Does Meaningful Use delay really encourage faster EHR adoption?

There's no question that the decision by Department of Health & Human Services to give providers an additional year to meet the Stage 2 Meaningful Use objectives under the electronic health record incentive program was a welcome relief for many. As healthcare attorney Jeffrey Ganiban of Washington, D.C.-based law firm Drinker Biddle tells FierceEMR, the delay gives breathing room to eligible hospitals and doctors, especially in light of the additional demands of ICD-10. "It also takes some pressure off health IT professionals, [who are] already stretched thin by overloaded schedules and unable to keep up with demand for their services," he says.

But will this postponement ultimately help HHS achieve its goals, or is it merely putting an on-message "spin" on the delay? According to HHS, the reason for pushing back Stage 2 is "to encourage faster adoption." That's all well and good, but since the change occurred after the deadline for eligible hospitals to qualify for Meaningful Use in 2011, it won't make adoption faster. It does enable a few lucky hospitals that had met the requirements for Stage 1 in 2011--but were delaying attestation so that they wouldn't have to worry about Stage 2 a year early--to go ahead and attest in 2011, since the delay removes the disincentive, Ganiban says. HHS itself acknowledges in its announcement that the 'faster adoption' potentially applies only to physicians, and even then, only if they "act quickly" to qualify for incentive payments in 2011.

In actuality, the delay really only helps the early adopters who attested in 2011, since they would have been forced to transition to Stage 2 in 2013, a year ahead of everyone else. Now, they get a third year to attest to meeting the Stage 1 requirements, Ganiban says. 

Even so, eligible physicians still may not want to rush to attest since, while they'll be entitled to three years' worth of incentive bonus money by meeting the lesser Stage 1 requirements, they'll be giving up their 2011 e-prescribing bonus payment. What's more, from a pure numbers standpoint, it may be better to get the latter payment, points out Lynn Scheps, vice president of government affairs for SRSsoft, in a recent blog post for EMR and HIPAA.

The delay reduces a provider's legal liability for failing to comply with the Stage 2 Meaningful Use requirements in 2013. Since the final rule containing the requirements is expected to be revealed this summer, eligible hospitals that attested in 2011 will have to be live for Stage 2 by October 2012 to meet Meaningful Use in fiscal year 2013. Ganiban says that is simply way too short a timeframe. With penalties for not meeting Meaningful Use ready to hit in 2015, the government realized that it would be pointless to set providers up to fail, especially since the vendors aren't even up to speed themselves, Ganiban says.

The delay also perhaps gives HHS some breathing room to better assess just what those Stage 2 Meaningful Use requirements should be. The American Medical Association calls on HHS to take advantage of the delay to do just that, noting in its response to the announcement that HHS should use the extra time to "fully evaluate" Stage 1 and to consider "flexibility in later stages" to increase EHR adoption. We'll have to see how this top will ultimately turn. - Marla

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