Recent comments by the Centers for Medicare & Medicaid Services (CMS) Acting Administrator Andy Slavitt have been broadly reported to signal more changes to meaningful use (MU) or even the phasing out of the MU program.
Regarding the MU program, Slavitt stated: “[W]e 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.”
Slavitt’s comments came during his January 12 presentation at the annual J.P. Morgan Healthcare Conference, where he spoke to healthcare policy and widespread changes in the healthcare delivery system, including the growth of ACOs and other alternative payment models and the bipartisan MACRA law.
Reporting has focused largely on this remark, while leaving out the context.
Under MACRA, a new merit-based improvement program (MIPS) replaces the penalties associated with MU, PQRS and the value-based modifier with a new performance and outcome-based system for calculating payment positive and negative adjustments. Prior to Slavitt’s remarks, it was well understood that MU would in this sense become part of MACRA/MIPS.
To be clear, the MACRA law explicitly requires the meaningful use of certified EHR as a component of its MIPS scoring. While CMS is within its power to make additional changes to MU, nothing short of an act of Congress can remove this statutory requirement.
In his remarks, Slavitt addressed poorly implemented measures divorced from physician workflow and realities, which has been a longstanding criticism by providers and groups such as the AMA. He acknowledged a need to streamline programs and sunset the three programs into one new program as part of implementing MACRA. At the same time, he emphasized that CMS is “deadly serious” about interoperability.
Whether Slavitt’s remarks signal additional MU rulemaking and rebranding, or simply summarize the net effect of the last year’s modified Stage 2 rules and MACRA legislation, it is clear that MACRA will continue to require meaningful use of certified EHR technology.
Impact for NextGen Healthcare clients: In the absence of contradictory legislation and rulemaking, clients must assume that the meaningful use program and all associated incentives, penalties and deadlines remain intact. In any event, CMS will not be making any changes between now and the February 29 deadline for 2015 MU attestations. Clients should focus on successfully attesting for 2015 MU and preparing to successfully achieve MU for a full year in 2016.