It’s official. The Department of Health and Human Services has postponed implementing the Stage 2 meaningful use objectives by one year. We first reviewed this proposal during the summer. From the provider’s perspective this will only impact the physicians electing to demonstrate meaningful use in 2011. Basically those providers will face the Stage 1 objectives for three years: 2011, 2012 and 2013. In 2014 they must meet the Stage 2 objectives to continue to participate in the program. Providers waiting to start attesting to meaningful use in 2012 or later will see the Stage 1 objectives for two years and then make the transition to the Stage 2 objectives.
There appear to be two principal reasons driving this decision. First HHS is concerned many providers are waiting on the sidelines, capable of demonstrating meaningful use in 2011, but electing to wait until 2012 because of concerns related to the original timing of the Stage 2 objectives (2013). Providers and vendors alike will have enough on their plates in 2013 as the deadline for ICD-10 arrives that fall. While encouraging providers on the sidelines to jump in this year is one of the stated objectives for delaying Stage 2, I doubt we will see an impact. After all, the latest one could start the 90-day reporting period was the first week of October.
Perhaps the bigger driver behind the delay was an impractical timeline that both providers and EHR vendors alike would face. It is widely believed the Stage 2 objectives will not be finalized prior to June of 2012. That leaves about six months for vendors to develop, test and deploy a certified solution, not to mention finding time for implementation and training for the early adopters who first participated in 2011. During the same timeframe there will be a substantial amount of work going on related to the ICD-9 to ICD-10 conversion. Providing relief from this very tight timeline is the other principal driver behind the delay.
I imagine HHS is taking a little heat for slower than expected adoption. EHR utilization is clearly on the rise; however, the number of providers demonstrating meaningful use in 2011 is on track to fall well below the most conservative estimates HHS provided when the program began. I previously commented on this following CMS’ release of the first provider-specific report in August. The pace has picked up, but the latest figures, now current through the end of October, strike me as anemic compared with the original estimates. Just over 135,000 providers have registered for meaningful use, but less than 15,000 have received the incentive as of the end of October. With two months to go, HHS will need a strong finish to reach the 40,000 providers they targeted in their low estimate. It is safe to say the agency’s high estimate—136,000 providers demonstrating meaningful use in year one—is now a pipe dream.
At the end of the day, delaying the Stage 2 objectives until 2014 is fantastic news if you were able to meet the Stage 1 objectives in 2011. It means you have an additional year (Reporting Year 3) with the Stage 1 objectives, while everyone else will have only two years. But that may be the end of the good news. Because although HHS continues to work hard to spur adoption, it doesn’t seem like the delay will help them hit the mark.
Randy Gertner says
Interesting. I certainly agree that the early adopters win here. I am also surprised about the slow rate of adoption. Around our hospital there is a basic lack of insight into the benefits of this program. I have referred many of them to this blog. I do believe that if all of the details were known, and in particular the subtlety of the 90 day reporting period, many providers would have rushed in. In particular, I am surprised at the health care systems that employ many physicians. This was low hanging fruit that should have been jumped on. I would have to say the main issue, in my mind, for the slow adoption is that the information for some reason was not received or reviewed by the appropriate physician or staff champions. Of the less than 15,000 that did achieve, I wonder how many were nephrologists and Acumen customers. I know you put that in a previous post during the summer, but any updates?
Terry Ketchersid, Vice President and Medical Officer at HITSG says
Randy,
Of interest the 15,000 figure is all providers and includes over 9,000 that have taken the Medicaid path. Among this group there are 6,600 physicians, but CMS does not break this group down by specialty. On the Medicare side of the program 5,800 providers have successful demonstrated MU through the end of October. The vast majority of the providers in this group are physicians. It is within this later group that CMS identifies providers by specialty. As of the end of October there were 174 successful nephrologists in the Medicare group. We do know from internal numbers the majority are our customers.