E-Push Back: AMA, MGMA Weigh In on "Meaningful Use" Criteria on Orlando Medical News

E-Push Back: AMA, MGMA Weigh In on "Meaningful Use" Criteria

By: LYNNE JETER

The American Medical Association (AMA) and the national Medical Group Management Association (MGMA) recently weighed in on the Centers for Medicare and Medicaid Services (CMS) proposed rule outlining the "meaningful use" criteria for the federal electronic health records (EHR) incentive programs.

The AMA, along with nearly 100 state and specialty medical societies, submitted formal comments in early March to the CMS, saying the proposed criteria for meaningful use makes it too difficult for physicians to successfully participate.

"The AMA is supportive of the widespread adoption and meaningful use of EHRs by physicians, but the Stage 1 criteria proposed by CMS are too aggressive," said AMA board member Steven J. Stack, MD. "It could unreasonably punish physicians who undertake great efforts to achieve meaningful use of EHRs–only to be denied incentive payments due to overly complex and unattainable criteria."

To facilitate adoption of EHRs, the AMA provided several recommendations to the proposed rule governing meaningful use:

Removing the "all or nothing" approach by requiring physicians to meet five of the 25 proposed objectives and measures instead of all 25;
Eliminating the objectives and measures that do not directly apply to EHR adoption, such as checking insurance eligibility electronically;
Revising the definition of meaningful use for certain hospital-based physicians to broaden eligibility for the federal incentive programs; and
Reducing the number of quality measure reporting requirements by allowing physicians to identify only three clinically relevant measures.

"Overall, the proposed reporting criteria require more flexibility," said Stack. "We'd like to see more help for physicians in identifying the data necessary for accurate reporting."

Stack reiterated that the AMA is committed to EHR adoption that streamlines physician practices and helps them continue providing high-quality care to patients. "But successful integration of EHRs into patient care takes time," he emphasized. "We support the staged approach to health IT adoption, and we're hopeful that we can work with the administration to finalize regulations that truly encourage EHR adoption and successful physician participation in the EHR incentive programs."

The national MGMA released research data conducted in February suggesting that changes in practice operations necessary to meet the 25 meaningful use criteria proposed as part of the EHR incentive program would lead to decreased physician productivity.

"For the incentive program to succeed, the meaningful use criteria must be practical and achievable," said MGMA CEO William F. Jessee, MD, FACMPE. "If the final rule mirrors those outlined in the current proposal, there is a significant risk that the program will fail to meet the intent of the legislation, and that a historic opportunity to transform the nation's healthcare system will be missed."

To justify the high cost of software, hardware and staff training, the deployment of an EHR system in a medical group must produce administrative efficiencies and not result in a sustained and significant decrease in productivity, Jessee emphasized.

"It's clear that the transition to electronic health information technologies must begin by successfully aligning incentives with overall cost to the implementing entities," he said.

Of the proposed criteria most difficult to achieve, MGMA provider representatives surveyed listed two:

The proposed requirement that 80 percent of all patient requests for an electronic copy of their health information be fulfilled within 48 hours (45.9 percent); and
The proposed requirement that 10 percent of all patients be given electronic access to their health information within 96 hours of the information being available (53.5 percent).

"We remain strong advocates for the adoption of EHRs in medical groups and urge the administration to significantly streamline the incentive program requirements in the final rule to permit dramatically larger numbers of practices to embrace this important technology," Jessee said.

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AMA, American Medical Association, Bill Jessee, Medical Group Management Association, MGMA, Steven J. Stack

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