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4/29/2015CMS Meaningful Use Stage 3 NPRMElizabeth HollandCenter for Clinical Standards and QualityCenters for Medicare & Medicaid Services1

4/29/2015Disclaimer» CMS must protect the rulemaking process and comply withthe Administrative Procedure Act. During the rulemakingprocess, CMS can only present the information that is in theNPRM as it is contained in the NPRM. CMS cannot interpretthat information, nor clarify or provide any furtherguidance.» CMS cannot address any comment suggestion or statementmade by anyone attending the presentation or consider anysuch comment or suggestion in the rule writing process.» Please submit comments through the formal processoutlined in the Federal Register.12

4/29/2015Stage 3Stage 2Stage 1ImprovedoutcomesAdvancedclinicalprocessesData capturingand sharing23

4/29/2015Stage 3NPRM Requirements34

4/29/2015Goals of Proposed ProvisionsProvide a flexible, clear framework to simplify the meaningful useprogram and reduce provider burden123Ensure future sustainability of Medicare and Medicaid EHRIncentive ProgramsAdvance the use of health IT to promote health information exchangeand improved outcomes for patients45

4/29/2015Stage 3 NPRM Streamlines ProgramsStreamlining Synchronizing on single stage andsingle reporting period56

4/29/2015Stage 3 NPRM Streamlines ProgramsStreamlining Reducing burden by removing objectives that are: Redundant to other more advanced measures being retained Duplicative of other measures using same certified EHRtechnology function Topped out and have reached high performance67

4/29/2015Stage 3 NPRM Streamlines ProgramsStreamlining 8 advanced use objectives78

4/29/2015Stage 3 NPRM Improves OutcomesStage 3 NPRM focuses on objectives which supportadvanced use of EHR technology and quality improvementHealth information exchange objectives improve outcomesby: Ensuring providers caring for same patient are sharing info with oneanother Providing patients with easy access to health info Fostering data collection in sharable format across multiple health careorganizations Supporting learning health system through sharing of common clinicaldataset and expanding types of registries to which hospitals andproviders can report89

4/29/2015Stage 3 NPRM Increases InteroperabilityStage 3 NPRM increases interoperability by: Simplifying requirements to focus on objectives supporting advanced use of health IT Requiring providers to report on 2 of 3 HIE measures Requiring Stage 3 in 2018 for all to increase scale of participation and support growthin HIE and patient engagement infrastructure910

4/29/2015Stage 3 NPRM Provides FlexibilityThe Stage 3 proposed rule makes themeaningful use program more flexible: Have option to report on Stage 3 criteria in 2017 Required to report on Stage 3 beginning in 2018regardless of prior participation/stage ofmeaningful use1011

4/29/2015Stage 3 NPRM Provides FlexibilityThe Stage 3 proposed rule makes the meaningfuluse program more flexible: Simplifying meaningful use objectives and measures andallowing flexible measures for: health information exchange consumer engagement public health reporting Providing enhanced flexibility and options for public healthreporting1112

4/29/2015Stage 3 Requirements,Objectives & Measures1213

4/29/2015Reporting Period» Full calendar year reporting period beginning in2017» CQM reporting in coordination with qualityreporting programs1314

4/29/2015Stage 3 Proposed Objectives1. Protect Electronic Health Information2. Electronic Prescribing (eRx)3. Clinical Decision Support4. Computerized Provider Order Entry (CPOE)5. Patient Electronic Access to Health Information6. Coordination of Care through Patient Engagement7. Health Information Exchange8. Public Health Reporting1415

4/29/2015Modifications formeaningful use in2015-20171516

4/29/2015Goals of Proposed ProvisionsAlign with Stage 3 proposed rule to achieve overall goals ofprograms123Synchronize reporting period objectives and measures to reduceburdenContinue to support advanced use of health IT to improve outcomesfor patients1617

4/29/2015Modifications to Meaningful Use in 2015through 2017 NPRMProposed rule for Medicare and MedicaidEHR Incentive Programs: Streamlines program by removing redundant, duplicative and topped outmeasures Modifies patient action measures in Stage 2 objectives related to patientengagement Aligned reporting period with full calendar year Changes EHR reporting period in 2015 to 90-day period to accommodatemodifications1718

4/29/2015Changes to Participation Timeline2015Attest to modified version of Stage 2with accommodations for Stage 1providers2016Attest to modified version of Stage 22017Attest to either modified version of Stage2 or full version of Stage 32018Attest to full version of Stage 31819

4/29/2015Submitting Comments1. Electronically: You may submit electronic comments on this regulation to:http://www.regulations.gov Follow the “Submit a comment” instructions.2. By regular mail3. By express or overnight mail4. By hand or courier1920

4/29/2015CMS Help Desks»EHR Information Center Help Desk––»NPPES Help Desk––»Visit https://nppes.cms.hhs.gov/NPPES/Welcome.do(800) 465-3203 - TTY (800) 692-2326PECOS Help Desk––»(888) 734-6433 / TTY: (888) 734-6563Hours of operation: Monday-Friday 8:30 a.m. – 4:30 p.m. in all time zones (except onFederal holidays)Visit https://pecos.cms.hhs.gov/(866)484-8049 / TTY (866)523-4759Identification & Access Management System (I&A) Help Desk–––PECOS External User Services (EUS) Help Desk Phone: 1-866-484-8049TTY 1-866-523-4759E-mail: [email protected]

Stage 3 NPRM Provides Flexibility The Stage 3 proposed rule makes the meaningful use program more flexible: Simplifying meaningful use objectives and measures and allowing flexible measures for: health information exchange consumer engagement public health reporting Providing enhanced flexibility and options for public health .