Providers: 'Strike a balance' with MU, other programs

For providers transitioning from Stage 1 to Stage 2 of Meaningful Use, 2014 will be a challenging year. Many must assess the costs and benefits of the federal incentive program, and whether they should even continue to participate.

Micky Tripathi (pictured), is founding president and CEO of the Massachusetts eHealth Collaborative, a nonprofit geared toward helping providers exchange health information, and also serves as chair of the information exchange workgroup, a sub-committee of the Health IT Policy Committee in the Office of the National Coordinator for Health IT. In an exclusive interview with FierceEMR, Tripathi shares his insights on Meaningful Use and the looming provider conundrum.

FierceEMR: Why is 2014 such a difficult year for providers?

Tripathi: The Meaningful Use Stage 2 requirements are going up in substantial ways at the time of a perfect storm of obligations: ICD-10, the Affordable Care Act, HIPAA compliance, penalties for breaches, changes in the reimbursement models and hospital readmission penalties.

Also, the Stage 2 requirements didn't give the vendor community time to develop the systems, so they're not yet fully available. The number of products certified for Stage 2 are well below the figures from Stage 1. Some vendors have announced that they will not be able to meet Stage 2. Now some providers, especially smaller ones, have to switch vendors. It wouldn't surprise me to see providers just drop out of the program because they can't afford to buy a new system.

FierceEMR: What does this mean for providers and the program?

Tripathi: A number of organizations are making a list of priorities, and Meaningful Use is of lower risk, lower exposure [and dropping out]. It's too early to tell how many may formally drop out. There's no need to make a formal declaration.

FierceEMR: Will the new hardship exemption to include EHR vendor delays help providers?

Tripathi: It may help a little but it's not really an exemption. It's not like the IRS, where you can get an extension [to file your return after April 15] but you're in the same position with the IRS April 15. Here, you're giving up what you could have gotten [in incentives] in 2014 and you'll never get that back.

FierceEMR: What is your overall view of the Meaningful Use program?

Tripathi: In general the Meaningful Use program is a runaway success. The growth in penetration of EHR systems is phenomenal. You can't point to a different industry with such growth in such a short time. The challenge is to strike the balance of Meaningful Use and the other programs coming to the fore.  That's why the Health IT Policy Committee cut back on the requirements for Stage 3. This is a good thing – it allows for flexibility and allows us to take stock and adjust.

FierceEMR: What should providers do now?

Tripathi: Providers have to look at what makes best sense for their patients and their business and clinical needs. Look at that in a very clear headed way, do the calculations and the costs. See if Meaningful Use also allows you to take advantage of being in an accountable care organization, patient centered medical home or PQRS. Take into account how Meaningful Use may help you, and the penalties, and include that in the calculations. The program is designed as an incentive, not a mandate.

If it doesn't make sense [to participate], it doesn't.

Editor's Note: This interview has been condensed for clarity and content.