incentive Program does not take into consideration that technology can often get in the way of meeting the criteria, while certain requirements are nearly irrelevant to specific practices that are trying to adhere to them. With stage 3 criteria expected to be implemented relatively soon, the AMA stressed that now is the time to address these issues.
"After three-and-a-half years of provider participation, we are at a critical crossroad where we believe it is important and necessary to pause and fully assess what is working and what needs improvement before moving ahead to stage 3 of the program," wrote AMA executive vice president and CEO James L. Madara, M.D. in a letter to the CMS and the Office of the National Coordinator for Health Information Technology.
The most recent effort to ease these burdens by providing percentage thresholds has failed, as it only caused additional problems for the administrative aspect of physicians' workflows. Physicians were forced to develop various workflows for different patients and had to spend more time tracking to be certain their practice was properly meeting the criteria and thresholds. The AMA reported that these arbitrary thresholds even have the potential to cause inconsistency in the care that is provided for patients.
The recommendation
In its letter, the AMA listed points and suggestions for more successful stage 3 meaningful use criteria. Here are the main four:
- Creating a more flexible approach for meeting the meaningful use requirements will enable a greater number of practices to participate in the program successfully.
- Improvements in the coordination of quality measure requirements is necessary. This includes easing the reporting burden previously placed on physicians, which would save them from overlapping penalties.
- In order to enhance the quality of care for patients and make sure that physicians are following the latest evidence, ensure practices are using current quality measures and clinical decision support within the program.
- Place more time and energy into key aspects, such as interoperability, through the reconstruction of EHR certification.
"Given these challenges and that the MU program is moving into the penalty phase in 2015, we firmly believe that a pass-fail approach should not apply," Madara explained. "Under the Medicare e-Prescribing program, physicians needed to send fewer scripts electronically in order to avoid a penalty than they did to obtain an incentive. There is no evidence to suggest that this approach slowed down the use of e-Prescribing."
However, following the CMS' and ONC's recent decision to reconstruct their regulatory approaches to cater to the needs of providers, its current effort has the potential to prove successful. The association is hoping that the new eRx Incentive Program will promote the adoption of EHRs while maintaining steady participation as a result of its flexibility.
