AMA House of Delegates

Betsy L. Thompson, MD, DrPh, chief medical officer for the Centers for Medicare & Medicaid Services' Region IX office in San Francisco, spoke during an educational session at the AMA Interim Meeting. Photo by Ted Grudzinski / AMA

AMA meeting: Physician input welcomed on meaningful use, CMS official says

■ A CMS regional chief medical officer says past medical association suggestions have improved rules governing bonus pay for EMR use.

By Victoria Stagg Elliott — Posted Nov. 22, 2010

San Diego -- With stage 1 regulations for meaningful use released and discussion begun on stage 2, a federal official speaking at the AMA Interim Meeting called for more feedback to ensure these regulations will be workable for physicians.

"We need to work together and make sure that meaningful use is defined and carried out appropriately," said Betsy L. Thompson, MD, DrPh, chief medical officer for the Centers for Medicare & Medicaid Services' Region IX office in San Francisco. She spoke during an educational session at the meeting. Based on a show of hands when she asked the crowd about EMR use, about half of the participants had an EMR in their offices, and the remainder were considering getting one.

Stage 1 rules are intended to increase adoption of health information technology, stage 2 rules are meant to change the process of care, and stage 3 rules are for improving outcomes. "Right now our emphasis is for practices to adopt and start to use these systems," Dr. Thompson said. "At stage 2, we expect processes of care to change so that we can truly improve outcomes and population health by stage 3."

Achieving meaningful use at the three stages qualifies physicians for financial incentives for using electronic medical records. They were part of the 2009 economic stimulus package. While finalizing meaningful use standards for stage 1, CMS received more than 2,000 comments, including those from the AMA and other medical associations.

"We had to read and respond to each, and the comments improved the rule substantially," Dr. Thompson said.

This led to stage 1 rules being issued with more flexibility for physicians and deferral of some early requirements, but the AMA continues to request improvements.

"These are challenging times. ... It is worth the effort to be able to collect data and collaborate with each other for the betterment of the patient, but we have reasons to be concerned and worried about what the future holds," said AMA Trustee Steven J. Stack, MD.

Stage 2 of meaningful use is scheduled to begin in 2012.

ADDITIONAL INFORMATION

Meeting notes: Legislative actions

Issue: The National Health Services Corps scholarship program encourages primary care physicians to practice in underserved areas, but the program is still underutilized. The Patient Protection and Affordable Care Act will expand it by $1.5 billion during the next five years.

Proposed action: Work to increase physician, medical school and medical student representation in the decision-making process of the program to help make it more popular and more efficient. [Adopted]

Issue: Debt incurred by patients for health care is far less predictable and more complex than most consumer debt, but it can impact financial health significantly. In addition, consumers looking to improve credit scores would be more likely to pay off medical debt first if these amounts were cleared from their records within 30 days rather than the usual seven years.

Proposed action: Support the principles that are stated in the Medical Debt Relief Act, which passed the House on Sept. 29 and has been referred to the Senate. [Adopted]

Issue: The Patient Protection and Affordable Care Act requires companies offering group and individual health insurance with dependent coverage to continue offering this until the child is 26. The law does not apply to those covered by Tricare.

Proposed action: Support legislation providing coverage of military children under Tricare in line with that offered by private health plans. [Adopted]

Issue: The Patient Protection and Affordable Care Act is a flawed piece of legislation that did not sufficiently address medical liability reform, the sustainable growth rate and problems with antitrust rules.

Proposed action: Identify flaws in PPACA and advocate that they be fixed. [Adopted]

Issue: Hospitals declaring bankruptcy that do not pay for "tail coverage" leave physicians personally liable for any claims made after the institution closes.

Proposed action: Seek federal legislation amending the bankruptcy code such that medical liability premiums paid for physician employees will be considered a priority claim and paid immediately out of the proceeds of a bankrupt hospital's estate. [Adopted]