For most providers, the period for determining whether an organization has achieved the Stage 2 meaningful-use requirement to avoid penalties from the EHR incentive payment program starts Jan. 1. The penalties don't go into effect until 2015. Meanwhile, a recently announced HHS extension of Stage 2 and pushback of Stage 3 leaves the Medicare payment penalty schedule unchanged.
In addition to stepping up to Stage 2, the other big change of 2014 comes Oct. 1 with the nationwide conversion to the ICD-10 family of diagnostic codes and procedural codes. This enormous changeover has been likened to the Y2K upgrades of 1999—one that, if botched, will undermine a healthcare organization's cash flow.
Of course, those are far from the only IT troubles on the healthcare horizon. Adapting to the Patient Protection and Affordable Care Act and complying with more-stringent federal privacy and security rules from amendments to the Health Insurance Portability and Accountability Act will impact doctors and hospitals in the year ahead. Many folks are already feeling the strain of such high-stakes multitasking.
“There was one dark side of 2013,” said Dr. John Halamka, chief information officer of Beth Israel Deaconess Medical Center in Boston. “IT strategic plans were entirely co-opted by regulatory mandates. Local priorities, innovations, and good-to-have quality improvement projects were overshadowed by must-do compliance requirements.”
On Dec. 6, the CMS and the Office of the National Coordinator for Health Information Technology at HHS announced their intention to expand the Stage 2 reporting period from two years to three, thus delaying the start of Stage 3 until Jan. 1, 2017, for physicians and other “eligible professionals.”
The Electronic Health Records Association, a trade group of about 40 developers affiliated with the Healthcare Information and Management Systems Society, said in a statement it was “pleased” the CMS moved back the start of Stage 3.
The American Medical Association's Dr. Steven Stack, it's immediate past chairman, said, however, “We remain deeply concerned about the program's current pass/fail approach to demonstrating meaningful use,” and asked for “greater flexibility” in program requirements.
The Texas Medical Association, in a letter to HHS Secretary Kathleen Sebelius, said the Stage 2 extension “will allow for a much better understanding of what works and what doesn't” before moving to Stage 3. But its author, Dr. Joseph Schneider, chairman of the 47,000-member group's ad hoc health IT committee, added that the TMA was “deeply disappointed that the CMS has not recognized the importance of extending the 2014 meaningful-use requirements and the penalty measurement deadline” and “does not indicate an appreciation of patient safety.”
Follow Joseph Conn on Twitter: @MHJConn