AHA asks Trump to cancel Meaningful Use Stage 3

Avoiding the last part of the EHR Incentive Program will save hospitals large sums of money that otherwise would go toward records system upgrades, says AHA’s Richard Pollack.

The American Hospital Association has asked President-elect Donald Trump and his emerging administration to cancel Stage 3 of the Meaningful Use program.

In a November 30 letter addressing a variety of regulatory pressures faced by the nation’s hospitals, AHA asked Trump to cancel the final Meaningful Use stage “so that hospitals will not be forced to spend large sums of money upgrading their electronic health records solely for the purpose of meeting regulatory requirements.”

Currently, the mandatory start of Stage 3 is 2018, as established by the Centers for Medicare and Medicaid Services in a final rule released this fall.

Addressing the AHA’s request of President-elect Trump, a CMS spokesperson said the agency has been responsive to stakeholder requests for flexibility in the EHR incentive program.

“In the 2017 OPPS rule published on November 14, CMS finalized policies that aimed to reduce administrative burdens by allowing for a minimum of any continuous 90-day reporting period for all participants in the EHR Incentive Program in 2016 and 2017,” said the CMS spokesperson. “And, specifically for hospitals, we have eliminated the requirements to report on the clinical decision support (CDS) and computerized provider order entry (CPOE) objectives and its associated measures. We also reduced the threshold for a subset of objectives and measures for modified Stage 2 and Stage 3 of Meaningful Use.”

However, AHA would like to do away completely with Stage 3, given its concerns that the Meaningful Use program is broken and burdensome.

In the AHA letter to President-elect Trump, the association’s president and CEO Richard Pollack made a broad appeal seeking a reduction in the regulatory burden shouldered by the association’s 5,000 member hospitals, which he called substantial and unsustainable.

“We urge your Administration to modify or eliminate duplicative, excessive, antiquated and contradictory provider regulations,” wrote Pollack. “Reducing the administrative complexity of healthcare would save billions of dollars annually and would allow providers to spend more time on patients, not paperwork.”

Pollack noted that hospitals are advancing health information technology and that these healthcare organizations need to ensure they “have the workforce and health IT infrastructure to best support care delivery.” He urged the incoming Trump administration to “advance health IT by supporting the adoption of interoperable EHRs, promoting a more consistent use of IT standards and providing improved testing, certification and transparency about vendor products.”

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At the same time, AHA called on Trump to promote use of telehealth, remote patient monitoring and other technologies by “removing barriers to their use and payment.”

The association also urged Trump to streamline, prioritize and simplify quality reporting to identify and focus on meaningful and valid “measures that matter.” Specifically, AHA recommends modifying the current readmissions policy to include a socio-demographic adjustment “so that providers are not penalized for factors outside of their control,” as well as developing a performance reporting option that allows hospital-aligned physicians to fulfill the MACRA quality reporting requirements based on hospital measures.”

In addition, AHA would like to see the new Trump administration “suspend the flawed hospital star ratings” on the Hospital Compare website maintained by CMS “as they are inaccurate and provide misleading information to consumers.”

CMS contends that its star rating system reflects comprehensive quality information about the care provided at U.S. hospitals, and that the methodology takes 64 existing quality measures already reported on the Hospital Compare website and summarizes them into a unified rating of one to five stars.

According to Kate Goodrich, MD, director of the CMS Center for Clinical Standards and Quality, the Hospital Compare website helps millions of patients and their families to “learn about the quality of hospitals, compare facilities in their area side-by-side, and ask important questions about care quality when visiting a hospital or other healthcare provider.” Further, Goodrich says it has received numerous letters from national patient and consumer advocacy groups supporting the release of these ratings “because it improves the transparency and accessibility of hospital quality information.”

CMS has stated that the agency will continue to analyze the hospital star rating data and consider public feedback to make enhancements to the scoring methodology as needed.

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