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In 2018, all providers will be required to participate in Stage 3 regardless of their prior participation. Moving all participants to a single stage of meaningful use aims to reduce the program’s complexity and simplify reporting requirements. In 2017, participation in Stage 3 is optional.

To meet Stage 3 Meaningful Use (MU) requirements, Eligible Professionals (EPs) must attest to a single set of objectives and measures. For EPs, there are 8 objectives outlined in the Stage 3 Specification Sheets Adobe Acrobat Reader Symbol. There are no alternate exclusions or specifications available.

To meet Stage 3 requirements, EPs must use technology certified to the 2015 Edition. A provider who has technology certified to a combination of the 2015 Edition and 2014 Edition may potentially attest to the Stage 3 requirements if the mix of certified technologies would not prohibit them from meeting the Stage 3 measures. However, a provider who has technology certified to the 2014 Edition only may not attest to Stage 3.

If the EP practices in more than one site/location that has Certified EHR Technology (CEHRT), the Meaningful Use numerators and denominators need to include the patient records from all CEHRTs and any records maintained on paper or non-certified EHR. For further guidance on calculating numerators and denominators from multiple locations, refer to the Guide for Practicing in Multiple Locations.

There are changes to the measure calculations policy which specify that actions included in the numerator must occur within the EHR reporting period if that period is a full calendar year, or, if it is less than a full calendar year, within the calendar year in which the EHR reporting period occurs. Specific measures affected are identified in the Additional Information section of the specification sheets.

Flexibility within Objectives and Measures
Stage 3 includes flexibility within certain objectives to allow providers to choose the measures most relevant to their patient population or practice. The Stage 3 objectives with flexible measure options include:

  • Coordination of Care through Patient Engagement – Providers must attest to all three measures and must meet the thresholds for at least two measures to meet the objective.
  • Health Information Exchange – Providers must attest to all three measures and must meet the thresholds for at least two measures to meet the objective.
  • Public Health Reporting – Eligible professionals must report on two measures.

EHR Reporting Period
Starting in 2018, all providers are required to use an EHR reporting period of a full calendar year, with the exception of providers attesting to meaningful use for the first time; these providers will have a minimum of any continuous 90-days EHR reporting period.

Note: In 2017, for all new and returning participants, the EHR reporting period is a minimum of any continuous 90 days between January 1 and December 31, 2017.
Note the distinction between MU reporting period (which is based on data from the current calendar year) and the patient volume reporting period (which is based on 90-days of data from the prior calendar year.)

EPs must upload EHR screenshots and other supporting documentation with Protected Health Information redacted (i.e., HIPAA protected information) at the time of attestation in order for the payment request to be processed. In addition, screenshots must be dated from within the Meaningful Use reporting period.


  • EPs that work at multiple practice locations: at least 50 percent of their total patient encounters must take place at a location(s) where certified EHR technology is available. (These EPs would base all MU measures only on those encounters that occurred at locations with CEHRT.) For the purpose of calculating the 50 percent threshold, all encounters (and not just Medicaid and/or Needy Individual encounters) should be considered in this calculation.
  • Measure results do not round up. For example, a numerator of 199 and a denominator of 1,000 is 19%.
  • Measures that require a result greater than a given percentage must be more than that given percentage to pass. For example, in a measure requiring a result of greater than 80%, a result of 80.1% will pass, but a result of 80.0% will not pass.
  • There are two types of percentage-based denominators reported for MU measures. The first is when the denominator equals all patients seen or admitted during the EHR reporting period. In this instance, the denominator is all patients regardless of whether their records are maintained using certified EHR technology. The second is based on actions or subsets of patients seen or admitted during the EHR reporting period. In this instance, the denominator only includes patients, or actions taken on behalf of those patients, whose records are maintained using certified EHR technology.


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