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Stage 2

On September 4 2012, CMS published a final rule that specifies the Stage 2 criteria that eligible professionals (EPs), eligible hospitals, and critical access hospitals (CAHs) must meet in order to continue to participate in the Medicare and Medicaid Electronic Health Record (EHR) Incentive Programs. All providers must achieve meaningful use under the Stage 1 criteria before moving to Stage 2.

If you want to learn about Stage 1 meaningful use criteria, please click on the Meaningful Use tab on the left for more information. If you have not participated in the Medicare or Medicaid EHR Incentive Programs previously, please click on the Getting Started tab on the left to learn how you can take part in the program.

Click here to View Your EHR participation Timeline

To help providers better understand Stage 2 Meaningful Use requirements, CMS developed Stage 2 Meaningful Use Specification Sheets for EPs and Eligible Hospitals that provide detailed information on each Stage 2 objective, including:

  • How to calculate the numerator and denominator
  • How to qualify for an exclusion
  • Definitions of important terms
  • Requirements for achieving the objectives

Click here for:

For resources related to EHR certification and standards, please follow these links to resources from the Office of the National Coordinator of Health IT (ONC):
Stage 1 Reference Grid: Stage 1 meaningful use objectives for 2014 Certified EHR Technology and correlated certification criteria and standards
Stage 2 Reference Grid: Stage 2 meaningful use objectives for 2014 Certified EHR Technology and correlated certification criteria and standards

Stage 2 Timeline

The earliest that the Stage 2 criteria will be effective is in fiscal year 2014 for eligible hospitals and CAHs or calendar year 2014 for EPs. The table below illustrates the progression of meaningful use stages from when a Medicare provider begins participation in the program.

1st Year Stage of Meaningful Use

2011

2012

2013

2014

2015

2016

2017

2018

2019

2020

2021

2011

1

1

1

2

2

3

3

TBD

TBD

TBD

TBD

2012

 

1

1

2

2

3

3

TBD

TBD

TBD

TBD

2013

 

 

1

1

2

2

3

3

TBD

TBD

TBD

2014

 

 

 

1

1

2

2

3

3

TBD

TBD

2015

 

 

 

 

1

1

2

2

3

3

TBD

2016

 

 

 

 

 

1

1

2

2

3

3

2017

 

 

 

 

 

 

1

1

2

2

3

Note that providers who were early demonstrators of meaningful use in 2011 will meet three consecutive years of meaningful use under the Stage 1 criteria before advancing to the Stage 2 criteria in 2014. All other providers would meet two years of meaningful use under the Stage 1 criteria before advancing to the Stage 2 criteria in their third year.


In the first year of participation, providers must demonstrate meaningful use for a 90-day EHR reporting period; in subsequent years, providers will demonstrate meaningful use for a full year EHR reporting period (an entire fiscal year for hospitals or an entire calendar year for EPs) except in 2014, which is described below. Providers who participate in the Medicaid EHR Incentive Programs are not required to demonstrate meaningful use in consecutive years as described by the table above, but their progression through the stages of meaningful use would follow the same overall structure of two years meeting the criteria of each stage, with the first year of meaningful use participation consisting of a 90-day EHR reporting period.

For 2014 only, all providers regardless of their stage of meaningful use are only required to demonstrate meaningful use for a 3-month EHR reporting period. For Medicare providers, this 3-month reporting period is fixed to the quarter of either the fiscal (for eligible hospitals and CAHs) or calendar (for EPs) year in order to align with existing CMS quality measurement programs, such as the Physician Quality Reporting System (PQRS) and Hospital Inpatient Quality Reporting (IQR). The 3-month reporting period is not fixed for Medicaid EPs and hospitals that are only eligible to receive Medicaid EHR incentives, where providers do not have the same alignment needs. CMS is permitting this one-time 3-month reporting period in 2014 only so that all providers who must upgrade to 2014 Certified EHR Technology will have adequate time to implement their new Certified EHR systems.

 

Core and Menu Objectives

Stage 2 uses a core and menu structure for objectives that providers must to achieve in order to demonstrate meaningful use. Core objectives are objectives that all providers must meet. There is also a predetermined number of menu objectives that providers must select from a list and meet in order to demonstrate meaningful use.


To demonstrate meaningful use under Stage 2 criteria—

  • EPs must meet 17 core objectives and 3 menu objectives that they select from a total list of 6, or a total of 20 core objectives.
  • Eligible hospitals and CAHs must meet 16 core objectives and 3 menu objectives that they select from a total list of 6, or a total of 19 core objectives.

Download the Stage 2 Overview Tipsheet for a complete list of the Stage 2 core and menu objectives for both EPs and eligible hospitals and CAHs. Providers can also download a table of the Stage 2 core and menu objectives and measures by clicking on the links below:

 

Clinical Quality Measures for 2014 and Beyond

All providers are required to report on CQMs in order to demonstrate meaningful use. Beginning in 2014, all providers regardless of their stage of meaningful use will report on CQMs in the same way.

In addition, all providers must select CQMs from at least 3 of the 6 key health care policy domains recommended by the Department of Health and Human Sevices’ National Quality Strategy:

  • Patient and Family Engagement
  • Patient Safety
  • Care Coordination
  • Population and Public Health
  • Efficient Use of Healthcare Resources
  • Clinical Processes/Effectiveness

A complete list of 2014 CQMs and their associated National Quality Strategy domains will be posted on the Clinical Quality Measures tab in the future. CMS will also post a recommended core set of CQMs for EPs that focus on high-priority clinical conditions.


For more detailed information on 2014 CQMs and electronic reporting options, click to download our 2014 Clinical Quality Measures Tipsheet.