Physicians Weigh Costs, Benefits of Skipping Meaningful Use Stage 2

The numbers are discouraging.

According to the Office of the National Coordinator for Health Information Technology, 56% of all hospitals eligible for the meaningful use program were qualified for Stage 2 as of November 2014, compared with only 42% of eligible healthcare professionals.

Those numbers are consistent with other surveys of physicians indicating that 55% do not intend to attest to stage 2 meaningful use this year. Those numbers fly in the face of potential penalties associated with not attesting to Stage 2.

“There are a variety of penalties for physicians associated with not attesting,” explains Greg Fulton, a member of Greenway Health’s government affairs team. And yet, he points out, approximately 256,000 of the nation’s 537,600 physicians are leaving themselves open to penalties totaling $200 million.

Mistake in the Making

If there is a bottom line for physicians contemplating their meaningful use future and the financial considerations intertwined, it is not necessarily that they should stay the course and keep attesting or not. They should if they can, Fulton says. But the main goal is for physicians to make certain their technology vendor supplies them with certified software that meets the criteria for meaningful use, whether they attest or not.

“At this point in time, it would be a mistake to withdraw from the meaningful use program,” Fulton says. “The Centers for Medicare and Medicaid Services are working to make it easier for healthcare providers by announcing its intent to offer a 90-day reporting period in 2015 (versus the entire calendar year).”

So why are physicians withdrawing? Fulton explains that the Stage 2 requirements include greater expectations for health information exchange, including: higher thresholds for ePrescribing; addition of clinical laboratory test results; electronic transmission of summary of care records across unaffiliated providers, settings, and EHR systems; and higher thresholds for patient viewing, downloading, and transmitting their health information.

The problem, says Seth Flam, DO, chief executive officer and director for HealthFusion, a cloud-based EHR and practice management company, is that CMS is too optimistic about the infrastructure that’s required for the rules it establishes.

“Doctors get frustrated,” Flam explains. “They say, ‘This is impossible. I’d rather just get the penalty.’ We’d like to see CMS understand that it needs to have more flexibility; that the ecosystem isn’t mature.”

Weighing the Costs

According to Fulton, penalties physicians could incur are based on 1% of annual Medicare billables per eligible healthcare professional. The penalty is not based on a percentage of the incentive the physician is qualified for. However, those penalties will increase annually to a maximum of 5% payment adjustment.

“Overall, though, individual penalties are arguably not that great,” he says. According to CMS’ breakdown, approximately 70% of physicians facing penalties in 2015 will experience less than $2,000 each.

Reiterating CMS’ intention to allow a 90-day only reporting period for 2015, versus the entire calendar year as original required, Fulton believes that’s added motivation for physicians to attest for Stage 2 in 2015.

“And depending on when they started the program, some can still attest to Stage 1 in 2015,” he explains.

Important to Be There

Flam also encourages physicians to stay the course and attest for Stage 2 of meaningful use. He says the key is for companies like HealthFusion to continue developing cutting edge technologies, but for CMS to provide enough flexibility and exceptions until the ecosystem catches up.

“It’s like being the first person with an email address back in the old days,” Flam says. “It’s good that you had the computer and the email address, but it didn’t mean you could send an email to your grandma. But it paid off in the long run, and eventually grandma caught up. That’s kind of where we are with the healthcare ecosystem.”

Fulton also encourages physicians to hang in regarding meaningful use attestation, and to push their vendors to make sure they have 2014 certified software.

“Or, if you’re fed up with meaningful use, and the penalties breakdown eases that pain, maintain your certified software over time—the 2015 version is scheduled to be required in 2017 to align with Stage 3—and make sure you have staff that can use it, either via a vendor-supplied dashboard or in-house experts, to take advantage of other public and private payer incentive programs aligning with meaningful use.”

Echoes Flam, “You’re not going to use every bell and whistle on your computer every day. But it’s good to know you have them for when the rest of the world catches up.”