Early adopters of Medicare and Medicaid’s EHR Incentive Programs will need to meet Meaningful Use Stage 2 requirements this year. While similar to Stage 1, this interim step introduces higher reporting thresholds, more comprehensive measures, and utilizes growing EHR capabilities. The key differences are discussed below.  

The basis of MU is comprised of core and menu objectives. In Stage 1, Eligible Professionals were required to meet 18 objectives to qualify for incentive payments. However, for Stage 2, this number rises to 20. The following chart shows a side-by-side comparison as to how core and menu objectives are calculated for each stage.

The objectives remain largely the same in Stage 2. With a strong focus on advancing clinical processes and data sharing, Stage 2 stresses the importance of increasing reporting thresholds. For example, Stage 1 required that EPs record demographics for more than 50% of unique patients. That threshold has been increased to 80% for Stage 2.

It’s important to remember that MU must be demonstrated under Stage 1 objectives for two years before entering Stage 2. Additionally, for 2014 and whether in Stage 1 or 2 currently, all providers will only be required to demonstrate meaningful use for a 3-month EHR reporting period. CMS has extended this one-time provision so that those who have yet to upgrade to 2014 Certified EHR Technology have sufficient time in which to do so.

Besides satisfying the core and menu objectives of Stage 2, new guidelines for reporting clinical quality measures have been introduced. All providers will follow this updated criteria, regardless of current MU Stage.   

For 2014, there are now a total of 64 CQMs. EPs must report on 9 measures, while EHs must report on 16. An additional requirement regarding newly created domains has been added for 2014 as well.

Through a concerted effort between HHS’ National Quality Strategy and the HIT Policy Committee, six key healthcare domains have been established. Each CQM is classified according to one of the following domains:

  1. Patient and Family Engagement

  2. Patient Safety

  3. Care Coordination

  4. Population/Public Health

  5. Efficient Use of Healthcare Resources

  6. Clinical Process/Effectiveness

When selecting quality measures for reporting, EPs and EHs must ensure that those measures span at least 3 of the 6 domains. A complete list of CQMs and their corresponding domains can be reviewed here.

One final note: CMS isn’t requiring providers submit a core set of eCQMs for 2014. Instead, they have recommended two distinct categories of core measures: adult and pediatric. Providers are advised to report from the core set that most closely aligns with their patient population and scope of practice.

Stage 2 is a critical step for MU compliance. While it piggybacks off of Stage 1 objectives, it also serves as a lead-in to the forthcoming Stage 3. You can expect this final MU stage, anticipated in 2017, to mandate even more rigorous guidelines, while seeking improved clinical outcomes.  

We’ve helped many practices get their stimulus funds for Stage 1 and we're ready for Stage 2. If you need additional assistance sorting out the complexities of MU, please contact us for find out how we can create a customized compliance plan that works for every stage.         

Logan Solutions is the health care technology company with a clinician's perspective. We provide clinical documentation expertise to customers using Dragon Medical with eClinicalWorks and other electronic medical record systems. Contact us to learn how our clinical and technological expertise can help your practice with Dragon Medical software and training, HIPAA compliance tools and EMR consulting.