Meaningful Use: Is it really ending?

Thursday, January 28, 2016

If you’re like me, last week your inbox was flooded with news alerts from various HIT publications proclaiming the end of meaningful use. On January 11th, Acting Administrator for CMS, Andy Slavitt, delivered a speech at the 2016 J.P. Morgan Healthcare Conference in San Francisco highlighting the major themes on the CMS agenda for the year ahead. He shared his vision of a CMS acting with clarity and collaboration to be more effective as a regulator, service provider to beneficiaries and providers alike, and as a market catalyst.

Reality CheckHowever, it seems like the only takeaway that made headlines were those sweet, most anticipated words: MU as it has existed…will now be effectively over…

Ahh, take a moment and soak that in. Feels nice, right? Now, let’s get back to reality.

Yes, those words were said, and perhaps more importantly, tweeted1. However, the headlines eulogizing the death of MU left out an important thing called “context.” This lack of context has fed into the misinterpretation that meaningful use of certified EHR technology (CEHRT) is no longer necessary. Let me assure you that most certainly is not the case.

The actual context of Slavitt’s speech2 stressed CMS’s commitment to working alongside providers, to simplify, advance, and innovate the way in which healthcare is delivered in this country. Regarding MU specifically, Slavitt commented that:

The Meaningful Use program as it has existed, will now be effectively over and replaced with something better. Since late last year we have been working side by side with physician organizations across many communities — including with great advocacy from the AMA — and have listened to the needs and concerns of many. We will be putting out the details on this next stage over the next few months…”

“Something better” is being guided by the following principles:

  • Rewarding providers for outcomes achieved, rather than for technology use
  • User-centric technology that supports providers and their specific needs, rather than distracting them
  • Requiring open APIs to allow for apps, analytic tools, and other connected technologies
  • Interoperability to close referral loops and engage patients in their care

If those guiding principles sound familiar, it’s probably because they are. Not just because Slavitt followed up to his initial tweet with a succession of 5 additional tweets listing them, but also because these are built out of larger themes we’re already familiar with: lower cost, high quality, value-based, interoperability, and MIPS.

And there it is: MIPS. Referring back to Slavitt’s original comments, it’s no surprise that he said the meaningful use program – as it has existed over the last 5 years– is going to be replaced. We actually knew that in early 2015, April 15th to be exact. That was the day the Medicare Access & CHIP Reauthorization Act of 2015 (MACRA) was approved, which carries with it the Merit-Based Incentive Program System (MIPS).

Since then, we’ve known the definition of meaningful use “as it has existed” is positioned to be transformed and redefined: the incentive payments are getting smaller, the payment adjustments are getting larger. The first incarnation of this re-definition is happening soon with MIPS: 2017 performance is determining MIPS scores in 2019 – with a quarter of the points in the MU of CEHRT category. It’s the definition of the phrase “meaningful use” that will be transformed, not the idea itself. It’s not going to happen overnight, but it’s going to happen.

So what of that infamous tweet, supposedly proclaiming the end of MU? This week, Slavitt, along with Dr. Karen DeSalvo, National Coordinator for Health IT and HHS’s Acting Assistant Secretary for Health, co-authored a blog post4, offering answers the question we were all left with: Where do we go from here? They reassured providers that transitioning from the current definition of MU to the vision of the program under MACRA will take time. While we are all encouraged to get familiar with MACRA, MIPS, APMs (a whole slew of new acronyms!), we must not forget that existing regulations and standards are still in effect.

So, where do we go from here? The same place we were going, continuing on the current MU and PQRS paths, knowing we are going to a place where those disparate reporting requirements converge.

Need help preparing for MIPS? Contact PHA to learn more about the GLPTN, a four-year, CMS-funded grant initiative aimed at preparing providers for value-based care.


 

 

1 -Andy Slavitt (@ASlavitt) 01/12/2016

2 http://blog.cms.gov/2016/01/12/comments-of-cms-acting-administrator-andy-slavitt-at-the-j-p-morgan-annual-health-care-conference-jan-11-2016/

3 https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/Value-Based-Programs/MACRA-MIPS-and-APMs/MACRA-MIPS-and-APMs.html

4 http://blog.cms.gov/2016/01/19/ehr-incentive-programs-where-we-go-next/

 

 


Writer: Natalie Stewart, 765-496-1265, nmstewart@purdue.edu

Tags: Quality Services

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