Dissecting Stage 2 of EHR Adoption

The new CMS rule for the EHR Incentive Programs defines the new objectives as the program moves into stage 2. Eligible Professionals (EPs) will have to meet 17 core objectives and 3 of 6 menu objectives. Eligible hospitals must meet 16 core objectives and 3 of 6 menu objectives. Unlike the stage 1 objectives there are no Clinical Quality Measures (CQM) in these stage 2 objectives. The CQMs have been removed from the objective requirements and defined the reporting of CQMs as a requirement by themselves.

In 2014 all program participants must be using 2014 Certified Technology. The new technology will be certified to the 2014 standards and capabilities which include the new CQM criteria. In 2014, all EPs and eligible hospitals will report CQMs using the new 2014 criteria no matter what stage (1 or 2) or program (Medicare or Medicaid) they are attesting.

In 2013:

• EPs will continue to report stage 1 core objective #10 of 44 measures – 3 core or alternative core and 3 additional measures.
• Eligible hospitals will continue to report stage 1 core objective #9 of 15 measures.
• Beginning in 2012 and continuing in 2013, there are two reporting methods available for reporting these Stage 1 measures:

1. Attestation
2. eReporting Pilots: Physician Quality Reporting System EHR Incentive Program Pilot for EPs or eReporting Pilot for eligible hospitals

In 2014 and Beyond:

• EPs must report on 9 of the 64 approved CQMs
  • Recommended core CQMs – encouraged but not required
    • 9 CQMs for the adult population
    • 9 CQMs for the pediatric population
    • NQF 0018 strongly encouraged since controlling blood pressure is high priority goal in many national health initiatives, including the Million Hearts campaign
  • Selected CQMs must cover at least 3 of the National Quality Strategy domains
• Eligible Hospitals and CAHs must report on 16 of the 29 approved CQMs
  • Selected CQMs must cover at least 3 of the National Quality Strategy domains
• Beginning in 2014, all Medicare-eligible providers beyond their first year of demonstrating meaningful use must electronically report their CQM data to CMS. (Medicaid EPs and hospitals that are eligible only for the Medicaid EHR Incentive Program will electronically report their CQM data to their state.)

For more information see the CMS tipsheet on Clinical Quality Measures.

Read all of the Dissecting Stage 2 posts.