Monday, July 8, 2013

Whither/"Wither" Meaningful Use?

Wonder how they will try to spin this?

Meaningful Use Payment Growth Slows in May, CMS Data Show
Wednesday, July 3, 2013
As of the end of May, 292,217 physicians and other health care professionals received meaningful use incentive payments from Medicare, Medicaid or Medicare Advantage, marking only a slight increase from April figures, according to a report by CMS, Modern Healthcare reports...

The number of eligible professionals who received meaningful use incentive payments increased by only 892 providers in May, down significantly from the record 34,329 jump in April.

The May increase in paid eligible professionals was the lowest increase since June 2011.
According to the CMS report, 55.4% of the estimated 527,200 eligible professionals have received meaningful use payments, up only slightly from the 55.3% who had received payments as of the end of April...

The first table tabulates the EP/EH Body Count RECs were incessantly badgered to maximize. The second represents those having gotten to MU reimbursement. The third goes to The Green. $15,125,779,904 through May.

What can we take away from these developments, if anything? Well, it would seem that the low-hanging fruit has by now been picked; things will invariably get tougher going forward (and, without REC help). Moreover, as I noted on June 27th in "Bad News for the Meaningful Use Initiative," there appears to be significant rot in that low-hanging fruit (i.e., the "17% Stage 1, Year 2 dropout rate").

Here's a question I would like ONC to answer. Given that, amid their tepid support for the RECs they extolled the fact that EPs engaging their RECs were 2.3 time more likely to attest relative to those who went solo or used commercial consulting, what are the relative Year 2 dropout rates? If it's significantly lower for REC EPs, it would seem to make the case for the REC "value add" (particularly given that REC help was only legislated for Year 1, Stage 1 -- "One and Done"). Conversely, if the dropout rate for REC-client EPs is significantly higher, then you could fault the ONC EP Registration "Body Count" imperative.

I'm sure ONC could drill this stuff down right to the individual REC level. They have the data.


Meaningful Use program loses 20% of attesting docs
July 8, 2013 | By Marla Durben Hirsch

The dropout rate for Meaningful Use has "soared" in the second year of the program, with a whopping 21 percent of family physicians who attested in 2011 failing to do so in 2012, according to a recent article in AAFP News Now, a publication of the American Academy of Family Physicians.

AAFP reports that in reviewing Centers for Medicare & Medicaid Services attestation statistics, 23,636 family physicians became first-time attesters in 2012, a 180 percent increase from 2011. But of the 11,578 family physicians who attested in 2011, only 9,188 stuck with the program and attested in 2012.

The overall dropout rate among all physician specialties was 20 percent.

Possible reasons for the high dropout rate include the change in reporting period, which is only 90 days for the first year of participation, but a full 365 days for the second year. Some physicians may have also missed the two-month attestation window from Jan. 1 through Feb. 28, 2013, or received less support from the regional extension centers, which may be more focused on getting physicians to sign onto the program and attest for the first time...

"less support from the regional extension centers, which may be more focused on getting physicians to sign onto the program and attest for the first time"

Well, yes, Marla, as I've noted, the REC contractual mandate is One and Done. It should have been the case that Stage One, Year 2 would be easier to achieve. We always pitched it thus: "look, all you have to do now is monitor your MU Dashboard reports -- at least monthly -- to know where you might be falling short and take remedial action."

Another thing HHS should be assessing is the extent of outright fraud amid the 2011 Year One, Stage One attestors, and how much of that figures differentially into the 2012 dropouts.

Not that they would welcome shining any light into that dark corner.


Much has changed in the world of health information technology since our inaugural report in 2006, Health Information Technology in the United States: The Information Base for Progress. At that time, there was a dearth of methodologically rigorous data on health information technology adoption, the Office of the National Coordinator for Health Information Technology was relatively small with a limited budget and very few hospitals or physician offices had functional electronic health records. Over the last seven years, two major pieces of legislation have been passed, the Health Information Technology for Clinical and Economic Health provision of the American Recovery and Reinvestment Act and the Affordable Care Act, which have provided unprecedented levels of financial support for health information technology adoption and implementation, primarily in the form of financial incentives for providers, and emphasized the importance of this technology in delivery system reform. We have seen the rate of electronic health record adoption among physicians and hospitals begin to increase more rapidly and the focus has begun to shift from simply turning on the technology to using it in a way that improves the quality and efficiency of care.

In this report we continue to track progress toward the goal of universal adoption of electronic health records. We track the progress of hospitals and physicians, both overall and among those providers serving vulnerable populations; examine the state of health information exchange and mirroring emphasis at the federal level of implementing and using these technologies in a way that improves patient care, and; we examine the use of these tools for population management and patient education.
Full copy of the report here (PDF).


Meaningful use: Important deadlines are approaching
JUL 10, 2013 Jeffrey Bendix and Daniel R. Verdon and Rachael Zimlich

Meaningful use, the government program of financial rewards and penalties for encouraging doctors to use electronic health records (EHRs), has several important deadlines approaching. October 3, 2013, is the last day doctors and other eligible professionals (EPs) can begin the attestation process to qualify for the first stage of meaningful use (MU1) in 2013.  (The reporting period for MU1 attestation is 90 days.)

February 28, 2014, is the final deadline for reporting attestation results for 2013 and qualifying for the Medicare MU financial bonus. The final 2013 deadline for Medicaid attestation varies from state to state, so EPs need to check with their state Medicaid agency to learn their state’s deadline. EPs qualifying for the first time in 2013 under the Medicare program will receive $15,000, and those qualifying under Medicaid will receive $21,250.

In addition, EPs will be able to begin attesting to the second stage of meaningful use (MU2) on January 1, 2014. The MU2 attestation period for 2014 will be 90 days, but in 2015 and beyond will be for a full calendar year. That’s because the MU certification requirements for EHR systems will change in 2014, says Robert Anthony, deputy director of the health information technology initiatives group in the Centers for Medicare and Medicaid Services. The briefer reporting period will give EPs additional time to acquire or upgrade to MU2-certified technology.
Medicaid EPs can choose any 90-day period in 2014 in which to attest, but Medicare EP attestation periods will start on January 1, April 1, July 1, or October 1...
See also the interactive CMS resource "My EHR Participation Timeline."


More to come...

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