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    The meaningful use 2 challenge

    Recent changes allowing more flexibility for physicians to attest highlight the difficulty of the stage 2 requirements

    Is meaningful use Stage 2 (MU2) obtainable for most small-practice physicians? Perhaps not, as evidenced by the government’s decision to delay implementing MU2 and allow providers to attest using 2011-certified software. As 2014 moves beyond the halfway point, the answer may hinge on what your practice does to prepare for attestation and the relationship you have with your electronic health record (EHR) vendor.

    MU2 challenges vendors, providers

    Although the Centers for Medicare and Medicaid Services (CMS) delayed the start  of MU2 attestation for a year, 2014 is proving to be a challenging deadline for many EHR vendors and their clients.

    Medicare-eligible providers attesting for MU2 now must report on a total of 20 objectives—17 core objectives and three of six menu-set objectives—as well as nine of 64 approved clinical quality measures (CQMs), during a fixed quarter of the calendar year.
    Early results show that MU2 attestation is off to a tepid start. As of May 1, CMS reported that only 50 eligible professionals and four hospitals had attested for Stage 2 in the 2014 reporting year.

    Michael Zaroukian, MD, PhD, FACP, vice president and chief medical information officer for Sparrow Health System, says some practices are struggling due to their vendors’ inability to provide a certified product in a timely manner, while other physicians may not have anticipated the impact that Stage 2 would have on workflow.

    While there were no “big surprises” in Stage 2, Zaroukian says, “perhaps some of the vendor challenges in getting their software ready to meet the requirements and the increased emphasis on information exchange is more than practices or vendors were expecting.”

    Zaroukian, who works in two practices that use different EHR vendors, says his own experience has been mixed, with one practice experiencing a “comparatively smooth path” toward attestation while the other is being challenged by a vendor slow to upgrade its EHR.

    Until earlier this month, all practices  were required to use a 2014-edition certified EHR to qualify for incentive payments no matter if they are in MU1 or MU2, but that vendor certification was a roadblock for many practices. As of May, about 115 vendors representing 220 products had received full 2014 ambulatory certification. That contrasts with the 1,932 complete products certified for 2011.

    If a vendor promises to be certified by a specific date, Rosemarie Nelson, a medical practice consultant with MGMA Healthcare Consulting Group, recommends asking for a “letter of agreement” from the vendor to cover a practice’s loss of incentive money or penalty in a subsequent year because of an inability to attest in 2014.

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    • Dr. Robert Freinkel
      Why bother? I attested for 2013 and was"selected" for a prepayment audit as of March 1. Passed audit effective June 2. NO INCENTIVE PAYMENT HAS BEEN RECEIVED AS OF 6/25/14. Screwed over by big government and hordes of useless overpaid bureaucrats. Robert L. Freinkel, M.D.

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