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March 11, 2016

Meaningful Use lives on!

This blog was originally reposted at HLN.com and was republished with permission.

“The reports of my death have been greatly exaggerated.”

- Mark Twain

The controversial report of the demise of CMS EHR Incentive Programs and Meaningful Use (MU) was greatly exaggerated. The confusion began with a statement that CMS Acting Administrator Andy Slavitt made at a health care conference on January 11, 2016. He was discussing the changes coming in the next few years to the Medicare program under MACRA, the Medicare Access & CHIP Reauthorization Act of 2015. Among other things, Mr. Slavitt said, “Now that we effectively have technology into virtually every place care is provided, we are now in the process of ending Meaningful Use and moving to a new regime culminating with the MACRA implementation. The Meaningful Use program as it has existed, will now be effectively over and replaced with something better.”

Norman Sharpless, MD, the director of University of North Carolina Lineberger Comprehensive Cancer Center, reviews digital patient data. Photo courtesy of IBM Communications.

Out of context, these statements in fact seem rather sweeping. However, Mr. Slavitt was speaking only in the context of the Next Generation ACO model (or Next Gen) as it related to the Medicare Program and the steady march from fee-based service reimbursement to pay for performance. It seems clear that as this transition accelerates all related Federal programs – including the EHR Incentive Programs – will have to be adjusted to better fit the new way of doing things. Note, however, that this relates only to the Medicare side of the incentive programs, not the Medicaid side, which ostensibly will also change over time as that program evolves.

So it appears for now that the EHR Incentive Programs will continue to roll out as originally planned, and that Stage 3 of MU will be implemented by 2018 as described in the recent Final Rule. The National Coordinator for Health Information Technology, Dr. Karen DeSalvo, released a statement (co-authored with Mr. Slavitt) clarifying CMS’s and ONC’s position on this issue. In that post they said, “While MACRA provides an opportunity to adjust payment incentives associated with EHR incentives in concert with the principles we outlined here, it does not eliminate it, nor will it instantly eliminate all the tensions of the current system. But we will continue to listen and learn and make improvements based on what happens on the front line.”

But MU still does have its detractors. A group of 31 prominent healthcare organizations sent a letter to HHS Secretary Burwell expressing their concern about the onerous requirements of MU Stage 3. Other organizations, such as the American Academy of Family Physicians (AAFP), have sent cautionary correspondence to HHS as well. Congress as well is considering a variety of health information technology bills, which could have a profound effect on these programs. Only time will tell.

Noam Arzt, PhD

President, HLN Consulting