The latest appeal to CMS to delay the meaningful use Stage 2 timeline by one year came from the American Academy of Family Physicians last Friday.
Otherwise, AAFP notes in the Aug. 7 letter to CMS Administrator Marilyn Tavenner, the program is likely to "outstrip the capacity of many certified electronic health record technology vendors and ambulatory family medicine practices."
AAFP Board Chair Glen Stream, MD, wrote in the letter that although the AAFP supports family physicians' adoption of EHRs and the patient-centered medical home model of care, Academy leaders increasingly are concerned about both the regulatory expectations of meaningful use Stage 2 and the timeframe for physician compliance.
"2014 brings a perfect storm of regulatory compliance issues for family physicians that, we fear, may derail health information technology adoption and substantially interfere with our shared progress toward achieving better care for patients, better health for communities and lower costs through improvements to the health care system," said Stream.
Stream highlighted the AAFP's main concern with the implementation deadlines set by CMS and ONC:
"Our members will be unable to obtain the products, implementation services training and support required to meaningfully use 2014 CEHRT in their practices while continuing to provide the high levels of safety, quality and service that their patients deserve,” he wrote.
"Though we do not wish to impede the progress of early adopter physicians poised for MU stage two on Jan. 1, 2014,” Stream added, “We do not wish to see other family physicians who have committed to health care transformation through the thoughtful application of health IT abandon the MU journey due to factors beyond their control.”
The AAFP proposal would create three distinct cohorts of physicians and other eligible professionals, each of which would be affected differently by the modified schedule.
The first group would include physicians who attest to meaningful use in 2014 as their first payment year and who then would follow a specific timeline for meaningful use reporting to receive a bonus payment.
The second group would include physicians attesting to MU in 2014 as their second payment year, and they would follow a separate set of EHR upgrade and reporting period guidelines to receive a 2015 bonus payment.
The third group would include physicians attesting to meaningful use in 2014 as their third or fourth payment year. This group also would have to comply with specific EHR upgrade and reporting period guidelines, and qualifying physicians would receive both their 2014 and 2015 meaningful use bonus payments.
"This modified timeline would allow exemplar practices to implement MU stage two requirements early in 2014," said Stream. As an added benefit, he explained, the experiences of that first group of practices could be leveraged by physicians in the next two groups, as well as by EHR vendors.
"Pressure would be kept on vendors to be ready for MU stage two by Jan. 1, 2014, while distributing the strain of conversion of vendor product and physician workflow over a 21-month period rather than a nine-month period," said Stream.
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