Meaningful Use - What Do We Do Now?
As Dean Martin once said, ain’t that a kick in the head? After the billions of dollars spent by providers to meet the Centers for Medicare and Medicaid Services’ (CMS) Meaningful Use (MU) Stage 1 and Stage 2 requirements, and the $21 billion already paid to providers in the form of incentives, CMS took less than 140 characters to drop a huge bombshell on the healthcare industry January 11. But was it really a bombshell? Much like the Federal Reserve doesn’t communicate with blunt clarity, perhaps CMS has followed in their footsteps with a series of messages that may have obscured impending plans when considered separately, but which did foreshadow the future when considered in aggregate.
The CMS bombshell came from Andy Slavitt, acting administrator for CMS, who on January 11, 2016, tweeted that the whole Meaningful Use program - a core driver of the Health Information Technology for Economic and Clinical Health (HITECH) Act since its inception - would be going away in favor of something new. “The meaningful use program as it has existed will effectively be over and replaced with something better.” Like a political candidate on the stump in an election year, Slavitt didn’t say specifically what would replace it - just that we would learn more in March.
That is potentially great news for physicians, who almost universally loathe MU. Very little about it encourages use in a meaningful way, and most feel it actually hinders the doctor/patient relationship.
Still, the announcement doesn’t mean that all efforts to implement and improve electronic health records (EHRs) will stop now. The EHR candle has been lit, and we’re never going back to the darkness of paper records. Consider this: the legislative part of Meaningful Use is included in ARRA, and is part of the law. That limits what CMS can do without going back to Congress to change things through legislative action. In addition, there is a requirement that CMS evaluate an eligible professional (EP) who is operating under the Merit-based Incentive Payment System (MIPS), within the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), which was signed into law earlier this year, and as such isn’t negotiable under the law. Providers have to be evaluated on whether they are a meaningful EHR user or not. The wildcard in all of this is the future definition of what “meaningful use” will measure.
By all reports, the government is actually listening to what physicians are saying and are looking for ways to take the work that’s been performed already and use it to enhance patient care. Rather than focusing on whether an arbitrary X or Y technology condition was met, it is believed the new program will instead use data from EHRs to track and help improve outcomes.
Consolidating all the different quality reporting mechanisms into a single, easier-to-use format is expected to be a big part of this effort. With the current emphasis on population health management, shared risk and value-based care, it is likely that revamping workflows to match the way clinicians work and promoting interoperability between EHRs (as well as other technologies) will be high on the list of priorities.
We’re happy about all of this because these are the types of issues Aprima was created to solve, and has been solving for a decade since EHR certifications first began under the entity once known as CCHIT. Unlike many younger companies, Aprima has a long and consistent record of success meeting the government’s ever-changing rules and regulations.
With so much uncertainty about possible changes in direction, and so much provider unhappiness with EHR usability and functionality, it’s a great time to check out the Aprima Rescue Plan™, which is designed not only to solve current EHR issues but also to help physician practices safeguard themselves from the uncertainty of the future.
Regardless of how you decide to proceed into the unknown world of MU, MIPS, and MACRA, it is important that you continue to proceed. While the exact measurement mechanisms may be unknown, the overall goal will not change. The objective is still to provide the highest quality care at the lowest possible cost in a way that leaves patients healthier and feeling more satisfied. At Aprima, we believe that can be achieved SIMULTANEOUSLY with providers being happier, more efficient, and remaining financially independent. Think of the CMS announcement as a detour, rather than a new destination.
How do you feel about the CMS announcement? Do you think it will help or hurt physician practices? Will your current EHR lead you into the future or weigh you down and hold you back?
Michael Nissenbaum, Aprima President and CEO