The four largest medical associations in the United States—the California Medical Association (CMA), Florida Medical Association, Medical Society of the State of New York and Texas Medical Association—have jointly called on the Centers for Medicare and Medicaid Services (CMS) to address the challenges of the meaningful use program before moving on to stage 3.

CMA and the other medical associations sent a joint letter to CMS expressing their disappointment and frustration with the agency's push to move forward with stage 3, despite glaring problems with the program. Only 12 percent of eligible physicians were able to meet stage 2 despite the fact that nearly 80 percent of physicians in the United States have adopted electronic health records (EHR).

“This demonstrates that there is something wrong with the program, not physicians,” the letter said. “The constantly changing requirements, high costs of EHR implementation and upgrades, inconsistencies on how EHRs report data and lack of interoperability combined with the onerous meaningful use stage 2 requirements have made it extremely difficult for physicians to continue to participate in the EHR incentive program.”

Many physicians have reported expending large amounts of financial and staff resources into implementing EHRs and achieving "meaningful use," but still failing to meet the stage 2 requirements.

CMA and the other associations told CMS that without meaningful changes to the program, the new stage 3 requirements will drive physicians out of Medicare and exacerbate access to care problems. The final rule as currently written will continue to ensure that physicians fail and are penalized by CMS for participating in Medicare.

“Physicians across this country are uniformly frustrated, angry and demoralized by these difficult regulations. Most physicians are working hard to meet the requirements and cannot because of the lack of specialty measures, the all-or-nothing approach, vendor problems, the lack of interoperability or other issues beyond their control," the letter said. "Many physicians have been early adopters of technology and are enthusiastic about using EHR as means to improve workflow, patient care and quality outcomes. However, the EHR incentive program must have feasible and attainable requirements to help physicians achieve these goals rather than act as a burden and hindrance to EHR use by physicians. “

The associations are asking CMS to delay stage 3 meaningful use, implement reforms for stage 2, eliminate the all-or-nothing approach to reporting and give physicians credit for the measures they successfully complete, expand hardship exemptions and focus on interoperability.