2015-2017- Modified Stage 2- Final Ruling

On October 6, 2015- CMS/ONC released the final ruling for the proposed 2015-2017 Modified Stage 2 program that had been open to public comments since the spring of 2015. Below are the key items of the ruling.

• All providers attest to modified measure set of 10 Objectives for 2015-2017 with alternative metrics for Stage 1 providers.
• Reporting period for 2015 is any, continuous 90 day period for all Eligible Providers (EP's)and Eligible Hospitals (EH's)

What existed before this ruling?

• Previously Stage 1 was 13 Core objectives and 5 of 9 Menu objectives for EP's
• Previously Stage 2 was 17 Core objectives and 3 of 6 Menu objectives for EP's
• Previously Stage 1 was 11 Core objectives and 5 of 10 Menu objectives to include 1 public health for Eligible Hospitals (EH's)
• Previously Stage 2 was 16 Core objectives and 3 of 6 Menu objectives for EH's

What is required today for 2015 reporting year and moving forward?

• 10 objectives for all EP's
• 9 objectives for all EH's
• Menu objectives no longer exist
• No change to Clinical Quality Measure (CQM) reporting, previous standard are in place for EP's (9 CQM's) and EH's (16 CQM's) across 3 of the 6 domains.

What does the MU participation look like 2015 and beyond?

• 2015: All providers attest for 90 days on Modified 2015-2017 Stage 2, 10 Core objectives for EP's and 9 Core objectives for EH's
• 2016: All providers attest for a Full Calendar year on Modified 2015-2017 Stage 2, 10 Core objectives for EP's and 9 Core objectives for EH's (first time participants can attest to 90 days only)
• 2017: All providers have 2 options to attest to either Modified 2015-2017 Stage 2 (first time participants can attest to 90 days only for Modified 2015-2017 Stage 2) or Stage 3 (stage 3 would be 90 days)
• 2018: All providers attest to Stage 3 for a full calendar year.

What Core measures were modified in the 2015-2017 ruling?

• Provide patients the ability to view online, download, and transmit their health information within 4 business days of the information being available to the EP.

• Use secure electronic messaging to communicate with patients on relevant health information.

• Public Health Reporting- The EP, eligible hospital or CAH is in active engagement with a public health agency to submit electronic public health data from CEHRT except where prohibited and in accordance with applicable law and practice.

• see detailed changes [1]

What Core measures were removed for EP's?

• Record demographics: More than 80% of all unique patients seen by the eligible professional (EP) have demographics recorded as structured data.

• Capture vitals: More than 80% of all unique patients seen by the EP during the EHR reporting period have blood pressures (for patients age 3 and over only) heights or lengths, and weights (for all ages) recorded as structured data.

• Smoking status-More than 80% of all unique patients 13 years old or older seen by the eligible professional (EP)have “smoking status” recorded as s tructured data.

• Provide Office Visit summaries for patients for each office visit.Clinical summaries provided to patient or patient-authorized representatives within 1 business day for more than 50% of office visits.

• Lab results- More than 55% of all clinical lab test results ordered by the eligib le professional (EP) during the EHR Reporting Period (RP)whose results are expressed in a positive/negative affirmation or numerical format are incorporated in the certified EHR technology (CEHRT) as structured

• Generate patient lists- Generate lists of patients by specific conditions to use for quality improvement, reduction of disparities, research or outreach.

• Patient Reminders- More than 10% of all unique patients who have had 2 or more office visits with the eligible professional (EP) within the 24 months before the beginning of the EHR reporting period (RP) was sent a reminder, according to each patient’s preference, when it has been recorded.

Meaningful Use Resources

• Meaningful Use
• 2015-2017- Modified Stage 2- Objectives
• V11.2 Meaningful Use Enhancements
• Meaningful Use Matrix
• Meaningful Use FAQ
• Patient Summary Information (AKA Clinical Summary)
• Medicare Reimbursement Schedule
• Medicaid Reimbursement Schedule
• Meaningful Use Stage 2
• Journey to Meaningful Use
• Stimulus Set