From The Editor | December 11, 2013

Stage 2 MU Extended: Now What?

ken congdon

By Ken Congdon

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Many health IT stakeholders have long urged the federal government to adjust the Meaningful Use (MU) program’s timelines. I was one of the voices in favor of a Stage 2 MU extension, and I outlined my argument in the article 4 Reasons To Delay Stage 2 MU. Even with this collective call for change, it was never clear whether or not the federal government would acquiesce. Several high-ranking government officials and industry insiders argued that it was important to stay the course when it comes to MU. For example, former ONC chief Dr. Farzad Mostashari stressed that there should be no hesitation in moving health providers toward Stage 2 MU goals. However, in the end, CMS budged and announced a MU deadline extension on December 6.

CMS is giving providers another year to meet Stage 2 and Stage 3 criteria of the MU program. Stage 2 will be extended through 2016 and Stage 3 won’t begin until fiscal year 2017 for hospitals and calendar year 2017 for physicians and other eligible professionals.

According to CMS, the goal of the extension is two-fold: 1) It will allow CMS and ONC to focus on helping providers meet Stage 2 demands for patient engagement, interoperability, and information exchange; and 2) It gives CMS more time to use the data collected during Stage 2 to inform policy decisions for Stage 3. The proposed rules for Stage 3 are expected to be released in the fall of 2014.


Reaction to CMS’ announcement was swift and largely positive. For example, HIMSS said the following in an issued statement: “The additional time to attest offers an opportunity for increased feedback and analysis on technology implementation, eClinical Quality Measure reporting, and progress toward interoperability that will enhance the ability of eligible hospitals and professionals to meaningfully use health IT, and thus improve the quality and cost-effectiveness of patient care.” While HIMSS views the overall extension of Stage 2 MU through 2016 as a positive move, it also urged the federal government to take it a step further and address its Call To Action to extend the Year 1 Stage 2 attestation period to at least 18 months.       

The AMA also applauded CMS’ decision to push back MU deadlines. In an issued statement, Dr. Steven J. Stack, immediate past chair of the AMA said the following: “The federal government’s decision to extend Stage 2 of the EHR MU program is a welcome reprieve that will provide physicians and vendors with an additional year to adequately prepare for Stage 3 of the MU program. From the beginning, the AMA has urged the federal government to adjust the program’s timelines to ensure a safe, orderly transition so EHRs can be widely adopted and implemented throughout the healthcare system.”

However, like HIMSS, the AMA also stressed that more needed to be done. Specifically, the AMA expresses concern over the program’s current pass/fail approach to demonstrating MU, and advocates for greater flexibility in participation requirements.


The extension granted by CMS was definitely a wise decision, but it really doesn’t do much to solve the problems of many provider organizations struggling with Stage 2 MU today. That would have only been addressed by a delay to the start of Stage 2 in 2014, and those deadlines remain unchanged. In reality, the extension only affects providers who would attest for Stage 2 this year, and that impact won’t be felt until 2016. However, it does give these facilities (with 2014 MU-certified systems already in place) an extra year to perfect systems and workflows in line with Stage 2 requirements. For providers that don’t plan to attest until 2015, the only change the extension provides is it allows more time to prepare for Stage 3. So, while the MU is a sign that CMS and ONC are listening and responding to the concerns of the industry, there is still a challenging road ahead for providers in 2014 and beyond. Hospitals and health systems will need to remain diligent in their MU roadmaps to attest successfully. Health IT Outcomes remains committed to providing you with the best practices, strategies, and success stories to help you do just that.