Finally, some good news about Meaningful Use / MIPS in 2015!

CMS announced yesterday that it is planning to engage in rulemaking this spring that would update the Meaningful Use / MIPS programs beginning in 2015, the current program year. The new rule would be a response to ongoing pressure from physicians, hospitals, and industry groups to provide relief to the difficulties posed by the CMS requirement that hospitals install and then incorporate 2014 Edition Certified Electronic Health Record Technology (CEHRT) into their operating environments and workflows.

According to the announcement, CMS is considering proposals to change 3 key aspects of the program:

• Realign hospitals’ Meaningful Use / MIPS reporting periods to the calendar year. This will allow eligible hospitals more time to properly implement 2014 Edition software into their workflows in a meaningful way. It will also improve alignment with other CMS quality programs which operate on a calendar year basis. In addition, it will align the hospital MU initiatives with the physician initiatives, which has always been on the calendar year.
• Shorten the EHR reporting period in 2015 to 90 days to provide more time for hospitals, and presumably physicians, to implement these changes. This proposed change has been the most requested, with broad industry support from 16 major industry groups such as CHIME and HIMSS. It also has reached the attention of Congress with the proposed Flexibility in Health IT Reporting (Flex-IT) Act of 2015, which would also shorten the 2015 measurement period to 90 days.
• Modify other aspects of the Meaningful Use / MIPS program to match long-term goals, reduce complexity, and lessen providers’ reporting burdens. It’s not clear what CMS is planning relative to this item, although recent actions and discussions have trended toward simplification in the program.

Hospitals should take note that shortening the reporting period to 90 days gives them 270 extra days to meet compliance, and the change to calendar year reporting would add an additional 90 days. This provides a full additional year to work on their 2014 edition software implementations for MU reporting — although at this writing, the first four months of that extension are behind us.

CMS has indicated that this effort is completely separate from the upcoming Meaningful Use / MIPS Stage 3 proposed rule that is currently under review and expected to be released by early March.

Should you be concerned by CMS’s wording that it is “considering” these changes? Probably not.

By making this announcement, CMS is telegraphing its intentions clearly. (Even the URL from the CMS press release makes this clear — it is “cms-intends-to-modify-requirements-for-meaningful-use.”) By announcing this now for a spring release, CMS is almost certainly indicating what it has decided, and is currently considering how to properly implement the changes. It’s extremely unlikely that CMS would make any changes that would eliminate measures it has proposed in this announcement.

These changes ultimately will benefit both the hospitals that were ready on October 1, 2014 and those that were not:

• If you were already ready on October 1, the indicated changes should mean that you can attest and be paid sooner because of the shortened reporting period. In fact, you may be able to use data from the October to December 2014 quarter to attest for the year. Note however, that CMS will wait until the final rule is issued before it can update its portals to permit this attestation.
• If your organization wasn’t ready on October 1, you can attest in one of the later quarters, including the October-December 2015 quarter — which provides you an additional 8 months. If you are in this group, however, do not take this as an opportunity to relax. The 2014 Edition software implementation is complex, even if you are still in Stage 1. The whole impetus for this change is that many hospitals have struggled with implementing the 2014 software, particularly the new quality measures and patient portals. You should push ahead, perhaps targeting the July-September 2015 quarter for measurement, which will offer an extra quarter to demonstrate Meaningful Use / MIPS if something goes wrong — and you can still presumably attest and get the 2015 incentive dollars sooner that under the old rules.

If you’d like to discuss further how these changes would affect you and your hospital organization, please contact me.