Less than three weeks ago, I reported from the American Medical Informatics Association Annual Symposium in Washington that officials from the Office of the National Coordinator for Healthcare Information Technology were publicly saying it was unlikely there would be a delay to Stage 2 of Meaningful Use.
In October, noting that the federal rule-making process can be arduous, former national health IT coordinator Dr. Farzad Mostashari said, “I think folks should assume that the timelines stick.” He was speaking to the College of Healthcare Information Management Executives a week after leaving government service.
Today, we find out that they knew something we didn’t. The Centers for Medicare and Medicaid Services proposed extending Stage 2 to 2016 and delaying the start of Stage 3 to 2017.
Under the revised timeline, Stage 2 will be extended through 2016 and Stage 3 will begin in 2017 for those providers that have completed at least two years in Stage 2. The goal of this change is two-fold: first, to allow CMS and ONC to focus efforts on the successful implementation of the enhanced patient engagement, interoperability and health information exchange requirements in Stage 2; and second, to utilize data from Stage 2 participation to inform policy decisions for Stage 3.
The phased approach to program participation helps providers move from creating information in Stage 1, to exchanging health information in Stage 2, to focusing on improved outcomes in Stage 3. This approach has allowed us to support an aggressive yet smart transition for providers.
The delay to Stage 3 was likely. As I exclusively reported in June, ONC’s deputy national coordinator for programs and policy, Judy Murphy, dropped a strong hint that Stage 3 would not start until 2017, saying, “2016 would be a problem.” By pushing back the start of the third stage, we would automatically get an extension to Stage 2, making it a three-year program instead of two.
The start of Stage 2 already had been pushed back a year from the original plan of 2013. From my reading, what CMS is proposing today is not another delay to the beginning of Stage 2. Hospitals that have begun their attestation periods since Oct. 1 may continue and physicians are allowed to start Jan. 1.
CMS said to expect proposed Stage 3 regulations, as well as proposed ONC EHR certification rules for Stage 3, in the fall of 2014.
What strikes me as odd is that this announcement came late on a Friday afternoon. There is no time stamp on the ONC blog post, but CMS’ Travis Broome tweeted this at 4:05 pm EST:
Late Friday is typically when government agencies take steps they don’t want plastered all over the news. I don’t see anything here that is surprising or controversial, and it could be argued that ONC didn’t mislead people with earlier statements because the start dates for Stage 2 are not changing. Did I miss something?
UPDATE: CMS held a webcast about this that started at 1 p.m. EST. That’s still Friday afternoon, but not so late that it looks like they’re trying to bury the news.