The

Centers for Medicare and Medicare Services (CMS) and the Office of the National Coordinator for Health Information Technology (ONC) have published the final rules for Stage 2 of meaningful use.

The federal incentive program for Medicare and Medicaid physicians to adopt electronic medical records (EMRs) began in January 2011. Stage 1 focuses on collecting data and starting to use decision-support tools.

To date, more than 120,000 eligible health-care providers have qualified to participate—significantly more than the federal government had hoped to enlist by now. Around $6.6 billion has been paid out in incentives.

Now it’s time for the next step. The big push with Stage 2 is to move beyond data collection to improving care. They contain 20 measures for physicians, of which 17 are core and three of six are menu. Stage 2 rules will become effective for program participants in the program no earlier than 2014.

One of the changes physicians might like is “batch attestation”. Providers who are part of groups will no longer have to attest to participation in the program one-by-one; they can do so together.

The rules also lower thresholds for some measures. In previous proposals for Stage 2, for example, providers had to send a summary-of-care record for more than 65 percent of transitions of care and referrals. Now, it’s 50 percent. The Stage 2 rules can be found in theFederal Register.