This slide show is an overview of the CMS Meaningful Use Updates Final Rule announced October 6, 2015.

1. Meaningful Use Final Rule Updates
Friday, October 16, 2015
Disclaimer: Nothing that we are sharing is intended as legally binding or prescriptive advice. This presentation is a
synthesis of publically available information and best practices.

2. Meaningful Use Final Rule
March 2015
MU Proposed Rule Changes
October 2015
MU Final Rule Announced

3. Meaningful Use
www.cms.gov
Uses certified electronic health record technology to:
Improve quality, safety, efficiency, and reduce health disparities
Engage patients and family
Improve care coordination and population and public health
Maintain privacy and security of patient information

4. Meaningful Use Eligibility
Doctors of
medicine or
osteopathy
Doctors of dental
surgery or dental
medicine
Doctors of
podiatry
Doctors of
optometry
Chiropractors

5. MU1 vs MU2
MU1
•13 Core
•5/10 Menu
•Total: 18
MU2
•17 Core
•3/6 Menu
•Total: 20

6. Penalties
• Based on 2 years’ prior performance
• 2015 is the first year providers are subject to penalties
• Can reach as high as 5% by 2019
Data Year Penalty Year Penalty Amount
2014 2015 -1%
2015 2016 -2%
Continues at
additional
-1% each year

7. Meaningful Use Timeline
First year as a
Meaningful
EHR user Stage
of MU
Stage of
2015
Meaningful Use
2016 2017
2011 Modified Stage 2 Modified Stage 2 Modified Stage 2 or 3
2012 Modified Stage 2 Modified Stage 2 Modified Stage 2 or 3
2013 Modified Stage 2 Modified Stage 2 Modified Stage 2 or 3
2014 Modified Stage 2* Modified Stage 2 Modified Stage 2 or 3
2015 Modified Stage 2* Modified Stage 2 Modified Stage 2 or 3
2016 N/A Modified Stage 2 Modified Stage 2 or 3
*The modifications to Stage 2 include alternate exclusions and specifications for certain objectives
and measures for providers who were scheduled to demonstrate Stage 1 of meaningful use in 2015.
NOTE: Alternate exclusion reporting continues in 2016 for CPOE (all providers) and eRX (for eligible
hospitals) only.
www.cms.gov

8. MU2 Changes with Modified Rule
= CQMs stay the same
= One year reporting period shortened to
90 days
= Core and Menu framework ends:
• 17 Core Objectives to 9 Core Objectives
• 3 out of 6 menu items reduced to 1 public health
objective (2 options)

9. More Changes …
= Attestation no longer needed for:
• Demographics
• Vital signs
• Smoking status
• Clinical summaries
• Structured lab results
• Patient list
• Patient reminders
• Summary of care (measures 1 and 3, but not 2)
• Electronic notes
• Imaging results
• Family health history

10. What’s Left?
• Protect PHI
• Clinical Decision Support
• CPOE
• Electronic Prescribing
• HIE
• Patient Specific Education
• Medication Reconciliation
• Patient Electronic Access
• Secure Messaging
• Public Health Reporting: pick 2 of 3 measures:
- IMM registry
- syndromic surveillance reporting
- specialized registry

11. Changes in Objectives
Patient Electronic Access
Measure 2 - Instead of 5%, this measure now requires
only 1 patient seen by the EP during the EHR reporting
period to VDT to a 3rd party
EP Secure Electronic Messaging
Instead of 5% threshold, EP only has to note
messaging was fully enabled during the EHR reporting
period (yes/no)

12. MU Stage 1 First Time Attester
Exceptions
• Clinical decision support - only 1 rule
• CPOE - reduced thresholds
• Electronic prescribing - reduced thresholds
• HIE - may claim exclusion
• Patient education - may claim exclusion
• Medication reconciliation - may claim exclusion
• Patient electronic access (VDT) - pay claim exclusion for
measure 2, but not measure 1
• Secure messaging - pay claim exclusion
• Public health reporting - only need to report one measure

13. What’s On the Horizon:
2015-2017
Thresholds 2015 2016 2017 2018
eprescribing 50% 50% 50% 60%
CPOE 60/30/30 60/30/30 60/30/30 60/60/60
Pt. Electronic Access 50% 50% 50% 80%
Pt. Education 10 10 10 35
Secure Messaging Capability to send
and receive
1 patient 5% 25%
Pt. Actively Engages
with EHR
1 patient 1 patient 5% 10%
HIE 10% 10% 10% 60%
Reconciliation 50% of med. 50% of med. 50% of med. 80% of med.,
medication allergy,
& current problem
list

14. What’s On the Horizon:
Stage 3
All EPs must attest for 2018.
EPs may voluntarily elect to attest for Stage 3 in 2017 and only have to report for
90 days.
Summary of Care, Measure 2
40% of transitions or referrals received and patient encounters in which the provider
has never before encountered the patient, the EP must incorporate into the
patient’s record an electronic summary of care document from a source other than
the providers EHR system
For public health reporting, can choose 2:
a) immunization registry reporting b) syndromic surveillance reporting
c) electronic case reporting d) public health registry reporting
e) clinical data registry reporting
Patient Engagement
5% of all unique patients seen by EP must have patient-generated health data or
data from a non-clinical setting incorporated in to the EHR

15. What’s On the Horizon:
MIPS
• April 2015 - Congress passed “doc-fix” bill (MACRA - Medicare Access CHIP
Reauthorization Act of 2015), repealing the SGR and enacting Merit-Based
Incentive Program (MIPS)
• Incentive programs set to expire in CY 2018; MIPS begins in CY 2019, with
performance year of 2017 - CMS laying groundwork for smooth transition
WHAT IS IT?
- Part B Providers scored from 0 - 100
•VBM-measured quality outcomes (30 points)
•VBM-measured resource use (30 points) *VBM cost measures
•MU (25 points)
•Clinical Practice Improvement (15 points) * new category
- COSTS: 2019: +/- 4.0% → 2022: +/-9.0%
- BENEFIT: Simplifies from 3 programs to 1
- 5% lump sum payment to those in alternative payment models (e.g., ACO,
demonstration project)

16. Attest by February 29, 2016
(unless CMA extends it)
CMS encourages providers to apply for hardship exceptions,
which are reviewed case-by-case.
Sun Mon Tue Wed Thu Fri Sat
1 2 3 4 5 6
7 8 9 10 11 12 13
14 15 16 17 18 19 20
21 22 23 24 25 26 27
28
29
FEBRUARY 2016

17. CMS 60-Day Comment Period
CMS has instituted a 60-day comment period to
gather feedback on its "vision for the EHR Incentive
Programs going forward." Feedback will be used to
inform future policy as CMS continues its rule
making to implement the Medicare Access and
CHIP Reauthorization Act (MACRA), expected in
spring 2016.

18. Q&A
David.cooling@quirkhealthcare.com