The U.S. Department of Health and Human Services (HHS) has come out with the final rule for the second stage of the Medicare and Medicaid electronic health record (EHR) incentive program.
Congress included the EHR incentive program in the American Recovery and Reinvestment Act of 2009 in an effort to reward doctors and hospitals for making "meaningful use" of EHR systems.
The program affects only providers who participate in Medicare and Medicaid, but, because so many providers participate in those programs, health policy experts are hoping the program also will help commercial health insurers, by dramatically increasing the percentage of payer-provider communications that can be handled with automated systems rather than with paper forms and envelopes, traditional mail and data entry and analysis processes that rely heavily on live humans.
Officials also are hoping that providers, insurers and others eventually will use EHR databases to improve efforts to identify and do something about gaps in patients' care.
Budget analysts estimate HHS will spend about $5.1 billion to encourage providers to move beyond manila folders in fiscal year 2014, which will start Oct. 1, 2013.
Stage 1 of the program started in 2011. Stage 1 rewards physicians and hospitals for taking relatively simple steps toward use of EHR systems, such as capturing data electronically and giving patients electronic copies of health information. HHS officials say that about half of eligible hospitals and about 20% of eligible health care professionals are participating in the EHR Stage 1 incentive payment program.
Stage 2 — the next stage to start — is supposed to encourage providers to exchange patient health information with one another and to give patients online access to health information through Web portals. HHS now has posted a preliminary version of the Stage 2 regulations, and the Federal Register expects to publish the final version of the final rule Sept. 4.
Stage 3 will encourage providers to use EHR systems to improve the quality of care.
Providers have until 2017 to start participating in the incentive program.
HHS and the HHS arm responsible for the incentive program, the Centers for Medicare & Medicaid Services (CMS), received about 6,100 comments on a draft of the Stage 2 program regulations that was published March 7, officials say.
The final rule states that no providers will have to follow the Stage 2 requirements before 2014 and that providers will have to encrypt electronic personally identifiable health information.
