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March 27, 2018

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Meaningful Use as Separate Program to End This Year

March 17, 2016:

The staged meaningful use program will be replaced with something better this year, according to Department of Health and Human Services Acting Director Andy Slavitt. He made the announcement on January 11 at the J.P. Morgan Annual Health Care Conference. He added that the MU program placed too much of a burden on physicians while distracting them from patient care.

Slavitt says the implementation of the Medicare Access and CHIP Reauthorization Act (MACRA) will make a separate incentive payment program based on meaningful use of electronic health records (EHR) unnecessary. MACRA Medicare payments will still consider the use of certified EHR, but other, more patient-focused elements will be heavily weighted.

Karen DeSalvo, the national coordinator of the Office of the National Coordinator for Health Information Technology (ONC), clarified that meaningful use will basically be rolled up into the Merit-based Incentive Payment System (MIPS), which is one of two payment programs MACRA makes it easier for providers to use (the other one is alternative payment models [APMs]). ONC is the federal entity that coordinates national efforts to use the most advanced health information technology and the electronic exchange of health information. DeSalvo says that Medicare incentive payments will refocus on patient outcomes instead of the short-term goal of promoting the use of electronic health records.

Incentive payments under both MIPS and APMs are slated to begin January 1, 2019. Health IT will be crucial in both payment programs to optimize providers’ use of data to ensure optimal patient outcomes.

Slavitt pointed out that financial incentives for physicians to adopt EHR are no longer necessary, since technology has seeped into every site of care. The implementation of MACRA will mean that MIPS and APMs will assume the lead roles in making sure patient outcomes are reflected in payment rates. EHR will be just one tool to be used in this endeavor.

ONC will drastically change and issue new regulations for the meaningful use program this spring.

The new MIPS rule to be released in the next few months will base physician payment on a composite performance score that considers four factors:

  • Quality measures (30 percent)
  • Resource use (30 percent)
  • Clinical practice improvement activities (15 percent)
  • Meaningful use (25 percent)

CMS is still deciding on whether to base the performance score on full achievement of meaningful use or whether there would be levels of achievement.

Hardship Exemption Application Is Now July 1

Although the attestation deadline for the meaningful use of EHR in 2015 was March 11, physicians still have plenty of time to submit applications for hardship exceptions. CMS has stated that it will broadly grant exceptions for applications submitted by July 1, 2016, because it was late publishing stage 2 criteria for meaningful use. This year, it also allows groups of providers to apply for the exceptions.

For those not meeting MU criteria, being granted an exception could mean avoiding as much as a 3 percent cut in Medicare payment in 2017. For those meeting MU requirements, applying for an exemption does not negate their eligibility to receive an MU incentive payment in two years.


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