Meaningful Use Stage 2: How Not To Bridge The Digital Divide

By Stephanie Zaremba, senior manager of government and regulatory affairs, athenahealth, Inc.

Last month, the Centers for Medicare and Medicaid Services (CMS) formalized its decision to extend Meaningful Use Stage 2 through 2016 — a year longer than initially planned. Though the delay was no surprise to stakeholders (it was announced in December 2013), the agency also proposed that providers required to attest to Stage 2 in 2014 continue to receive incentive payments even if their Electronic Health Record (EHR) software fails to meet 2014 certification requirements.

CMS surely thought this policy change necessary to protect care providers running underperforming technology. No one would want to punish providers for the shortcomings of their EHRs. However, the decision is counter-productive; it will punish care providers and vendors who are ready, while giving laggard vendors a pass. If the goal of the Meaningful Use program is to bridge the digital divide in healthcare, the government must not subsidize technology inherently incapable of doing so.

Perhaps a bit of background is in order: the Office of the National Coordinator for Health IT (ONC) runs an “EHR Certification Program” that designates EHRs capable of basic requirements in the digital age such as electronic data capture, sharing, and usage. The Certification Program works in tandem with CMS’ “Meaningful Use” incentive program, which subsidizes doctors who upgrade to certified EHRs and use them “meaningfully” by meeting a series of measures, such as the requirement to electronically capture diagnosis data for more than 80 percent of patient visits. The ONC and CMS programs have progressed in lock-step, so that the first and second generations of the EHR Certification Program (“2011 Edition” and “2014 Edition” respectively) coincided with the first and second generations of the incentive program (“Meaningful Use Stage 1” and “Meaningful Use Stage 2,” or simply MU1 and MU2).

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