The National Association of Public Hospitals & Health Systems (NAPH) has released an issue brief on "Health Technology and the Safety Net" that is, in effect, a commentary on the Meaningful Use Stage 2 proposal of the Centers for Medicare and Medicaid Services (CMS).
Nearly all (97 percent) of NAPH members plan to participate in both the Medicare and the Medicaid electronic health record incentive programs, the brief says. That's well above the 74 percent of all hospitals that intend to participate. But NAPH members are more likely than other hospitals to be unable to meet the Meaningful Use criteria until fiscal year 2013, according to the report.
Public hospitals have limited resources, and the government's incentive payments cover only 30 to 50 percent of the cost of EHR implementation. In addition, these hospitals find it difficult to compete financially for experienced health IT staff, the brief points out. And, because public healthcare systems are often large, with extensive outpatient clinics, it is difficult to achieve Meaningful Use within the government's time frame.
Consequently, NAPH argues, CMS should allow all hospitals three years in between the deadlines for Meaningful Use Stage 1 and Stage 2, regardless of when they begin to participate in the program. "This flexibility would help ensure safety net systems are not unfairly disadvantaged for being larger health systems with fewer resources," the report says.
NAPH's position on the time frame echoes the comments of the American Hospital Association on Meaningful Use Stage 2. And, like AHA, NAPH opposes the MU Stage 2 requirement for providers to ensure that 10 percent of their patients view, download and/or share their electronic health information.
The association notes that 58% of patients seen by NAPH members are racial or ethnic minorities, many of whom have limited access to technology. "Meaningful Use measures that hold providers accountable for patients viewing and downloading their health information could unfairly punish safety net providers for fulfilling their mission to serve the most vulnerable among us."
The issue brief also urges CMS not to raise the thresholds for core measures of Meaningful Use for Stage 2 until a "wide range of hospitals" can meet the thresholds for Stage 1. NAPH also asks the agency to retain flexibility on the menu items in Stage 2 and to exempt public hospitals from the health information exchange requirements because of the low EHR adoption rates in their communities.
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