CMS to Overhaul Meaningful Use

From: HFMA News – 1/13/16

In a sharp departure, the Centers for Medicare & Medicaid Services (CMS) is altering the focus of the federal electronic health record (EHR) incentive program.

The program, launched as part of the HITECH Act included in the 2009 stimulus law, was structured to provide bonus payments and then to phase in potential payment cuts based on providers’ “meaningful use” (MU) of EHRs. But the existing MU structure is about to change.

“The meaningful use program, as it has existed, will now be effectively over and replaced with something better,” said Andy Slavitt, acting administrator of CMS, in an address this week during the J.P. Morgan Healthcare Conference in San Francisco.

The announcement represented a big change for an agency that was signaling as recently as the fall that it was staying the course in the MU program.

“It did surprise people—in a good way, but it surprised people,” Kristine Martin Anderson, an executive vice president for Booz Allen Hamilton, said in an interview. “It was an important moment because he acknowledged the industry consternation about the meaningful use program. Many providers have had difficulty complying with Stage 2 and Stage 3 raises the bar.”

Just this week, an agency report revealed 209,000 eligible providers face Medicare payment cuts in 2016 under meaningful use. Slavitt said that since late 2015 CMS has worked with physician organizations, including the American Medical Association, to understand “the needs and concerns of many.”

The MU changes, which will be released over the next few months, will move away from rewarding providers for the use of technology and toward rewarding patient outcomes, Slavitt said.

The changes also aim to allow providers to customize their goals so technology companies can build around individual practice needs.

“Technology must be user-centered and support physicians, not distract them,” Slavitt said.

A third objective of the changes will be to level the technology playing field for start-ups and new entrants.

Slavitt said CMS is “deadly serious about interoperability” and will launch initiatives with physicians and consumers to move technology toward “closing referral loops and engaging a patient in their care.” He warned technology companies engaging in “data blocking” in opposition to new regulations that such a practice won’t be tolerated.

The MU changes come as CMS moves to implement the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), which designated a new Medicare physician reimbursement system, one-quarter of which would be based on MU compliance.

However, the MU changes do not appear solely tied to MACRA—in part because regulations implementing that law are not expected until the summer, according to industry observers.

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