Dr. Electron

The Centers for Medicare & Medicaid Services (CMS) is trying to get doctors, hospitals and other health care providers that take Medicaid or Medicare to take electronic health record (EHR) efforts up another notch.

CMS has released a proposed rule for Stage 2 of the EHR Record Incentive Program.

The proposed rule is set to appear in the Federal Register March 7.

CMS developed the EHR incentive program to implement a federal law that requires the agency to reward eligible providers for having and making meaningful use of EHR systems.

To qualify for Stage 1 incentive payments, providers had to meet a minimum number of standards given in a list of program standards. To qualify for Stage 2 payments, providers must meet more standards.

One proposed standard, for example, would indicate whether at least 10% of a provider’s patients were making at least some use of EHR summary information. The summary would include a list of the procedures a patient had received from the provider, lab test results, any medications prescribed, vital signs and smoking status.

Incentive program organizers are hoping encouraging providers to make more use of EHR systems will increase the efficiency and improve the quality of the entire U.S. health care system, including the private insurance reimbursement system.

The percentage of U.S. hospitals making some use of EHR systems seems to have increased to 35% in 2011, up from 16% in 2009, when the American Reinvestment and Recovery Act of 2009 (ARRA) created the program, officials say in the preamble to the proposed rule.

Another survey showed that the percentage of physicians making at least some use of EHR systems increased to 34% in 2011, from 17% in 2009, officials say. In the practices of primary care doctors, usage increased to 39%, from 20%.

“While these numbers are encouraging, they are still low relative to the overall population of providers,” officials say. “The majority of EPs still need to purchase certified EHR technology, implement this new technology, and train their staff on its use. The costs for implementation and complying with the criteria of meaningful use could lead to higher operational expenses. However, we believe that the combination of payment incentives and long-term overall gains in efficiency will compensate for the initial expenditures.”

Debra White, a health care lawyer in the Washington office of Manatt, Phelps & Phillips L.L.P., CMS is proposing to give providers more time to make full use of EHR systems. The extended timeline “is important in encouraging those who have been hanging back on the sidelines to stay the course and get involved in the effort,” White says.

CMS officials seem to be working hard to fine-tune the program in response to feedback, White says.