Experts: Meaningful Use Isn’t Dying Anytime Soon
Recently, CMS officials announced that Medicare’s EHR Meaningful Use (MU) program is going away. “In 2016, meaningful use, as it has existed, will now be effectively over and replaced with something better,” CMS Acting Administrator Andy Slavitt wrote in a Twitter post heard around the healthcare industry.
But this seemingly bold pronouncement has practically no near-term implications for how your practice approaches meaningful use attestation and EHR usage, experts tell The Business of Medicine.
While the industry reacted strongly to Slavitt’s Twitter comments, with many physicians cheering the perceived death of meaningful use, CMS posted a clarifying blog article weeks later that appeared to soften Slavitt’s words.
In the blog post, CMS talks about a “transition from the staged meaningful use phase to the new program as it will look under MACRA,” the acronym for the Medicare Access and CHIP Reauthorization Act of 2015, also known as the official Sustainable Growth Rate (SGR) repeal law.
In addition to the removal of SGR, MACRA creates a larger umbrella program called the Merit-Based Incentive Payment System (MIPS), which will encompass not just meaningful use, but also PQRS, Physician Compare, and more.
Initially, Slavitt’s Twitter posts “caused a lot of panic among vendors and providers,” says Stanley Nachimson, a former Senior Technical Advisor for Health IT at CMS who is now CEO of Nachimson Advisors in Reisterstown, Md. “Then CMS really walked that backwards to say they’re not killing meaningful use, they know there’s problems with it and they’re going to try to address them.”
In the meantime, don’t expect Stage 3 of the MU program to simply disappear, Nachimson says. “CMS has already said that stage 3 of the MU program is still going to happen, although it’s possible that changes could be made as part of this new process.”
Look for the agency to release a proposed rule for MIPS at the end of March that will contain changes to the MU program. The proposed rule will offer details on CMS’ approach and will also be an opportunity for people to use the comment period and give feedback, Nachimson says.
Meaningful use will have more meaning
The move by CMS is a response to provider complaints and criticisms of the MU program, which include workflow disruption and compliance risks, says Sean Weiss, partner and chief compliance officer with DoctorsManagement.
Providers who attest to meaningful use and earn an incentive payment can have their attestation audited, and be asked to return large amounts of incentive money, Weiss says. Also, the initial stage 1 rules were so convoluted that successful attestation was difficult, while first-generation EHRs were hard for providers to implement and disrupted their workflow.
Finally, physician coding and documentation has been negatively impacted “because many EHRs are configured to produce much beefier documentation than physicians would create on paper records,” Weiss says. The result is more aggressive code selection and billing, which raises providers’ audit liability.
All of these concerns have given many practices a reason to avoid EHR adoption and/or MU participation for as long as possible, Weiss says.
The good news is, CMS has been spurred into action, and providers can hope for MIPS to advance the program with more provider input.
“So the reports of the death of meaningful use were certainly premature, and we will be living with this program, as it evolves for a number of years,” Nachimson says. “Don’t throw away your EHR because you will still need it.”
— Grant Huang, CPC, CPMA (email@example.com). The author is Director of Content at DoctorsManagement.