CMS Promises Future Without Meaningful Use Program

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The Centers for Medicare and Medicaid Services (CMS)’s recent announcement of the end of Meaningful Use made headlines in healthcare circles because less than a year ago, the agency’s leadership seemed committed to Stage 3 of Meaningful Use through 2018 and beyond.

Learn the Motivators Behind CMS’s Announcement

What changed? Unrelenting pressure from healthcare industry groups like the Medical Group Management Association (MGMA) and the American Medical Association (AMA) appears to have helped CMS see the light. Last year, reporting the results of a survey of its members, the MGMA labeled Medicare physician quality reporting initiatives as “needlessly complex” and “not improving patient quality.” In an online town hall meeting in July, AMA President Steven Stack, MD, hosted a group of physicians who delineated the ways that EHR technology has reduced healthcare documentation quality. For example, Atlanta orthopedic surgeon Kay Kirkpatrick, MD, said her multiphysician practice turned away from EHR template-based documentation and returned to tried and true dictation and transcription, which produces documentation readily available in the practice’s EHR system. She said this not only improved her practice’s efficiency, but it also produced documentation that was clearly understood and directly related to patient care.

CMS Hears AMA, MGMA Recommendations

In December, the AMA sent a 10-page manifesto to CMS, recommending fixes the program needed before it moved on to Stage 3. Dr. Stack said doctors want to spend their time with patients, “not measuring the number of clicks.”

In a January 19 blog post, CMS Acting Administrator Andy Slavitt and Health and Human Services (HHS) Acting Assistant Secretary Karen DeSalvo, MD, MPH, echoed Stack’s statement, saying that moving away from the Meaningful Use program was a way of “transitioning from measuring clicks to focusing on care.”

Meaningful Use Met Goal, Got Healthcare Wired, CMS Says

In the blog post, Slavitt and DeSalvo referred to the roots of the EHR Incentive Program, which began in 2009 when healthcare organizations were “sparsely wired,” physician offices often lacked the capital to invest in electronic health record technology, and investing in technology seemed daunting. Today, they said, more than 97 percent of hospitals and 75 percent of physician offices are using electronic health records. While the programs helped healthcare organizations make progress, they also “created real concerns about placing too much of a burden on physicians and pulling their time away from caring for patients,” Slavitt and DeSalvo said.

What’s Next for MU Under MACRA

Though a requirement to measure physicians on their meaningful use of certified EHR products is written into the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), Slavitt and DeSalvo said MACRA grants CMS a chance to transition the program towards new regulations that reward providers for patient outcomes. The transition will focus on interoperability of EHR systems, they said, and information-blocking practices by EHR vendors will not be tolerated.

Slavitt and DeSalvo said that CMS’s transition from MU “won’t happen overnight.” In the meantime, existing regulations, including Meaningful Use Stage 3, remain in effect. However, Congress gave CMS authority in December to streamline the process for granting hardship exceptions under Meaningful Use, which allow provider groups to apply rather than requiring each individual doctor to go through the application process. They promised guidance on this new process “soon.”

What Improvements Would You Ask For?

CMS wants provider feedback as it develops the EHR reporting program’s replacement. What would you like to see? Let us know in the comment box below. We love to hear from you!

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Susan taught health information and healthcare documentation at the community college level for more than 20 years. She has a special love for medical language and terminology. She is passionate about ensuring accurate patient healthcare documentation through education. She has a master's degree in healthcare administration, is a certified healthcare documentation specialist, and serves as immediate past president for the Association for Healthcare Documentation Integrity (AHDI).

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