Meaningful Use Penalties Likely Under Stage 2

Stage 1 is tough, but Stage 2 is ‘darn tough’

There are going to be a fair amount of hospitals that will miss achieving meaningful use Stage 2 in 2013, according to experts.

The difficulty between what it takes to achieve Stage 1 and Stage 2 is so great, it could easily catch some providers off guard, says Laura Kreofsky, principal advisor at Naperville, Illinois-based Impact Advisors, who specializes in meaningful use.

"Stage 1 is tough, but not too tough. But, Stages 2 and 3 are darn tough," Kreofsky says.

By making Stage 1 so much easier than Stage 2, in some ways, CMS has set a false sense of security for providers, she says.

Most organizations that are concerned about penalties are those driving toward their first year of meaningful use. However, providers have to be demonstrating well in advance of 2015 to avoid penalties. After the first year of MU, some organizations could receive incentives for the current year but be penalized for a previous year. "There are some weird scenarios here," Kreofsky explains.

Jason Fortin, senior advisor at Impact Advisors travels nationwide with Kreofsky giving lectures on meaningful use. He said they are familiar with the concerns many hospitals and eligible providers have, but even more telling are the results of a survey that shows the majority of hospitals and EPs have deferred a transitions-of-care measure in Stage 1 that will be required in Stage 2.

Fortin and Kreofsky warn that the transitions-of-care measure is going to be the most difficult part of achieving Stage 2.

"Many thresholds will increase significantly in Stage 2," Kreofsky says. The first challenge is going to be for providers who have gotten used to performing at one level to not forget that the percentages will increase for them in Stage 2.

In addition to transitions of care, Kreofsky predicts public reporting and patient engagement will also be the "big gotchas" for Stage 2.

There will also be fewer choices on the menu and a smaller set of measures that can be deferred, Fortin says.

Damon Auer, vice president of healthcare practice at Tribridge, a nationwide IT consulting firm, offers one solution. "Organizations striving to meet MU Stage 2 requirements have a number of new objectives and measures to achieve outside of their own facilities, including clinical quality measures for patient and family engagement, care coordination and population health, Auer says. "Customer relationship management technology - especially when integrated with an electronic personal health record - is ideally suited to help providers coordinate and communicate with remote patients and other caregivers."

"An integrated PHR will meet the transitions of care objectives with patients while the EMR will produce the summary of care documents for the referred provider," Auer says.